CSO Exam -- Appendix 8 -- Drug, Nutrient, Food, and Dietary
Supplement Interactions with Cancer Meds
Axitinib/Inlyta
Take 2x/day -- 12 hours apart - ANSWER Grapefruit juice + Ketoconazole + Erythromycin may
increase drug activity (CYP34A inducers)
St. John's Wort + Phenobarbitoal may decrease drug activity (CYP3A4 Inhibitors)
Baxarotene/Targretin
Take 1x/day w/ food - ANSWER Grapefruit juice = may increase [ ] + toxicities
Limit Vit A to <1500 IU/day as possible toxicities
Bortezomin/Velcade
IV or SC - ANSWER NO Green tea, especially if liquid/capsule form
CYP3A4 inhibitors/inducers may affect
Busulfan/Myleron
Take on empty stomach - ANSWER NO aspirin OTC
Capecitabine/Xeloda
w/in 30 min of po + glass water - ANSWER monitor if taking warfarin/clotting
, vit B6 (50 mg-100 mg BID-TID) to prevent/reduce hand-foot syndrome severity
Cetuximab/Erbitux
IV - ANSWER Monitor: serum Mg, serum Ca ----> those at risk: elderly, hypomagnesemia @
baseline, prior tx w/ oxaliplatin
Chlorambucil/Leukeran
Empty stomach (1 hr prior or 2 hr s/p meal times) - ANSWER Inc risk toxicity if barbiturates have
been taken (ex: phenobarbital)
Cisplatin/Platinol
IV - ANSWER Rigours hydration to prevent nephrotoxicity ---> monitor BUN, Cr, mg, ca, na, k -->
at risk: elderly, hypomag @ baseline, impaired renal fxn @ baseline
Cyclophosphamide/Cytoxan
IV or PO
take early in day w/ vigourous hydration - ANSWER Vigorous hydration -- at least 3L/day with
frequent empty of bladder q2-3 hours
Mesna given w/ high dose to prevent hemorrhagic cystitis
Increases the effect of anticoagulants
Dasatinib/Sprycel
can take w/ or w/o food - ANSWER *Do not crush or cut drug*
Supplement Interactions with Cancer Meds
Axitinib/Inlyta
Take 2x/day -- 12 hours apart - ANSWER Grapefruit juice + Ketoconazole + Erythromycin may
increase drug activity (CYP34A inducers)
St. John's Wort + Phenobarbitoal may decrease drug activity (CYP3A4 Inhibitors)
Baxarotene/Targretin
Take 1x/day w/ food - ANSWER Grapefruit juice = may increase [ ] + toxicities
Limit Vit A to <1500 IU/day as possible toxicities
Bortezomin/Velcade
IV or SC - ANSWER NO Green tea, especially if liquid/capsule form
CYP3A4 inhibitors/inducers may affect
Busulfan/Myleron
Take on empty stomach - ANSWER NO aspirin OTC
Capecitabine/Xeloda
w/in 30 min of po + glass water - ANSWER monitor if taking warfarin/clotting
, vit B6 (50 mg-100 mg BID-TID) to prevent/reduce hand-foot syndrome severity
Cetuximab/Erbitux
IV - ANSWER Monitor: serum Mg, serum Ca ----> those at risk: elderly, hypomagnesemia @
baseline, prior tx w/ oxaliplatin
Chlorambucil/Leukeran
Empty stomach (1 hr prior or 2 hr s/p meal times) - ANSWER Inc risk toxicity if barbiturates have
been taken (ex: phenobarbital)
Cisplatin/Platinol
IV - ANSWER Rigours hydration to prevent nephrotoxicity ---> monitor BUN, Cr, mg, ca, na, k -->
at risk: elderly, hypomag @ baseline, impaired renal fxn @ baseline
Cyclophosphamide/Cytoxan
IV or PO
take early in day w/ vigourous hydration - ANSWER Vigorous hydration -- at least 3L/day with
frequent empty of bladder q2-3 hours
Mesna given w/ high dose to prevent hemorrhagic cystitis
Increases the effect of anticoagulants
Dasatinib/Sprycel
can take w/ or w/o food - ANSWER *Do not crush or cut drug*
