Chemo interactions from Appendix 8 Flashcards
Zometa drug/nutrient interaction
Take oral supplement of
500mg calcium
400 IU vitamin D
Vincristine/Oncovin drug/nutrient interaction
Stool softeners/laxative can help prevent constipation
Avoid St John’s Wort/grapefruit
*F5U/Fluororacil drug/nutrient interaction and side effects
For IV bolus: ice chips 15min pre/post infusion to reduce mucositis
Vitamin B6 (50-100mg 2-3x/day) may reduce hand foot syndrome
side effects: mucositis, diarrhea, possible thiamine deficiency, possible cardiac failure
Mercaptopurine drug/nutrient interaction
Avoid dairy around timing of drug
Methotrexate drug/nutrient interaction
Avoid folic acid and derivatives during therapy
Avoid alcohol
Nilotinib/tasigna drug/nutrient interaction
May cause diarrhea due to lactose content
Use lactase if so
Oxaliplatin/eloxatin drug/nutrient interaction
Avoid cold exposure/ food or beverages for up to 5 days after IV
May increase with subsequent cycles
B6 may reduce hand/foot syndrome (50mg 2-3x/d)
monitor Ca and Mg
Melphalan drug/nutrient interaction
Take anti-emetic one hour before oral dose
Small frequent meals
Panitumumab drug/nutrient interaction
Monitor serum Mg
Especially in elderly, and baseline low Mg
Permetrexed/vectobix drug/nutrient interaction
To prevent anemia:
- folic acid po 1 week before, during and post treatment
- vitamin b12 IM injections given every 3 c)ycles starting 1 week prior
Procarbazine drug/nutrient interaction
Avoid high tyramine foods
Beer, red wine, sherry, brewers yeast
Favs beans, raspberries, figs, dried fruit, avocado, bananas
Miso soup, soy sauce, sauerkraut, aged cheeses, anchovies, caviar, livers /meat extracts
Salami, sausage, bologna, pepperoni
Avoid caffeine
Avoid alcohol
Can cause hypertensive crisis or intracranial hemorrhage
Stivarga/regorafenib drug/nutrient interaction
Take with low fat breakfast <=8 grams
Fat may interfere with absorption
Streptozocin/zanosar drug/nutrient interaction
May cause hypoglycemia
Provenge/ sipuleucelT drug/nutrient interaction
Avoid caffeine in day of leukapheresis
Drink more water prior to days treatments and eat high calcium breakfast
Bortezomib/ velcade drug/nutrient interaction
Avoid green tea, especially liquid and capsule forms
Avoid grapefruit
Capecitabine/ xeloda drug/nutrient interaction
Take within 30min of meal with glass of water
Vitamin B6 may prevent hand foot syndrome - 50-100mg 2-3x per day
Monitor if on warfarin
Cetuximab/Erbitux drug/nutrient interaction
Monitor serum Mg and Ca levels
Cisplatin /Platinol drug/nutrient interaction + side effects
Rigorous hydration is needed to prevent nephrotoxicity
Monitor BUN Cr, and serum electrolytes (Mg Ca Na K) -hold if Cr (above 1.3)
SIADH
supplements that may benefit: milk thistle, fish oil + caffeinated green tea, selenium or mannitol (prevent AKI), curcumin
Cyclophosphamide/ cytoxan drug/nutrient interaction
Vigorous hydration (3L per day) Empty bladder every 2-3 hours
Mesna is given to prevent hemorrhagic cystitis (also used with ifosfamide)
Deferasiox/Exjade drug/nutrient interaction
Contains lactose
May need lactase if diarrhea
erlotinib/Tarceva
lung or pancreatic ca
protein targeted therapy
- avoid st johns wort + grapefruit
- may cause skin rash, cardiotoxicity and gastrointestinal complaints (n/v/d/anorexia)
imatinib/gleevec
CML, GIST, MDS, ALL
protein targeted therapy
- avoid st johns wort + grapefruit
- may cause skin rash, cardiotoxicity, and gastrointestinal complaints (n/v/d/anorexia)
cytoxan/cyclophosphamide
SIADH, n/v
monitor vitamin D for deficiency
irinotecan/Camptosar
diarrhea
tacrolimus
immunosuppressant
- n/v, renal toxicity, low Mg and high K
sirolimus
immunosuppressant
- hypertriglyceridemia
cytokine treatments
interleukin-2, interferon - alpha
- flu symptoms, fatigue, anorexia, myelosuppression, n/v/d, renal and cardiotoxicity
