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February 2011 Archives : The Hotline

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Biaxin, also known by its generic name, clarithromycin, is most commonly used as an antibiotic to treat infections of the lung, bronchus, ear, sinus, skin, and throat.  Many of you may know Biaxin in a different context, however: as part of your treatment for myeloma.    It is a component of many regimens, several of which are still in clinical trials (thalidomide + Biaxin + dexamethasone (dex); Biaxin + Revlimid + dex [BiRd]; thalidomide + Biaxin + Revllimid + dex [T-BiRd]; pomalidomide + Biaxin + dex.).

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Biaxin made its debut in the myeloma world in the early '90s, when thalidomide was the only "novel therapy."  Doctors noticed that patients who were receiving Biaxin treatment for an infection (or to prevent infection) while they were being treated with thalidomide and dex responded better to treatment than those who were receiving thalidomide and dex but not Biaxin.  Researchers concluded that the synergy between thalidomide, Biaxin, and dexamethasone was responsible for the improved response rate.  Biaxin made the so-called "thal/dex" regimen more effective.  A recent phase II Mayo Clinic study of Biaxin + Revlimid + low-dose dexamethasone  vsersus Revlimid + low-dose dexamethason alone in patients with newly diagnosed myeloma [Gay et al, Am. J Hematol. 2010 Sep;85(9):664-9] demonstrated that "there is significant additive value when clarithromycin is added to Rd."  A phase III trial is planned to confirm these results. 

In fact, Biaxin interacts with many other drugs, not just those used to treat myeloma.  The National Center for Biotechnology Information (NCBI), part of the National Institutes of Health, has a large compendium of information on drugs.  In their entry for clarithromycin, there is a long list of drugs with which clarithromycin has interactions.  Patients are cautioned to:

molecule.jpgpills.jpgMany other medications may also interact with clarithromycin, so tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

This information about Biaxin is important in its own right, for those of you who are taking it, but should also serve as a warning about drugs in general.  MANY DRUGS CAUSE UNDESIRED OR UNANTICIPATED INTERACTIONS WHEN THEY ARE COMBINED.  

You should make it a practice to have your pharmacist check on drug-drug interactions no matter which medications you're taking, and no matter which days of the week or which times of day you take them. They don't have to be literally taken in combination.  This includes vitamins and supplements, not just prescription drugs.  

There is computer software available to pharmacists so that they can perform due diligence and prevent you from having problems with drug interactions.   Present you pharmacist with a complete list of all medications, vitamins, and supplements that you're taking.  This is part of being a good patient-  just ask blogger Mike Katz, The Good Patient.

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Here is a subject bound to raise a lot of discussion and perhaps some hackles: supplements. It's a big subject, one that is hard to define.  For now, let's just call supplements substances that are taken orally and can be easily purchased over the counter, often in health food stores.  They are often touted as treatments for all sorts of ailments, which is up for debate, but we know some supplements can be helpful to some people.  For myeloma patients, here is some information about supplements that you should know.  For starters, never take a supplement without first talking to your doctor.  Supplements that you might think can only help you, might turn out to hurt you, either directly or by interfering with your myeloma treatment.

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Like any other drugs, supplements can have unexpected effects.  There have been a series of scientific articles published within the last few years that indicate that some common supplements may inhibit the activity of Velcade (bortezomib).  They are alpha lipoic acidVitamin C and green tea.

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While these articles only look at the effect of these substances on Velcade in the lab and not in people, most doctors recommend caution with their use for patients taking Velcade.  Usually, the suggestion is that patients avoid alpha lipoic acid, Vitamin C, and green tea on the day before, the day of, and the day after they receive their Velcade.  Again, make sure you discuss this issue with your doctor before either starting or abandoning these substances while taking Velcade.

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We'll continue to blog occasionally on other supplements that are of particular interest to myeloma patients.

 

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Have you ever had the desire or the need to sit with a world-renowned myeloma specialist to learn about and ask questions about your own or your loved one's disease?  How about four world-renowned myeloma specialists?  We thought so!

 With that in mind, the International Myeloma Foundation created one of our flagship programs back in 1992, and we have been holding them ever since: Patient & Family Seminars.  Seminars are offered throughout the year in the US and in other countries.  The seminars are usually held over a Friday and Saturday and cover a wide range of issues, including: How to be a Better Patient, Management of Side Effects, Understanding Scientific Literature, Myeloma 101, Best Therapies for Elderly Patients, Stem Cell Transplantation, Management of Bone Disease, Clinical trials and New Drugs. 

The knowledge gained will empower you.  The experiences shared with other patients and caregivers will enrich and strengthen you.

Our 2011 Patient & Family Seminars in the US:

Boca Raton, FL - February 25-26 SOLD OUT

San Francisco, CA - March 11-12

Dallas, TX - July 15-16

Philadelphia, PA - August 26-27http://

Click here to register online or register by phone, please call (800) 452-2873.  Don't delay.  Hotel discounts are only valid up to 30 days prior to each seminar.

If you are unable to attend one of these events this year, we have made available a free DVD of our Los Angeles 2010 seminar.  To obtain one, just give us a call at (800) 452-2873.  There are also a number of videos from past seminars that can be viewed online.
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