Lemongrove you may wish to ask the pharmacy why they don’t add it to the pharmacy label…as they do in S Wales…many people take simple antacids but if they contain aluminium or magnesium the same applies.
Lemongrove - Letrozole is an aromatase inhibitor. I don’t think it is a PPI as well, is it?
I suppose it is necessary to avoid taking calcium and capecitabine at the same time. I do, but have never been told this.
Ann
thanks Herbgarden, I think the reason that the pharmacy did not put it on the label is because they were unaware I am taking Capecitabine. The Onc gives me a prescription for meds, like PPI’s and Co-codamol, but I collect my two weeks supply of Cap from the chemo unit (when I go to have my Herceptin and Zometa). But I’m now thinking the chemo unit should ensure that patients are advised not to take PPI’s/indigestion drugs together, and when I go on Thursday, I will mention it.
Lemongrove - that’s the first I heard about taking PPIs 2 hours before that Cap tablets. I’ve been taking Lansoprazole about 1 - 1.5 hours before the chemo pills. Will check that with my unit on Friday when I have my next appt.
I also picked up via bcpals that I should avoid fruit juice at same time as Cap pills. Checked it out with my SBCN and they agreed, so also concerned that I could have had better results as didn’t find this out until on cycle 6. I specifically asked about it at first chemo appt and was told it was OK to have fruit juice with my breakfast, so annoyed I was given incorrect advice.
Anne, sorry I meant to say Lansoprazole not Letrozole (brains not working).
Hi lemon grove , Ann and Gail , what are all these other drugs everyone takes. I haven’t been told to take anything an hour before. All I take is high blood pressure tablets and i take sick tablets if I need them.
Everyone else seems to mention other drugs?
Gail , did you go back to work ?
Louise
Just thought I would remind people that if you take any Proton Pump Inhibitors (such as Omprazole or Lansoprazole), or indigestion tablets, that these should be taken at least two hours before, or two hours after Capecitabine, as it can interfere with absorbtion. Anne 04 kindly brought this to my attention, and the manufacturers website mentions it. I also asked the pharmacy at Charing Cross Hospital yesterday, because I have been taking it only an hour before Cap (sometimes only half an hour), and am worried I may have stopped it working. To my horror, they said I should definitley take it two hours before or after Cap, and that I should report what has happened to my Onc, as it may have a bearing on how they interpret subsequent scans (in other words if the Cap hasn’t worked that might help explain it). Grrr … could kick myself.
pinkylou - I have just been prescribed Omprazole for acid reflux but I also take calcium/D3 for bone strength. I have been adding magnesium, to aid the absorption of calcium but, thankfully, I have them at lunchtime, so well away from Xeloda.
The Xeloda leaflet doesn’t mention this interaction, unless I have missed it. If it is that important, surely it should say.
Ann
Oh joy - it seems even the pharmacists can’t agree! I don’t particularly trust the oncs, GPs et al on the drugs front, but I have always put faith in the pharmacists. On reading Ann’s posts on Omeprazole and bone pills, and given I take calcium and Cap too, I thought I’d ask this morning when I collected my drugs. Scary aside - I walk into pharmacy - assistant smiles says hello and goes off to get my prescription without asking who I am - in there too often me thinks!!
The pharmacist checked twice, once on some kind of internet site then in her book, and said no reactions between Cap and Omprazole. She did recommend taking Omeprazole before food, and Cap definitely after, but that was it. I told her my routine - bone pill (ibandronic acid on wakening, 30 mins later all my other pills (anti depressants, beta blocker, Blood pressure, thyroxene, statin, aspirin, omeprozaloe, B6) then eat, then Cap. Exception being I take my calcium before bed on its own. She said this was exactly right!
I’m going to carry on as I am after that - I’ve had misleading advice from onc on anti depressant and tamoxifen when I was on that, which I got checked out with psychiatric pharmacist and onc was wrong, and I remember a GP telling me once the best person to ask was pharmacist as they know all the interactions.
Nina
Louise - I take lansoprazole for acid reflux. It’s classed as a proton pump inhibitor, so as Lemongrove says may be an issue with timing of pills.
Nina - that’s a lot of drugs you are on. You must be rattling.
Ann - I couldn’t find anything on this in my Xeloda leaflet either.
Am getting confused about whether PPI’s clash with Cap or not now. Have just visited the Roche site (who make Cap), and when I clicked on drug interactions, was transferred to the Europea Medicines Agency. medicines.org.uk/guides/xeloda/breast%20cancers#medicines
All the EMA say is that indigestion remedies can interact with Cap and should be avoided (are PPI’s indigestion remedies?) However, another site said there is no information on their data-base that PPI’s interfere with Cap. But the pharmacy at Charing X hospital said I should defiinitely take it two hours before or after - don’t know what to believe now.
PS Anne, take a look at the EMA link because it say’s that magnesium is a definite no-no.
Lemongrove - Well, that’s od since it says that Xeloda contains magnesium stearate!
Whilst is says that antacids containing magnesium may interact, it doesn’t really say if taking them at a different time would be ok, does it?
Anne, nope, it doesn’t. Very unclear isn’t it?. Have tried contacting Roche for clarification, but they will only speak to a medical professionals (doctor, pharmacist, specialist nurse). Why do the European Medicines Agency say that antacids and magnesium indegestion remedies are contra-indicated if you’re taking Xeloda, and do PPI’s count as an antacid?
Off omeprazole topic for a minute!
I had an aching eye! Even when shut and not in use as it were, it ached. Naturally I paniced - eye mets!! Saw optician last week and explained my drugs and fears - I knew Cap increased tear production, but hadn’t thought this would cause aching eye.
After some nice yellow dye, the optician told me usually tears remain in the ye for 7 - 8 seconds. Mine were only hanging around 3 seconds, so altho there was more tear production my eyes were dry - hence the ache. So to go with all my pills, I now have artificail tears to drop in 3 or 4 times a day. Life’s never boring with cancer is it?!
Nina
Hi Nina, I had the same problem but find it almost impossible to give myself eyedros. I had an operation to my eyes when I was very young and had stitches in my eyes and was awake when I got the stitches out. Had drops all the time as had exercises to do with a special machine where you had to fit a lion into a cage and a soldier into a sentry box ( to improve eye muscles. To this day I cannot give myself drops and I am quite a brave lady in other ways as NOTHING phases me any more! Good luck with the eyedrps. I still get the dry eye problem. I have heard that there is aproduct that you can now spray on the outside of your eye lid and was going to ask my optician about it the next time I visit him. Wishing you all the best. LOve V
Nina - I’m glad your eye problem was nothing serious. I had really dry eyes on FEC-T and got eye drops from the chemo unit. I think they’re called hypermellose or something similar.
Louise - I realised after last post I forgot to answer your question about returning to work. I’m still off just now but have to use up about 30 days holidays or will lose them, so will at least get full pay for them. I’m thinking of waiting until the worst of the winter is past and see how I am then.
Thanks Val - good to know I’m not alone in kinky eyes!! I spoke to the chemo nurse yesterday re the eye problem and asked if the spray was as good as drops, cos I end up dropping drops all over me before they hit my eye!! He said yes, and I bought one yesterday. Not sure I’d recommend it tho - it’s just as difficult to aim right!! it’s sposed to be 10cm away from eye, but you have to get the nozzle pointing at the eye and I gave up after spraying my cheeks brows etc and got my long suffering OH to apply it!!
Has interesting discussion about B6 too. Said I was taking it and that was fine, he went on to say lots of evidence it’s effective but not enuf ‘clinical’ evidence to mean all doctors were willing to prescribe!! One suspects cost!!
He also said if handling cap was a problem he’d have no hands left! I’m inclined to believe him - he ‘loves’ Cap, thinks its a great drug, and he’s studied it extensively, even presenting a talk at a European conference on it!! So my OH has decided he’s going to be a test case and get my pills out of the strips for me and see if he has any bad effects!! It must be love!
Nina
Nina - if you’re supposed to close your eyes to spray the eyedrops then it must be difficult to judge if you’re 10cm away. No wonder you can’t aim it properly.
I’m getting my first chemo ‘break’ after cycle 6 to let hands and feet recover. So will hopefully get supply for cycle 7 in a week instead of today. Luckily have onc appt next Friday too so will be at hospital anyway and she can check them before I have chemo. I don’t have any blisters or peeling yet at least, but was starting to have problems doing fiddly things (like cleaning contact lenses) and they are a bit more painful now.
Look on to the thread called “Capecitabine and Omeprazol” as there is a post from Mrsblue regarding LLyods the Chemist and something you can buy to help pop the pills out of the packs. if you cannot find it either PM me or post on here. Anything that heps make llife easier is worth a try. Mrsblue also asks a question about VAT when buyng good there and DLA if anyone has an answer to that question it woud be helpful. I didn’t know myself. val
Have replied there re VAT - basically no formal process just complete a declaration at time of purchase you are isabled - secondary bc counts as such - and it will help you live your life and it’s no questions asked. Helps a lot and should be publicised more.
Nina