Our NO had his pharmacist review the cocktail we're doing and had this to say about Chloroquine and Celebrex. I assume others are taking both - has anyone had problems? The drug interaction online says "moderate": http://www.drugs.com/drug-interactions/celebrex-with-chloroquine-560-284-593-0.html
| MEDICATION
DRUGS |
Interaction/Potential
toxicity |
| Celebrex |
No
clinical evidence for cancer prevention in gliomas. Risk outweighs benefit:
increased cardiovascular risk considering patient had recent stroke [annie: this is not accurate - Dad has not had a stroke]. Also
increased risk for gastrointestinal bleeding. Also, drug interaction with
chloroquine in which clearance of celebrex may be affected. Thus, potentially
higher drug levels of celebrex and increased toxicity. |
|
|
|
I think we will asume these risk, is way better than glioblastoma,and i think that benefit outweighs risks. doctors may say many things against cockteil approach.
ReplyDeletebut It is the only way to defeat this disease.
I agree with Melinda. "Risks outweighs benefit" is a statement of opinion, not fact. As far as the presumed pharmacokinetic interaction between chloroquine and celebrex, I haven't seen a single study showing such an interaction. These are predictions based on findings that Celebrex may be an inhibitor of CYP2D6 and chloroquine may be a substrate. But in fact, chloroquine is metabolized by multiple other CYP enzymes, 2D6 is not even the main one. This sort of interaction in humans has yet to be shown to the best of my knowledge.
ReplyDeleteThe GI risks are valid concerns, but it would seem that the biggest risk is the GBM itself.
Celebrex does or does not increase risk of cardiovascular events, depending on which study you read, but even in studies where an association is shown, the risk is still rather small.
"Thus, these analyses
demonstrate no increased risk of serious CV thrombo-
embolic events associated with celecoxib compared with
conventional NSAIDs and therefore do not support the
hypothesis of a class adverse effect of cyclooxgenase 2
specific inhibitors on the CV system"
http://www.ncbi.nlm.nih.gov/pubmed/11835924
"A composite cardiovascular end point of death from cardiovascular causes, myocardial infarction, stroke, or heart failure was reached in 7 of 679 patients in the placebo group (1.0 percent), as compared with 16 of 685 patients receiving 200 mg of celecoxib twice daily (2.3 percent; hazard ratio, 2.3; 95 percent confidence interval, 0.9 to 5.5) and with 23 of 671 patients receiving 400 mg of celecoxib twice daily (3.4 percent; hazard ratio,3.4; 95 percent confidence interval, 1.4 to 7.8). Similar trends were observed for other composite end points"
http://www.nejm.org/doi/full/10.1056/NEJMoa050405
At high-dose celecoxib (400 mg twice daily), death from cardiovascular events increased from 1% in the placebo group to 3.4%. Weigh this against risk of death from GBM... the reason why so many people are comfortable to experiment even against their doctor's wishes.
Thank you both. That was my intuition as well. We will march forward.
ReplyDeleteFrom Aunt Jo (Joan)
ReplyDeleteApplies to: chloroquine, Celebrex (celecoxib) found information on Drugs.co,
Celecoxib may increase the blood levels and effects of chloroquine. If your doctor does prescribe thesemedications together, you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience increased side effects or if your condition changes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
We use both and have had no know adverse effects yet. He's been chloroquine for over a month. I am not sure how to monitor blood levels of chloroquine.
Aunt Jo/DS/Joan
Thanks Stephen and Jo. Were going to give it a try.
ReplyDeleteWe are a little bit concerned with adding Chloroquine alongside the virotherapy but I was thinking Mum could take it only on days she takes the Temodar as it is an autophagy blocker.
ReplyDeleteI asked Stefaan VG about it and he is understandably unsure, "Personally, I am not completely sure of chloroquine in relation to immunotherapy"
Stephen does adding only on the days Mum takes Temodar seem reasonable to you or would it still be more ideal to take Chloroquine continually alongside chemo?
We are hoping to add Celebrex and Minocycline next week (if we can get the prescription)