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Why Should Patients Avoid Antioxidants When Receiving Certain Myeloma Treatments?

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Published on May 3, 2016

In this Ask the Expert video segment, Dr. Jatin Shah of MD Anderson Cancer Center responds to a question about the reason why patients on multiple myeloma maintenance therapy are are advised to avoid antioxidants, particularly on medication day. Listen as Dr. Shah explains why high doses of vitamin C and green tea, as well as potential other antioxidants, are not recommended for patients on certain maintenance therapies.

Clinial Trials Mentioned in This Video

bortezomib (Velcade)
ixazomib (Ninlaro)

This Ask the Expert series is sponsored by the Patient Empowerment Network, which received funding from Celgene, Novartis and Takeda.

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Transcript | Why Should Patients Avoid Antioxidants When Receiving Certain Myeloma Treatments?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

Here’s a question we got in from Paula. Paula writes, “Patients who receive bortezomib (Velcade) are advised to take acyclovir (Valtrex) to prevent shingles and also to avoid antioxidants on medication days. What is the reasoning behind patients avoiding antioxidants? Do these precautions also apply to the recentlyapproved drug, Ninlaro or ixazomib?” 

Dr. Shah:               

The reason that we try to avoid or minimize antioxidants really comes around to the data with the use of bortezomib and high doses of vitamin C or green tea. And so we know that in preclinical studies when you take high doses of vitamin C, they can inactivate bortezomib or make bortezomib not work as well for patients. And so it’s really when you take very high doses of vitamin C or green tea in a short timeframe near bortezomib that we see that that doesn’t work as well. And so it’s for that reason that we try and minimize any additional antioxidants. 

At the end of the day, we should have some nice data around that suggesting that we shouldn’t be having high doses of vitamin C or green tea with Velcade. But I think that there [are] lots of other antioxidants and if you’re taking super high doses of that, we just don't know what the interactions may or may not be. So I think it’s for that reason that we would avoid using those antioxidants at a high dose or on the same days that you take the bortezomib. And I think that would probably apply to ixazomib as well, because they work in a very similar fashion, as well.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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