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Help with food restrictions on Nilotinib,trade name Tasigna

Hello

I would be grateful if someone could shed some light on the above drug. My mother has been taken off Gleevec due to resistance and will start taking Nilotinib within the next few days. I understand that you cannot take the pill without fasting for two hours before and one hour after. Will it be ok if the evening pill is taken a few hours either side of the 12 hour limit or should she stick to the 12 hour limit only? Hope that makes sense and thank you in advance for any information you can offer.

Many thanks.

LJ

It's important to try and stick to the 12 hour gap where possible.. If your a bit late or early then it does not matter to much. I used to adjust the times when I went on holiday to work around the breakfast lunch and dinner regime. I hope this helps..

Hey Steven

Many thanks for your reply. I think Mum will take her tablet in the morning around 8am and then only have an hour till breakfast. Evening meal I guess can be around 5pm and then evening tablet again at 8pm and snack before bedtime at 9pm!! I am assuming this can change on the odd day - for example - out for a family meal at 7pm - take the tablet a little later in the morning say 11am, eat at 7pm and take tablet at 11pm. Or do you think it wise to stick to the same 12 hour gap each day every day?

Are you ok to drink in the fasting times, sip water and just stay off food?

Many thanks again for taking the time to reply. I am hoping Mum gets her tablets soon to enable us to read the information sheet but really do appreciate your help.

All the best.

Laura

Some people set their alarm in the morning, wake up take their tablet and then go back to sleep, that way there is less issue in the morning and they can have their meal earlier in the night.

Hi Laura,
your mum can drink plain water during the fasting hours. It is food that causes problems with nilotinib. This is because the amount of drug metabolised is increased if taken with food- especially food with a high fat content. That does not mean that high fat food should not be eaten at other times.

As TKIs work best by keeping its concentration level (in the blood) stable over the course of a day, it is important to keep to the time schedule at far as is possible. An hour or so either side is probably OK, but better outcomes are seen if TKIs are taken regularly so the plasma level does not fall too much.

As you can see from Mo's post on the other thread- timings are best worked out according to an individuals daily routine. I am sure your mum will find one that suits her best, and hopefully will respond well.

Best wishes,
Sandy

Hello LJ,

I've been on Tasigna now for 3.5 years. I find a 10AM/10PM schedule works quite well for me. As for the 12 hours, Sandy's advice is spot on - consistency is better to maintain the plasma level. In fairness, my routine often ends up with about an hour variation i.e. 9.30AM and 10.30 PM ish.

As for the fasting, i try and stick to the 2hours after food and 1hr before food as strictly as possible; however, 20-30 mins after taking my tablets I will happily drink tea (with a half teaspoon of sugar) inside the hour. My advice is to avoid consuming anything with significant calorific value inside the hour after taking the meds - milk or cola would be a bad choice.

I do find that Tasigna can mess with my blood sugar levels and consequently I get ravenously hungry after taking the tablets - a cup of tea does help alleviate this. Once your mum gets into the rhythm it will be quite easy - I work full time and it fits into my day just fine.

I think it's the same on gleevec but stay away from grapefruit or grapefruit juice.

Happy to answer any more Qs you may have.

Chris

What about watermelon ? It's mostly water. Could someone eat this during fasting hours ? 

Nope. It really is just water only. Some people will drink things like a herbal tea, but that is against what the manufacturer say.

“Mostly” water isn’t really good enough. The reason it’s important to stick to this is that another things can potentiate nilotinib - increasing its effects, and you don’t want that to happen.

David.