Saturday 2 April 2016

Drug timing

Hi all
Hope everyone is well
I'm trying to work out the best times of when to give dad his cocktail in terms of when drugs peak in the body.
Now they say to have at least a 4 hour fast before taking temodar so what I'm asking is :
Celebrex takes about 2 hours to peak and Viagra takes about 1.2 hours to peak so in order to get these drugs to peak at around the same time of temodar you would be needing to take these whilst on the fasting period, is this aloud ?
Also how long dose it take for temodar to peak ?
And also how long dose other drugs take to peak ?

2 comments:

  1. I took my drugs during the fasting period when I was on Temodar. I took Celebrex and Viagra just as you are rationalizing; when they reach peak plasma concentrations in your blood and how long they stay at their plasma levels.
    As I recall, temodar doesn't stick around for long. It takes something like an hour to peak and only sticks around for 1.5 hours. Please confirm this. The plasma concentrations of any drug can be found by doing a google search - peak plasma concentration. I just did it for Temodar. Peak plasma concentration is achieved in .3 to 2 hours and has a 1/2 life of 1.8 hours. That means that the drug has its concentration cut in 1/2 every 1.8 hours. Half-life is also good to include in the search

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    Replies
    1. I think I may have missed some information along the way as Alan takes celebrex 200mg bid after meals and temodar bid, first up in the morning and 2 hours after night time meal. I didn't realize they should be used so plasma loads peak together, although I did realize the importance of Viagra and temodar peak plasma timing .
      I though celebrex worked more as an adjunct then being synergistic as such and celebrex was taken mainly for the cox2 inhibition. I found an old clinical trial and although the celebrex amounts were much larger then what we’re discussing it was interesting that peak plasma times wern’t considered, in fact celebrex was administered after meals. The study was looking at PFS and OS as well as methyltransferase promoter methylation status and serum levels of angiogenic peptides.

      Treatment Regimen
      Patients were treated with temozolomide given initially at 150 mg/m2/day for 5 consecutive days for the first 28 days. Barring significant toxicities, the dose of temozolomide in subsequent cycles was increased to 200 mg/m2/day for 5 days every 28 days. Thalidomide and celecoxib were given daily, continuously throughout the cycle. Thalidomide was begun at a dose of 200 mg orally at bedtime and escalated by 50 mg every 1–2 weeks as tolerated to a maximum of 1,200 mg daily. Celecoxib was begun at a dose of 200 mg twice daily after meals and increased to 400 mg twice daily if tolerated within 4 days. Therapy was continued until evidence of progression or unacceptable toxicity.

      Trial link

      https://www.researchgate.net/profile/Lisa_Doherty/publication/5450223_Phase_II_study_of_temozolomide_thalidomide_and_celecoxib_for_newly_diagnosed_glioblastoma_in_adults/links/00b7d521df93de7c5a000000.pdf

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