The instruction of Tykerb I have been taking says that this medicine is to be taken on an empty stomach—at least 2 hours after and 1 hour before meals. Also, I should not eat grapefruit.
However I found an article that if I take Tykerb with food or grapefruit, that will increase the bioavailability so that with less doses I can expect the same effectiveness as the high doses for the empty stomach, and in the result, that will save 60-80% of the cost.
The article was found in the Journal of Clinical Oncology issued in August 2007.
According to the article, the bioavailability of Tykerb will increase 167% with low-fat meals and 325% with high-fat meals. In another words, 1 tablet of Tykerb (250 mg) with food and grapefruit juice could expect the same effectiveness as 5 tablets of it (1250mg) for the empty stomach.
The reason of the instruction of 5 tablets for the empty stomach is simply because the data was collected in that condition without being aware of the effect of the food.
Because of my Kaiser insurance, I don’t have to worry about the cost, but what drew my attention was that the article also mentioned that if I take Tykerb with food, probably the food will help reduce the side effects such as upset stomach, diarrhea, nausea, and so on.
Since last November, when I reduced the dose of Tykerb to 4 tablets because of diarrhea, I haven’t changed the dose to 5 tablets. I wondered if I take 4 tablets 1 hour after meal, instead of 2 hours, maybe I would not have to increase the dose.
I showed my oncologist the article and asked her opinion. She didn’t want me to reduce the dose like 1 or even 3, but she approved that I could stay on 4 tablets and take them 1 hour after a meal.
Probably, as I am taking two antibiotics since I ran a fever, my stomach has been upset and this strategy has not been working yet. I even skipped taking any Tykerb some nights because of nausea and diarrhea.
Though I have to be careful not to play too much with those medicines, I appreciate that the doctor has allowed me to decide many decisions for my treatments.