Herceptin & Benadryl

[Janet/FL]

Hi
I just read Gina's post on Herceptin and she mentioned that Benadryl interferes with Herceptin doing its job. I have never heard of this before. I take Benadryl every night for sleep. And Tylenol for a slight headache after chemo. In fact, I was just taking Tylenol PM everynight since the first infusion. Usually I only take Benadryl.
I would certainly like to know more about this. Since I have only had one dose of Herceptin last Monday and my next is scheduled for tomorrow, any advice and pointing me to any studies on the would be VERY much appreciated!

And Scott, I skipped A/C and went straight to Taxotere/Herceptin and that makes since to me as I am stage 1. Don't know if insurance will pay for any of it or not.

Thanks
Janet

[imported_Joe]

Janet,

I have never heard of Benadryl interfering with Herceptin. In fact Benadryl is commonly given with a patient's initial loading dose in order to ward of flu like symptoms which is common.

I have even heard of oncologists giving Benadryl well into treatment with Herceptin.

You should ask your onc the next time that you see her/him.

Warmest Regards
Joe

[Sandy H.]

I'm with Joe I have never heard this about benadryl and Herceptin. I received benadryl with my herceptin until the last few months. When I said other places were not using any pre meds meaning tylenol and benadryl they said each hospital was different. I was told I could refuse it if I didn't want it. Just recently they have stopped giving it. I would ask the oncologist but I don't think its a problem. The reason I didn't want it, it made me sleepy and I wanted to do errands and was driving myself to treatments. It seems to me if it was a problem they would not be using it. hugs, Sandy

[triciak]

My oncologist has given benedryl and tylenol with every herceptin treatment I have had every other week in the past year, and continues to do so. I could refuse either, and have been told the reason they are given is to make sure there is never any allergy or discomfort because of the herceptin. Benedryl used to make me extremely sleepy but doesn't anymore. I have never heard of there being a problem with the combination except the possibility of sleepiness. Tricia

[Janet/FL]

Hi, Joe, Sandy and Tricia
If you guys haven't heard of a problem, then I doubt if there is one. But I will ask my onc.
Thanks,
Janet

[Lisa]

Janet,

With the Taxol/Herceptin combo, and maybe before with the Navelbine/Herceptin combo, my onc gave me 50 mg. of Benadryl through IV (eventually worked down to 25 mg.) I originally had a bad reaction to Herceptin and this was to prevent another one. Now, however, I'm given no Benadryl since I've been on it so long.

So this is news to me.

Love and light,


Lisa

[*_Tami_*]

I get bendryl and tylenol every 3 weeks with my herceptin. Last one (hopefully) is August 24th!

[StephN]

From the first dose of Herceptin over 3.5 years ago with my chemos for mets, I was NEVER given a Benadryl. Only got that with my Taxotere for 4 rounds before the mets.

When I went off the weekly doses of chemo and Hercpetin and got the loading dose for the 3-weekly I was not even offered anything like Benadryl or Tylenol. This does not seem to be the norm at my cancer center and I know a few other women on long term Herceptin as I am who do not get any pre-meds.
Maybe the pre-meds are part of a trial protocal??

But, I do not think the reason would be that Benadryl would actually interfere with the work of Herceptin. That is a new one on me as well!

[*_Irene from Tampa_*]

Hi Janet

I was on Herceptin for 6 1/2 years and never was told of "anything" interfering with it. I do not even believe that the Taxol would be effected by it. Benadryl is a anti-histamine which you would normally take for allergies. Pass by your doc. but I am sure it is ok.

Hope you are doing well Janet

Irene

[Barbara H.]

If you go back and read Gina's original post, I think she was most concerned with the Benadryl lowering the resistance of those of us fighting breast cancer. Her reply was under a post about Herceptin so that made it confusing. If you see my earlier post and questions to Gina, you will see that I am interested in how it lowers our immune system.
I think we need to wait to have Gina explain it to us.
Thanks,
Barbara H.

[Barbara H.]

If you go back and read Gina's original post, I think she was most concerned with the Benadryl lowering the resistance of those of us fighting breast cancer. Her reply was under a post about Herceptin so that made it confusing. If you see my earlier post and questions to Gina, you will see that I am interested in how it lowers our immune system.
I think we need to wait to have Gina explain it to us.
Thanks,
Barbara H.

[gianara]

I had problems with the Benedryl. It hit me like a ton of bricks and would make my muscles jump. I would squirm in my chair the whole time I was there and be very edgy. The nurses eventually cut the dose in half and it helped at first but my reaction to it kept getting more intense. After the year of 8 weeks on 2 weeks off I went to every 4 week cycles. I begged for the Benedryl to be stopped and now I am fine. I wish they had stopped it for me from the beginning.

That said... I also have never heard of Benedryl interfering, but it isn't always necessary.

[*_Scott_*]

I think some of the confusion with using Benadryl and Herceptin is that your immune system may be triggered to respond to the Herceptin as a non-self and mount an immune response against it. Which is a good thing. So, it makes sense to suppress the immune system with Benadryl until the antibodies can get to where they're going (i.e., find cancer cells). Once the antibodies reach the cancer cells, the body can mount an immune response to the Herceptin and hopefully increase its effectiveness as it flags the cell to be destroyed via ADCC.

The thing is the Herceptin is given in such large quantity that its going to get to where its going regardless if the body mounts an immediate immune response. It also hangs around so long (weeks) that the few hours the immune system is suppressed is insignifcant to whether or not it can work in concert with the Herceptin. So the Benadryl is probably a non-factor, but does reduce symptoms during the infusion and is actually part of the original protocol from Genentech.

Scott

[Lisa]

When I was first on Herceptin and chemo, the Benadryl made me feel "antsy", too. But then it grew to be my friend. I would always get drowsy--in a good way-- and often fall asleep. Now I don't get it by IV, but with my constant sniffles, I do take it OTC. Of course, that COULD be a reason I have constant sniffles. Too much of a good thing.

Love and light,

Lisa

[Janet/FL]

I went in for Herceptin and Taxotere today. Couldn't take the Taxotere as my WBC was too low. Couldn't get a shot of Neulasta as supposedly my Blue Cross won't pay for injections in the doctor's office. Right now I have it ordered for me through Costco and then I will self-inject. Walgreens wants $3,200 for the one shot. Costco $2,800. Blue Cross will pay so I figure going to Costco will save Blue Cross $400.00 --if that is how it works. At least it does not appear that I will have to pay. Because I won't. We still haven't figured who will pay for all the rest of the treatments!

Anyway, back to the question of Benadryl and Herceptin. I asked my Onc if he had heard of a problem with Benadryl and he hadn't. However, he did not premedicate at all this time with the Herceptin. No Tylenol or Benadryl. So far I am not having a problem.
I do remember that my acupuncturist does not like Benadryl at all. He said he would much rather I was on a prescription sleeping pill than taking Benadryl for sleep! I guess it wouldn't hurt to get off of it.
Thanks everyone for your input. Has anyone else had to self inject Neulasta and Procrit for Blue Cross to pay? Having to order it from a pharmacy, where it will take time for them to special order it, really will upset my treatment.

Janet

[sassy]

Janet,

Be sure to check with Blue Cross on that payment for Neulasta. My BLue Cross paid 100% for inject at doctor's office, but would have applied full cost to my prescription side and maxed out my benefit that way. I would have ended up paying.

Just a thought..

Sassy

[Janet/FL]

Hi Sassy

How did you ever get an anwer to your question through Blue Cross? I am afraid that they will give an answer over the phone and it will be the wrong answer and they won't be held accountable. A few years ago I asked if we had a max on our policy and the person on the phone said we didn't. Who knows? I did find someone else on another list that had to self inject and she had Blue Cross.

I may try BC/BS tomorrow, before I pick up the Neulasta.

Thanks for the heads up--though I don't think it will help me sleep better tonight!
Janet

[*_Irene from Tampa_*]

Hi Lisa -

I just took my first injection of Neulastra and also Aranesp for the hemoglobin.

I asked if I could inject at home, but my nurse told me that it is very expensive (I did not realize just how expensive) and she would prefer to give it to me at the hospital where I take my infusion of chemo.

Since you only give it once every 2 weeks instead of the daily like the Neupagen (?)

Has it helped your counts any?

I certainly hopes my insurance pays for it.

We have a 2 million dollar life time max on my insurance and I am afraid to ask what I have left. I am sure I am pretty close by now with all I have had done in the last few years.

Take care Janet -

Irene

[*_Irene from Tampa_*]

Hi Lisa -

I just took my first injection of Neulastra and also Aranesp for the hemoglobin.

I asked if I could inject at home, but my nurse told me that it is very expensive (I did not realize just how expensive) and she would prefer to give it to me at the hospital where I take my infusion of chemo.

Since you only give it once every 2 weeks instead of the daily like the Neupagen (?)

Has it helped your counts any?

I certainly hopes my insurance pays for it.

We have a 2 million dollar life time max on my insurance and I am afraid to ask what I have left. I am sure I am pretty close by now with all I have had done in the last few years.

Take care Janet -

Irene

[sassy]

Janet,

I found out when I went to pick up the shot from the pharmacy nd they told me how much it would be. They suggested tht I check hving it thru the doctor. I go to Wake Forrest Baptist Medical Center and they have check everything on my insurance for me to mke sure it all goes thru. IF you insurance is thru work, have your HR person get on it with your agent if need be.

Good luck, hope it works out.

Sassy

[Susan M(PA)]

Steroid rather than Benadryl? Possibly this is the medication
Gina meant. I also don't know of any problem with Benadryl
and I've taken it for years. Also it does help with the Herceptin
flu like symptoms the first few days.
Of course many troubles with steroid and immune suppression.

Susan

[Janet/FL]

Hi All
After talking to a woman at Blue Cross who seemed very knowledgable, I had the injection in the doctor's office. Seems I could have had it either way. I have a life time max on Master Medical of $1,000,000. and no max on the one doing it at the doctor's office! We figured that my first onc said I couldn't have injections at the office for one of two reasons. One, they didn't ask if it would be covered under the chemo therapy provision, or two, and most likely, Blue Cross wouldn't pay the amount the office wanted and therefore wouldn't give it. The place I am going to now doesn't even charge the max Blue Cross will pay! And the woman at BC/BS said they would cover the Taxotere/Herceptin.
Hope all of this is so. Have other complications now for payments of Muga and MRI. I will be paying over $1,000 out of pocket for this. Won't be going to that facility again!

Hugs
Janet

[Janet/FL]

Benadryl
I talked to my doctor who is an neurologist/neuro surgeon turned alternative medical doctor. He had no problem with Benadryl at all. He does not like Tylenol, however, and said to take Asprin of Advil for pain. He has given me a list of pills, vitamins and such. He would also like me to receive IV glutahione but I doubt if my onc will go along with that. Although the study sited below is for use with a platinum type chemo he feels it will help with Taxotere also.

http://www.annieappleseedproject.org/cisglut.html

Janet