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Living Well with Myeloma 2011 – Drug Interactions and Contra-Indications.
Timothy Tyler, PharmD, FCSHP
Director of Pharmacy Services at Desert Regional Medical Center
Palm Springs, California

An audio recording of this teleconference is available.


Alpha Lipoic Acid is recommended for reducing peripheral neuropathy. If it interfers with Valcade, how can a patient get relief from peripheral neuropathy ? Most of the recommendations are use of amino acids. Acetyl L-Cartinit and L-Glutimin .

Hi, and thanks for the post and good question. Per Dr. Durie's recommendations, patients who are receiving Velcade should avoid alpha lipoic acid (which is especially helpful for the leg cramps associated with peripheral neuropathy) and green tea on the day before, the day of, and the day after Velcade. During the rest of the 28-day cycle, it should be okay to take them.

These supplements, like the B vitamins, are neuro-protective, but we really don't know to what extent they improve nerve damage that has already been done. At the first sign of numbness, pain, and tingling, patients on Velcade should report all symptoms to the healthcare team (nurses first, usually), and discuss changes in the schedule, dose, and method of administration of this drug. The first step is to cut back to a once-weekly schedule before the neuropathy diminishes quality of life. If pain is a problem, then there are prescription medications that can be tried to relieve symptoms.

Here is a link to Dr. Paul Richardson's talk on prevention of drug-induced peripheral neuropathy that he gave at the International Myeloma Workshop this past May: http://myeloma.org/ArticlePage.action?articleId=2539

If you need to discuss this or any other problems, don't hesitate to call us on the Hotline, 800-452-2873.

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