foods to avoid on xeloda/tykerb

[molpus53]

Hi, this site has been so helpful. I knew so much about these drugs before my onc put me on them. Is there any food/drink that I should absolutely avoid while on these drugs???? how soon for the side effects to start?

[hutchibk]

Hi and welcome! In my experience so far, steer clear of grapefruit products. And I do so much better by eating as healthy and whole and clean as possible. No junk food or fast food... I have really been able to avoid any diarrhea the last 6 weeks with a really disciplined diet. Also, steer clear of milk if you are having diarrhea.

Hope this helps!

[molpus53]

thank you! i am also looking for the brave soldier friction cream that you like...my onc also suggested starting a probiotic supplement, i am going to a health food store to purchase today. another patient ended up with severe diarhea and ended up in the hospital, she has been find ever since starting probiotics......any one else doing this??????

[hutchibk]

Yes - I don't remember who, but someone else has had great luck with probiotics... I eat good organic yogurt everyday, so I think that helps. Good Luck, let us know how you are doing!

[Roz]

Hi Brenda,
I have been 10 days on T/X now and in the past 24 hours I have had the worst of the runs. Manageable, but worse than before. I went off dairy as I thought that might be irritating the bowel (they say don't do dairy with diarrhea). I usually eat good organic yoghurt (I love it!!) but I thought it better not to at present. Any suggestions? Also my face has broken out, but I'm going to try and ignore it.

[hutchibk]

Hi Roz - My first 5-6 weeks were my most active with occasional diarrhea... I lucked out and got it really regulated early on. I tried some very simple things, mostly dietary discipline. On the bad days I took immodium, but I never had to take it more than 1 -2 days in a row. But I opted more for dietary and natural fixes so that I wouldn't rely on immodium. It's not supposed to be good or healthy to start and stop your system the way immodium does, so I only used it for the most severe days and carried it in my purse for emergencies. I agree that yogurt or pro-biotics are probably more applicable to keeping the intestinal tract regular, but might not be a good idea during active bouts... I mostly adheared to the BRAT diet (bananas, rice, applesauce, toast - all day long if necessary until I got it under control) and I also tried Bentonite Clay (1 tablespoon in the morning each day during a bout) which has very good absorptive properties, and it seemed to really help along with the BRAT diet.

If your rash doesn't clear on it's own in a week or so, or worsens, don't continue to ignore, be sure and tell your doc! There are things they can do.
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Brenda's Tykerb/Xeloda hints:


DIARRHEA
For diarrhea, I steer clear of milk and most dairy. I do eat occasional organic yogurt. I eat the BRAT (banana, rice ~I prefer brown rice~, applesauce, toast) in the morning for breakfast. Every morning if I have to. I have found that I have to stay on a very very very strict clean diet. NO JUNK at all. I drink mostly water, juices and tea. NO soft drinks other than Izze or the ones made with carbonation and pure juice. I eat a 50/50 raw and cooked vegetable diet everyday. Salads, fruit, veggies (steamed, raw, sauteed), whole grains (brown rice, quinoa, oats, etc), whole grain pastas and breads (in other words, no bleached white flour products), natural meats sparingly, occasional cheese, lots of beans, cook with olive oil and I steer clear of sugar as much as possible. The cleaner my diet and the more disciplined I am about it, the less diarrhea I have. I am on my 7th round of T/X and I have only one day per cycle, at the most, of diarrhea these days. If I need Immodium at all, it is only one day out of 21... I know diet is a huge factor based on my experience, as I have gotten lazy a time or two (especially when traveling), and fast food has been my intestinal downfall. When I correct to my clean diet, all is well again in a couple of days. If that doesn't help you enough after a week, you can look into Bentonite Clay or Carob Powder to help as an absorptive agent in the bowels...

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RASH
As far as rash, here are some of the fixes that can be tried by your doctor...

*Employ a proactive approach in managing skin reactions.
*Suggest that patients use a thick, alcohol-free emollient cream.
*Suggest that patients use a sunscreen of SPF 25 or higher, preferably
containing zinc oxide or titanium dioxide
* If patient presents with rash, verify appropriate administration of drug and proceed with the following therapy algorithm:

Mild Rash:
Minimally located
No impact on activities of daily life (ADL)
No sign of superinfection

(shows picture of mild rash occurrence across bridge of nose and cheeks)

Continue EGFR targeted treatment @current dose and monitor for change in severity.

***Use:
Topical hydrocortisone 1% or 2.5% cream and/or Clindamycin 1% gel

Reassess after 2 weeks, if reaction worsens or does not improve, proceed to next step.
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Moderate Rash:
Generalized
Mild Symptoms (e.g. pruritus, tenderness)
Minimal impact on ADL
No sign of superinfection

(shows picture of red worsened rash occurrence (pruritus) across nose, around nostrils, top lip, lower cheeks, and entire chin.)

Continue EGFR targeted treatment @current dose and monitor for change in severity. Continue treatment of the skin reaction with the following:

***Use:
Hydrocortisone 2.5% cream or Clindamycin 1% gel
or Pimecrolimus 1% cream
Plus Doxycycline 100mg BID or Monocycline 100mg BID

Reassess after 2 weeks, if reaction worsens or does not improve, proceed to next step.
________________

Severe Rash:
Generalized
Severe symptoms (e.g. pruritus, tenderness)
Significant impact on ADL
Potential sign of superinfection

(shows picture of worsened rash occurrence similar to moderate with more facial coverage and continuation to shoulders and neck)

Reduce EGFR targeted therapy as per label and monitor for change in severity. Continue treatment of skin reaction with the following:

***Use:
Hydrocortisone 2.5% cream or Clindamycin 1% gel
or Pimecrolimus 1% cream
Plus Doxycycline 100mg BID or Monocycline 100mg BID
Plus Medrol dose pack

Reassess after 2 weeks, if reaction worsens, dose interruption or discontinuation may be necessary.

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HAND/FOOT SYNDROME
To stave off hand foot symtoms, be sure to take your B6 (50mg per meal - total 100-150mg a day). If you have problems, we have a bunch of ladies here with cream suggestions that have helped. Personally, I love Brave Soldier Friction Zone. It is miraculous for the feet!!

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MISCELLANEOUS
Don't take any folic acid while on T/X - it can markedly worsen the side effects. You will find it in your multi vits and B complex, so stay away from those supplements while you are on T/X.

And no grapefruit products at all while on this regimine...

[Roz]

Thanks Brenda. That is REALLY helpful. I think that I am reluctant to admit that I'm not "sailing through it", as I have been very lucky re side effects so far. But give over I will, and get straight onto the BRAT diet and use some cortisone cream on my face.
Cheers
Roz

[hutchibk]

Not everyone sails through it... I had my issues along the way, but I tried and tried things until I found what worked... but I am such a believer that eating really really healthy and whole is a HUGE key to abating the diarrhea...