Re: Is milk thistle ok to take if taking daily flucanzole

[Guest guest]

Pam, out of curiosity, what was your rx.

to the Placquenil & fluconazole? I take both these drugs as well as a few

other that go through the P450 system. I haven’t had any ill effects

that I’m aware of, but it has made me worry that I may be increasing the

retinal toxicity potential of Placquenil. Patrice

From: infections [mailto:infections ] On Behalf Of doggy532001

Sent: Thursday, May 19, 2005 1:47

PM

infections

Subject:

[infections] Is milk thistle ok to take if taking daily

flucanzole

Does anybody know if it is ok to continue to take milk thistle if one

is going to take a daily flucanazole?

Usually I take 2 or 3 milk

thistle capsules daily but was wondering if this

is a good idea

because I believe it acts on the P450 system as

does flucanzole.

I think this is a problem with flucanzole it is

contraindicated with

so many other meds and maybe supplements

too. It gave me a horrendous

central nervous system reaction because I had taken

it when Plaquenil

was still in my system and possibly erthyromycin

too. It took a week

and a half to for the reaction to settle down and

hope I don't have to

go through that again.

Thanks

Pam

[Guest guest]

> Pam, out of curiosity, what was your rx. to the Placquenil &

fluconazole? I

> take both these drugs as well as a few other that go through the P450

> system. I haven't had any ill effects that I'm aware of, but it has

made me

> worry that I may be increasing the retinal toxicity potential of

Placquenil.

> Patrice

>

>

Hi Patrice

Within 24 hours of taking the flucanzole I developed a severe zig-

zagging aura that went on for 20 minutes followed by a 2 day migraine

headache on the 1st occasion and on the 2nd occasion a few days later

the aura was much much worse and made me feel like death. The aura

went on for 2 hours but left me sick for days after it seemed to

shatter my central nervous system. I felt so ill and looked ill very

wired and miserable. It seemed like my nervous system was looking for

and dreading another aura starting. I also lost all my energy.

I have only had about 8 classical migraines like this in my life and

the previous one had been about 8 years ago or even longer than that

so to have 2 in 5 days was definitely related to the drug

interaction. I have taken Diflucan many times in this past year with

no bad reactions but that was when I was on Doxy.

If you do a check on the drugs that shouldn't be taken with flucanzole

there is a very long list but definitely Plaquenil is mentioned and Dr

Schardt mentioned Erthyromycin too.

Pam

[Guest guest]

Yes, I know that Placquenil is

contraindicated with Fluconazole but my ID Dr. sort of poo pooed that. I knew it

would take so long to get all of the placquenil out of my body anyway (as in

months), that I figured I would risk it. I didn’t have any issues. I

also take Minocin. I also take Cozaar and Amitryptilline all metabolized via

P450. I hope I’m not flirting w/fire but I haven’t had any ill

effects. Patrice

Fortunately, I don’t get headaches

easily. Other aches and pains are another story.

From: infections [mailto:infections ] On Behalf Of doggy532001

Sent: Thursday, May 19, 2005 2:15

PM

infections

Subject:

[infections] Re: Is milk thistle ok to take if taking daily

flucanzole

> Pam, out of curiosity, what was your rx. to

the Placquenil &

fluconazole? I

> take both these drugs as well as a few other

that go through the P450

> system. I haven't had any ill effects

that I'm aware of, but it has

made me

> worry that I may be increasing the retinal

toxicity potential of

Placquenil.

> Patrice

>

>

Hi Patrice

Within 24 hours of taking the flucanzole I

developed a severe zig-

zagging aura that went on for 20 minutes followed

by a 2 day migraine

headache on the 1st occasion and on the 2nd

occasion a few days later

the aura was much much worse and made me feel like

death. The aura

went on for 2 hours but left me sick for days

after it seemed to

shatter my central nervous system. I felt so

ill and looked ill very

wired and miserable. It seemed like my

nervous system was looking for

and dreading another aura starting. I also

lost all my energy.

I have only had about 8 classical migraines like

this in my life and

the previous one had been about 8 years ago or

even longer than that

so to have 2 in 5 days was definitely related to

the drug

interaction. I have taken Diflucan many

times in this past year with

no bad reactions but that was when I was on Doxy.

If you do a check on the drugs that shouldn't be

taken with flucanzole

there is a very long list but definitely Plaquenil

is mentioned and Dr

Schardt mentioned Erthyromycin too.

Pam

[Guest guest]

" Patrice " <PKR527@k...> wrote:

I also take Cozaar and Amitryptilline all metabolized via P450.

Patrice, are you taking Cozaar for high blood pressure or as an anti-

inflammatory? Are you taking a standard dose? If it's for high bp,

have you noticed any side benefits? Like a reduction in inflammatory

symptoms?

penny

[Guest guest]

I am taking Cozaar for anti inflammatory

purposes; standard dose. I would never mess with an increased dose of an ARB.

I’m taking 50mg which is the lowest strength. Patrice

From: infections [mailto:infections ] On Behalf Of penny

Sent: Thursday, May 19, 2005 8:44

PM

infections

Subject:

[infections] Re: Is milk thistle ok to take if taking daily

flucanzole

" Patrice " <PKR527@k...> wrote:

I also take Cozaar and Amitryptilline all

metabolized via P450.

Patrice, are you taking Cozaar for high blood

pressure or as an anti-

inflammatory? Are you taking a standard dose? If

it's for high bp,

have you noticed any side benefits? Like a

reduction in inflammatory

symptoms?

penny

[Guest guest]

> Has anyone answered the question. Is it alright to

> take Milk Thistle with daily Flucanizole.

> I am taking milk thistle and every other day

> Diflucan.I am really sick.

> Marie

Hi

I wondered if Barb might have some ideas on this one.

Pam

[Guest guest]

Patrice:

Amitriptyline (Elavil) is metabolized theu the CYP3A4

pathway... so you would need to discuss this with your DOc if you're

also taking CYP3a4 inhibitors (Like Fluconazole and Milk Thistle).

I think CYP3A4 only plays a minor role in Cozaar metabolism, using a

differ enzyme pathway as the major one.. SO you're probably OK there.

http://www.delano.com/Articles/cyp3A4-substrates.html

I duuno you guys - if you're mixing drugs (and your DOcs don't have

this info) then I'd be lookin it up.. becuase if you feel like crap-

it certainly CAN be becuase of Drug-drug or Drug-substance

interactions.

Barb

> " Patrice " <PKR527@k...> wrote:

> I also take Cozaar and Amitryptilline all metabolized via P450.

>

[Guest guest]

>

> The interaction most Dr.s worry about is when you take a

particular

> pathway inhibitor in combination with another drug that usues that

> pathway to be broken down (metabolised). In this combination, the

> inhibiting substances increase the consentration levels of the

other.

>

> You wouldn't want to take 2 drugs that specifically use the same

> pathway for metabolism either.. they compete, and can result

higher

> consentrations of either , or, or both.

>

> Combining an inhibitor with a substrate is not a good idea either

> (that would be Milk Thistle (3A4 inhibitor) with a substrate for

3A4

> (Flagyl)

>

>

> >>>>>>>>>>>>>>>>OK HERE's your SPECIFIC

QUESTION:>>>>>>>>>>>>>>>>>>>>

>

> Milk thistle INHIBITS the P450 pathway called CYP3A4.

> Fluconazole INHIBITS the same pathway (CYP3A4).

> as an aside, Cats CLaw (Samento) also inhibits CYP3A4

>

> Because 3A4 is a common pathway and is needed for drug

metabolism..

> and now you've got two substances competing to inhibit it. So you

> should be very carefull that you're not taking any drugs (or

herbs)

> that NEED that pathway to be metabolised. This may include many

anti-

> depressants and statin drugs. Also.., You need to review the

dosages

> of both with your DOc (I have no idea what doses your taking).

>

> Barb

>

Hi Barb

Many thanks for your detailed reply and I rather guessed it might be

something like that. Therefore the past 2 days since I restarted

flucanzole but only at 75mg daily I have stopped the milk thistle.

The only other drugs I take each day is Armour and a small amount of

T4 for my thryoid plus just 2.5mg Prednisolone, possibly they also

use that pathway.

I have also been taking Ibruprofen for my stiff neck and indeed it

does help a bit.

Best Wishes

Pam