What Foods Interact with Tamoxifen?

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Jo_Ann_K
Jo_Ann_K Member Posts: 277
edited June 2017 in Hormonal Therapy - Before, During, and After

Hi!

The first time I knew that grapefruit is contraindicated when taking Tamoxifen was on here. I haven't seen it anywhere in the literature and when I called Poison Control, they confirmed it. I asked whatever foods interacts but they didn't have time to tell me, and I can't find that information online.

Please..please, if anyone has access to this information, can you post here?

Thanks,

Jo Ann

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited February 2009

    grapefruit and grapefruit juice are the only two things I was told that weren't allowed--they decrease the efficacy of the tamoxifen (I just finished my 5 years up about 3 months ago),

    anne

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  • Northstar
    Northstar Member Posts: 89
    edited February 2009

    I'll be starting tamoxifen as soon as it arrives from the mail-order pharmacy, and I'd like to know, too.  Even my onc said that MDs don't have a lot of knowledge about what foods interact with it.  I'm thinking of resveratrol, among others, which is found in grape skins, juice, red wine, and now people are even taking it in supplements for anti-aging effects. I think flaxseed oil may be a no-no, but wonder if anybody has heard that? 

    Has anybody seen a list out there in internet land??  Northstar 

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  • priz47
    priz47 Member Posts: 470
    edited February 2009

    I am not sure abt exact foods. My onc told me that red wine could make my hot flashes worse, so I might want to be careful. It would benice to know what does interact. I don't eat grapefruit cuz of my bl pressure meds.

    D

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  • rumoret
    rumoret Member Posts: 685
    edited February 2009

    AVOID WHILE ON TAMOXIFEN
    Herbs to Avoid - Estrogen Effects

    What are the herbs to watch out for? For women who have had breast cancer, the following herbs have been found to have estrogen-like effects and should be avoided:


        •    red clover (trifolium pratense)
        •    chasteberry (vitex agnus castus)
        •    hops (humulus lupulus)
        •    ginseng
        •    soy
        •    dong quai (angelica sinensis) and licorice (glycyrrhiza glabra) also have estrogen-like effects, but they are not as great as the other above herbs.


    Women taking the drug tamoxifen are even more likely to use herbs and soy because of hot flashes. However, tamoxifen has an anti-estrogenic effect (it's used for estrogen-dependent breast cancers), so people taking tamoxifen should take special care to avoid the above estrogenic herbs.

    If you're taking tamoxifen you must avoid grapefruit and pomegranate and SSRI-type antidepressants. These items knock out an important enzyme that converts tamoxifen to its active form. Grapefruit and pomegranate can disable the enzyme for 3 days from a single dose.

    ST. John's Wort - has grapefruit in it....don't take.

    While on tamoxifen avoid:
    prozac, paxil (antidepressants)
    fluconazole (for yeast infections),
    amiodarone ( a heart medication),
    benadryl,
    cimetidine/Tagamet,
    ranidatine/Zantac,
    dexamethasone (steroid)

    Hugs, Terry 

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  • ChrisNM
    ChrisNM Member Posts: 47
    edited February 2009

    Dear Terry-

    This is helpful information.  Can you refer me to a web site that lists this so I can point it out to my doc?  Thanks!

    Chris in NM

    DX 3-08, IDC, ,1cm, Stage I, Grade 2, ) nodes, ER+, PR+ HER2-

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  • kerry_lamb
    kerry_lamb Member Posts: 778
    edited February 2009

    Girls, www.drugs.com  is the site to get very specific info about the drugs you are taking. I discovered it whilst trying to nut out some details about femara. XX

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  • saluki
    saluki Member Posts: 2,287
    edited February 2009

    Here Chris-- This should be of help to you

    http://meeting.ascopubs.org/cgi/content/abstract/24/18_suppl/504

    http://jop.ascopubs.org/cgi/content/full/1/4/155

    http://jco.ascopubs.org/cgi/content/abstract/22/12/2489

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  • Lucy47
    Lucy47 Member Posts: 183
    edited February 2009
    wow!!! I never knew that pomegranates were on the list ....I love them and I do eat them every so often :( . The only think my doc told me was to stay away from soy.....I don't care about grapefruits ...because their not my favorite....but pomegranates .....say it isn't sooooooooooooFrown
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  • saluki
    saluki Member Posts: 2,287
    edited February 2009

    To Rumoret's list I would also add Vitamin E

    http://www.surgjournal.com/article/PIIS0039606006003928/abstract

    Also, possibly the supplement I3C (Indole-3-Carbinol)

    http://www.journals.elsevierhealth.com/periodicals/cdp/article/PIIS0361090X03002058/abstract

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  • ChrisNM
    ChrisNM Member Posts: 47
    edited February 2009

    Thanks everyone.  This has been really helpful information.  I feel armed and ready for the next appointment!

     Chris in NM

     DX 3-08, IDC, <1cm, stage 1, 0 nodes, ER+, PR+, HER2-

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  • Rosemary44
    Rosemary44 Member Posts: 2,660
    edited February 2009

    Here's the Flockhart Table that is helpful.  Look for the drug your taking in whichever column and scroll down:

    http://medicine.iupui.edu/flockhart/table.htm

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  • rumoret
    rumoret Member Posts: 685
    edited February 2009

    Sorry......been to long to know where I got information......

    Hugs,

    Terry 

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  • PinkVelvet
    PinkVelvet Member Posts: 64
    edited February 2009

    Saluki,

    Thank you for the references.  I found them very interesting.  I just started Tamoxifen 2 weeks ago and have been taking Lexapro (ssri) for many years.  I will talk to my onc about this, as I don't want to be taking Tamoxifen for nothing.

    Jen 

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  • Annie62
    Annie62 Member Posts: 1,081
    edited March 2009

    Wow, I'm glad I saw this. I've been adding a splash of pomegranite blueberry cranberry 100% juice to my seltzer for flavor and health benefits. Had no idea I was counteracting tamoxifen. I also didn't know about the reversterol. I don't drink much now but over the years I've been on tamox, I have drunk a lot of red wine. Sheesh. My onc even recommended red wine to me!

    So has anyone heard anything about hemp oil? I haven't seen anything about this but easily could have missed it. I've been wanting to add more omega 3's and don't want to use flax oil

    Thanks,

    Annie

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited March 2009

    the only thing my pharmacist said to avoid was grapefruit and grapefruit juice.

    Anne

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  • Kleenex
    Kleenex Member Posts: 764
    edited March 2009

    No Benadryl with Tamoxifen? Why not? I hadn't heard that before...

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  • cureme1
    cureme1 Member Posts: 29
    edited March 2009

    Hey everyone. I've been on tamoxifen for 3 weeks and my sound and smell is so amplified. kicks in about noon. like scary loud. also extreeeme fatique after lunch. anyone else. I'm sure being a teacher doesnt help...

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  • Kleenex
    Kleenex Member Posts: 764
    edited March 2009

    FYI - I asked my oncologist about Benadryl and Tamoxifen - it's not a problem to take them both.

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  • PT63
    PT63 Member Posts: 329
    edited March 2009

    OMG

    I have been on Tamox. for 2 years and have never had anyone mention the grapefruit thing to me.  I looked through the paperwork that comes with the meds in the mail order and there is nothing mentioned.  I just started drinking grapefruit juice a month or so ago to get in all my recommended (8) daily fruits and vegetables.  I LOVE grapefruit juice.  I have got to look further into this.  I am soooo bummed.  No grapefruit juice and No benefit from Tamox. for a month!!! Will it never end???Frown

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  • kle
    kle Member Posts: 317
    edited March 2009

    I asked my oncologist also about grapefruit juice, after reading some negative stuff.  She said that it is not a problem with Tamoxifen and I can drink it.  Why then have I stayed away from it?  So many different views.  What's a grapefruit lover to do!

    kle 

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  • KathyNSW
    KathyNSW Member Posts: 57
    edited March 2009

    Hi everyone

    Does this mean you can't have a beer now and again on tamoxifen?

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  • PT63
    PT63 Member Posts: 329
    edited March 2009

    My oncologist told me that "of course you can drink" even on Tamox. I love my glass of wine in the evening.  She told me that was fine as long as I don't over-do it.

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  • idaho
    idaho Member Posts: 1,187
    edited March 2009

    I was told to also avoid black cohosh whick helped immensely with my hot flashes.  Tami

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  • Calif-Sherry
    Calif-Sherry Member Posts: 124
    edited March 2009

    The drug list is interesting.  My gyne-onc gave me diflucan for yeast infection.  Isn't that the same as the drug listed above????

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  • wallycat
    wallycat Member Posts: 3,227
    edited April 2009

    I found this study.  Seems pomegranite is fine...

    it does not use the cyp2D6 route...

    J Clin Pharmacol. 2007 Mar;47(3):286-94.
    Pomegranate juice does not impair clearance of oral or intravenous midazolam, a probe for cytochrome P450-3A activity: comparison with grapefruit juice.
    Farkas D, Oleson LE, Zhao Y, Harmatz JS, Zinny MA, Court MH, Greenblatt DJ.

    Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.

    The effect of pomegranate juice (PJ) or grapefruit juice (GFJ) on CYP3A activity was studied in vitro and in healthy human volunteers. In human liver microsomes, the mean 50% inhibitory concentrations (IC(50)) for PJ and GFJ versus CYP3A (triazolam alpha-hydroxylation) were 0.61% and 0.55%, (v/v) respectively, without preincubation of inhibitor with microsomes. After preincubation, the IC(50) for PJ increased to 0.97% (P < .05), whereas the IC(50) for GFJ decreased to 0.41% (P < .05), suggesting mechanism-based inhibition by GFJ but not PJ. Pretreatment of volunteer subjects (n = 13) with PJ (8 oz) did not alter the elimination half-life, volume of distribution, or clearance of intravenous midazolam (2 mg). Administration of PJ also did not affect C(max), total area under the curve (AUC), or clearance of oral midazolam (6 mg). However, GFJ (8 oz) increased midazolam C(max) and AUC by a factor of 1.3 and 1.5, respectively, and reduced oral clearance to 72% of control values. Thus, PJ does not alter clearance of intravenous or oral midazolam, whereas GFJ impairs clearance and elevates plasma levels of oral midazolam.

    PMID: 17322140 [PubMed - indexed for MEDLINE]

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  • KathyNSW
    KathyNSW Member Posts: 57
    edited April 2009

    Hi everyone

    What about grape seed extract which has been added to a Beta Boost drink that

    I take. ( only a small ammount of extract)?

    Its called Percy's4Tphy  Beta Boost.

    Thankyou and Take care

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  • rdrake0
    rdrake0 Member Posts: 180
    edited April 2009

    Two questions:

    1.  Anyone out there taking VEMA?  Would it be OK?

    2.  Do these foods you are listing also interfere with Arimidex?

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  • sandy2009
    sandy2009 Member Posts: 106
    edited May 2009

    Just curious if white tea is okay when taking tamoxifen.  I enjoy this during the day, instead of coffee.  I do have 1 cup of coffee in the morning but enjoy the white tea during the day (2-3 cups).

    Thanks, Sandy

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  • McKenzie
    McKenzie Member Posts: 1
    edited May 2009

    Cureme1, I also started Tamox about 3 weeks ago.  OH MY GOSH, YES!! Yes, noise is driving me nuts.  I also have had the crazy feeling of being on a carnival ride.  No stomach nausea but the kind that you get from motion.  Oh, and caffeine makes this sensation so much  worse.  And I love my caffeine.  Anyone else notice this on Tamox? Hits me in the late AM/early PM.  I also had wondered if it played a role in blood sugar but man, I can't live with this dizzy feeling all the time.  Does anyone find that this eventually goes away? No hair loss, a little weight loss (that could be stress). I am almost 44 and premeno as well.

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  • KatRNagain92
    KatRNagain92 Member Posts: 522
    edited February 2010

    Bumping this thread for us newbies.  Perhaps a comfort to the Benedryl users out there is a possible substitute.  Melatonin...naturally occurring in our bodies but depletes as we get older.  It can be purchased over the counter in the pharmacy section.  Ask your doctor if that may be the answer to your sleepless nights:

    http://www.publix.com/wellness/notes/Display.do?id=Drug&childId=Tamoxifen

    http://www.publix.com/wellness/notes/Display.do?id=Supp&childId=Melatonin

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