FW: Tylenol and Sprycel

[Guest guest]

Hi all:

Since there has been much discussion recently on whether one can take Tylenol

while on Sprycel, here is the answer I got from what we consider to be a very

good source! Since is a patient of Dr. Druker's, I was able to write to Dr.

Druker's nurse and get the answer in regards to Sprycel and Tylenol. I would

trust their opinion very much! Below is the response...

>

> ,

>

> Headaches are a known side effect of Sprycel, especially at first. They

> tend to subside after a couple of weeks.

> But, people get headaches for all sorts of reasons.

>

> Tylenol (acetaminophen) is metabolized through the liver and is a

> substrate and a weak inhibitor of CYP3A4. Sprycel is also a CYP3A4

> substrate and inhibitor. There is no mention of acetaminophen in the

> prescribing information for Sprycel.

>

> The maximum dose of acetaminophen is 4 Grams a day (4000 mg); this is

> for people without other risk factors. The incidence of elevated liver

> enzymes on Sprycel is very low, but still for our patients who are on

> drugs with a similar metabolic pathways, in general I recommend not

> exceeding 2 Grams a day. A big problem with acetaminophen is that it

> is an ingredient of many drugs and people overdose without knowing it.

> It is often in cold and pain medicines. It is also known that alcohol

> intake increases the toxicity of Tylenol.

>

> To put it another way, occasional use of Tylenol (acetaminophen) in

> doses not to exceed 2 Grams a day should not be a problem with Sprycel

> IF liver enzymes are OK. If someone has elevated liver enzymes I

> recommend NOT taking Tylenol at all, at least not without careful

> consultation with ones pharmacist and physician.

>

> As you can see, there are multiple factors to consider, so patients on

> Sprycel who want to take Tylenol need to check with their health care

> providers and discuss their individual risk factors and appropriate safe

> dosing.

>

> Carolyn

>

> Carolyn Blasdel, FNP, ARNP, OCN

> Center for Hematologic Malignancies

> Oregon Health & Science University

> 3181 SW Sam Park Rd., UHN-73C

> Portland, Oregon 97239-3098

> Phone: 503-494-1036

> Fax: 503-494-3623

> Email: blasdelc@...

>

>

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>

> >>> " Cervera " <weez_555@...> 1/6/2008 12:00 PM >>>

>

> Hi Carolyn:

> There is an ongoing debate between many CML patients we know regarding

> whether or not while on Sprycel you can take Tylenol. has

> occasional headaches (maybe once a month), who knows whether they are

> related to Sprycel or not. But, the forums we are a part of have tons of

> debates as to drug interactions between Tylenol and Sprycel... " yes, it

> is fine to take. " ... " no, you should not take it. " Made sense on Gleevec

> just since Gleevec was hard on your liver to begin with.

>

> Not urgent, just thought I would go " straight to the source " .

>

> Thanks for your time,

> Cervera

>

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