Tamoxifen and Benadryl and/or Bupropion
I was shocked to discover that I take large amounts of two drugs (Wellbutrin and Benadryl) that directly interfere with the function of Tamoxifen! With all of these doctors monitoring everything, including how many grams of vitamins C I take, how is it possible none of them noticed? It makes me angry!
Here's brief info, you can find more on this site and others.
Medications that can interfere with CYP2D6:
There are medications that can block the activity of CYP2D6 to varying degrees
(usually stated as “strong” or “moderate” inhibitors of CYP2D6). These
medications include some of the antidepressants known as serotonin-specific
reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors
(SNRIs). There are also other types of commonly prescribed medications, such as
Cardioquin (chemical name: quinidine), Benadryl (chemical name:
diphenhydramine), and Tagamet (chemical name: cimetidine), that can block
CYP2D6. Blocking the activity of CYP2D6 can interfere with the activation of
tamoxifen — reducing its effectiveness as an anti-cancer treatment. Most
doctors recommend that you avoid taking strong and moderate inhibitors of
CYP2D6 while you’re on tamoxifen.
Comments
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It seems that not all doctors agree on this point. I asked my MO about the Benadryl specifically, since I have seasonal allergies, and she said that taking some once in a while shouldn't be a problem. From the drugs.com site:
When used regularly or continuously for extended periods, diphenhydramine may reduce the effectiveness of tamoxifen in the treatment of breast cancer.
From this statement at least, the interference with tamoxifen seems mostly theoretical. In any case, I usually try to take Claritin or Zyrtec instead.
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I called my Onc's office and they said there was "no problem with Tamoxifen and Bupropion.or any other SSRIs". Of course, bupropion is fundamentally different from other SSRIs, but in any case, I was really surprised that my doctor had no problem with the combo. While sitting there on the phone I searched the two drugs and the same warnings came up. I guess since it doesn't cause sudden death or something it isn't getting much attention. I would be very upset if I had taken both of the drugs for years to suddenly discover I wasn't getting the protection expected from tamoxifen. Once time has gone by, you can never get it it back!
At the pharmacy today, I asked my trusty pharmacist if there were any concens with taking tamoxifen and bupropion. She reassuringly told me there was no problem. I asked her if she was really sure. She said she'd look it up just to be sure, then came back and told me that bupropion does weaken the potency of tamoxifen. I told her that I'm guessing that most women on tamoxifen want full potency from the medication.
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Bab you are so right!! If I'm going to take this drug I want full benefit.
I switched to celexa. It's working great for me and I'm only on a 10mg dose.
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If you are on an antidepressant that is working for you, maybe take Fareston instead of tamoxifen. It's metabolized differently.
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I am so glad to have found this thread. This is all new to me, as I was just diagnosed 2 days ago. Of course, against my doctors "orders", I have been obsessively researching online. So far, the thing that currently has me most worried, is the thought of possibly having to go off Wellbutrin and Zoloft. Just prior to my diagnosis, even before I felt a lump in my breast, I had suffered a relapse of depression and went up to the maximum dose of Wellbutrin, plus I take 75mg of Zoloft. They have literally been a life-saver. I honestly would have to give serious thought as to which path I'd take if it comes down to having to choose between tamoxifen for my physical health, and these antidepressants for my mental health.
I've never heard about Fareston. Does it serve the same purpose as tamoxifen? If so, why does tamoxifen seem to be more popular (at least it appears to be to me.)
Thank you.
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omg!--I just answered my own question--so relieved to see that there are options.
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