Hi Trevor.......... Your doctor should understand that if he is not experienced in treating CML then he should recommend you to another more CML experienced doctor.
It is essential that you do not take Tasigna/nilotinib with food... your must fast for 2 hours before and 1 hour after each dose. This is entirely opposite to taking Glivec/imatinib.
The reason is that combining it with food might mean that you will have too high a level of the drug in your plasma, which would lead to unacceptable side effects. This is obviously not something that you want.
Your doctor can request information and patient education booklets from Novartis.
I would advise you to talk to your doctor before you take any more of the drug... and change your regime.
I have been on the Tasigna website and it might be an idea if you take a look at it.... also ask your doctor to take a look at it too.
I have copied a few pointers about how it should be taken...see below.
I hope you feel better soon and manage to find some support, here on this forum, for the worries and fears you are experiencing. I am glad you have found this resource. At least you can inform yourself and begin to understand something about your disease and the life saving therapies that are available. I am sure that those members who are taking nilotinib will be able to help and advise you.
How should Tasigna be taken?
Tasigna should always be taken exactly as instructed by the physician. Patients should check with their doctor or pharmacist if they have any questions.
Tasigna should NOT be taken with food.
No food should be consumed for at least 2 hours before the dose is taken and no food should be consumed for at least one hour after the dose is taken
The capsules should be swallowed whole with water. Patients should not open the capsules. Tasigna should be taken twice a day, with each dose taken approximately 12 hours apart. Patients should not drink grapefruit juice, eat grapefruit, or take supplements containing grapefruit extract. These may affect the levels of Tasigna in the blood.
Before taking Tasigna patients should tell their healthcare provider if they: have a heart disorder; are taking medication for the heart; know that they suffer from low levels of electrolytes, such as potassium or magnesium; have a liver disorder; or have pancreatitis.
Can Tasigna be taken with other medicines?
Patients should tell their doctor or pharmacist before taking Tasigna if they are taking or have recently taken any other medicines, including over-the-counter medicines or herbal products. Tasigna and certain other medicines can interact with each other. Tasigna, as well as other drugs, are metabolized by enzymes in the liver. These enzymes may not work on several drugs at the same time. This can result in higher or lower than expected levels of Tasigna or other drugs in the bloodstream. Some medications should be avoided during your treatment with Tasigna including certain nonprescription medications and herbal products.
Examples of these drugs include, but are not limited to, the following list:
* quinidine, amiodarone – antiarrhythmics – used to treat irregular heart beat
* verapamil, diltiazem – used to treat high blood pressure
* ketoconazole, itraconazole, voriconazole, clarithromycin, telithromycin, erythromycin - used to treat infections
* cyclosporine, tacrolimus – used as immunosuppressants
* ritonavir - an anti-HIV medicine from the class “antiproteases”
* carbamazepine, phenobarbital, phenytoin - used to treat seizure disorder (e.g. epilepsy)
* rifampin - used to treat a type of infection called tuberculosis
* St. John’s Wort - a herbal product used to treat depression and other conditions (also known as Hypericum Perforatum)
* midazolam - used to relieve anxiety before surgery, which is usually administered by an anesthesiologist
* warfarin - used to treat blood coagulation disorders (such as blood clots or thromboses)
* phenytoin - used to treat seizure
If patients are taking any of these, their doctor might prescribe other alternative medicines. Patients should also tell their doctor if they are already taking Tasigna and are prescribed a new medicine or wish to take an over-the-counter medicine or herbal product they have not taken previously during Tasigna treatment.