Topic: omeprazole | GRACE

This topic has 4 voices, contains 6 replies, and was last updated by certain spring 89 days ago.

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February 22, 2012 at 9:50 am #6544
tilly15	a question for dr west please advanced adenocarcinoma lung been to the chemo unit today my husband has tarceva to start tomorrow i took all the medications my husband has one of which is omeprazole and asked should he take this whilst he is on tarceva he checked with the pharmacy , they say he can have it two hours after taking tarceva and yet when i read the contraindications for other meds this is one of them i have a deep feeling of mistrust with my husbands treatment so far this isnt helping also he has just been discahrged from hospital after having pnuemonia the consultant who saw him this morning told him something should have been done with the fluid round his heart cardiologist not doing anything says its only 1cm im in despair today with all the conflict that goes on with my husband its noty a nice way to feel when i want to do my best for him ] he also has to have two pints of blood at the chemo unit on friday due to anemia and yet they did his bloods in hospital so why didnt they do it there im not asking for miracles my husband has advanced adenocarcinoma which they say has progressedo after good response from pemetrexed /cisplatin chemo he has plureal effusion in left lung which again they say is minimal all i want to do is to know that my husband is on the right treatment and is having the right care i feel far from reassured of that thankyou dr west for taking the time to read my post
February 22, 2012 at 10:40 am #6546
certain spring	Tilly15, I think Dr West is on holiday with his family, but there are other GRACE doctors who will pick up on your question. However I wanted to point out that both Dr West and Dr Walko addressed the question of Tarceva and omezprazole in detail on your other thread: http://cancergrace.org/lung/topic/adenocarcinoma-stage-1v-and-tarceva/ From reading their posts, I have the clear impression that it is not something you need to be concerned about. It might reassure you to read them again. I do understand why you are worried about your husband’s treatment, and on your other thread I posted a link to Dr Weiss’s “Guide to a second opinion”, which might come in useful. All best to you and your husband. 48-year-old non-smoker, dx stage IV NSCLC May 2010 (squamous tumour of the left lung with multiple brain metastases). Radiotherapy to chest and brain; progressed through two cycles carbo/gemcitabine. Repeated lung collapses; pneumonia in collapsed lung, Nov 2010; bronchial stent placed, Dec 2010. Declined second-line Taxotere. Mutation testing Feb 2011, surprise EGFR exon deletion 19, ALK negative. Started Tarceva (150mg), Feb 2011.
February 22, 2012 at 1:27 pm #6555
Dr. Aggarwal	dear Tilly15, I am sorry to hear about this. It is normal to feel distraught, you and your husband are going through a lot. Omeprazole can decrease absorption of erlotinib, best to switch to another agent like zantac if possible. If not, take the erlotinib about 12 hours before or after omeprazole. Hope this helps! Dr. Charu Aggarwal University of Pennsylvania Dr. Aggarwal University of Pennsylvania Views expressed here represent my opinion, not those of GRACE or University of Pennsylvania. This information does not constitute medical advice and is intended to supplement and not replace medical information provided by your doctor.
February 22, 2012 at 1:36 pm #6557
Dr. Aggarwal	As previously detailed by Drs. Walko and West, there is also data that giving them together does NOT significantly alter the blood levels of the drug. If you are very concerned, you should change to another agent. http://cancergrace.org/lung/topic/adenocarcinoma-stage-1v-and-tarceva/ Hope this helps! Dr. Charu Aggarwal University of Pennsylvania Dr. Aggarwal University of Pennsylvania Views expressed here represent my opinion, not those of GRACE or University of Pennsylvania. This information does not constitute medical advice and is intended to supplement and not replace medical information provided by your doctor.
February 22, 2012 at 9:46 pm #6595
Dr West	I really don’t have anything to add. You had said that you are deeply distrustful, and I don’t think that you should expect that by asking the same questions again you’ll get different answers. If your concerns can’t be allayed from what you’re reading and hearing, it is completely appropriate to get a second opinion. -Dr. West +++++++++++++++++++++++++ Howard (Jack) West, MD Medical Oncologist Views expressed here represent my opinion, not those of GRACE or Swedish Cancer Institute. This information does not constitute medical advice and is intended to supplement and not replace medical information provided by your doctor.
February 23, 2012 at 9:42 pm #6646
tilly15	hello dr west and dr aggarwal and certain spring thankyou for your replies im sorry i seemed to create confusion by asking the same question ive been somewhat distraught its been a difficult week i take the advice given on here to give the omeprazole with some delay after the tarceva I dont want to come across as undermining any treatment my husband has had and i am certainly appreciative of any advice given on here i am so frightened i may lose my husband and its not helped that our oncologists registrar seems to chop and change with information he gives us i will get a second opinion dr west thankyou
February 24, 2012 at 1:17 am #6651
certain spring	Hallo Tilly15 – Please don’t apologise, we all understand how worried you are. It is so bewildering and there are so many things to think about. But in terms of risks to your husband, the pneumonia was a much bigger deal than the possible interraction between Tarceva and omeprazole. So it is great news that he came through it so well. I can’t second-guess how his doctors are thinking, but I wanted to suggest one reason why they want to give him Tarceva. Chemotherapy lowers the body’s resistance to infection (white blood counts). If someone has just had an infection in the lungs (pneumonia), you wouldn’t want to give them more chemotherapy straight away, for fear of inviting another infection. An advantage of Tarceva is that it doesn’t affect white blood counts, so your husband’s immune system will have time to recover. (As will his red blood counts – ie, no more anaemia and no more need for transfusions). I suspect this is how your husband’s doctors are approaching the situation, even though they are not spelling it out to you. I have often found this – only in retrospect do I understand the reasoning behind a decision that was made about my treatment. You must be glad to have him home from hospital and I hope he is doing well. All best. 48-year-old non-smoker, dx stage IV NSCLC May 2010 (squamous tumour of the left lung with multiple brain metastases). Radiotherapy to chest and brain; progressed through two cycles carbo/gemcitabine. Repeated lung collapses; pneumonia in collapsed lung, Nov 2010; bronchial stent placed, Dec 2010. Declined second-line Taxotere. Mutation testing Feb 2011, surprise EGFR exon deletion 19, ALK negative. Started Tarceva (150mg), Feb 2011.