Medicines, foods and supplements to avoid on abemaciclib

Abemaciclib is broken down in the liver mainly by an enzyme system called CYP3A4. Anything that strongly slows this enzyme can push abemaciclib levels up, increasing side effects such as loose motions, low blood counts and liver strain. Anything that strongly speeds it up can pull levels down, which may make the medicine less effective. The most important food to avoid is grapefruit, including grapefruit juice and products containing it, and some advice extends this to pomelo and Seville oranges. Among medicines, strong enzyme blockers include certain antifungal medicines such as ketoconazole and itraconazole, some antibiotics such as clarithromycin, and some medicines used for HIV. Ketoconazole should not be used with abemaciclib at all, and for other strong blockers your doctor may avoid them or lower your abemaciclib dose if they cannot be avoided. Strong enzyme speeders include rifampicin, used for tuberculosis, the epilepsy medicines carbamazepine and phenytoin, and the herbal remedy St John's wort, all of which should generally be avoided. Many everyday medicines are fine, including paracetamol and most blood pressure and diabetes tablets, but it is always worth checking. Tuberculosis treatment is common in India, so if you are ever prescribed it, make sure the prescribing doctor knows you take abemaciclib. The safest habit is to check with your oncologist or pharmacist before starting anything new, including herbal, Ayurvedic, homeopathic and over-the-counter products.

Grapefruit is the main food to avoid

It can raise abemaciclib levels for a long time after eating, so avoid it completely rather than just separating it from doses.

Some antibiotics and antifungals matter

Short courses are common. Remind every doctor and dentist that you take abemaciclib.

Herbal products are not automatically safe

St John's wort is the best-known problem, but many products have never been tested with cancer medicines.

Interaction advice can feel overwhelming. A few principles cover most of what matters.

No list is complete

New medicines appear all the time, and many herbal products have never been studied with abemaciclib.

Sometimes a needed medicine interacts

If you need an interacting medicine, your doctor may adjust your abemaciclib dose rather than deny you treatment.

Traditional remedies vary widely

Contents and strength of herbal preparations can differ from batch to batch, which makes their effects hard to predict.

What this page cannot tell you

It cannot check your own medicine list. Your pharmacist or oncologist can do that for you.

Apart from grapefruit and its relatives, there are no strict food bans with abemaciclib.

A balanced diet helps

Regular meals with protein, such as dal, eggs, fish, paneer or pulses, help you keep strength during treatment.

Alcohol

Alcohol can worsen loose motions and liver strain. Many teams suggest avoiding it or keeping it very occasional.

Food safety

When white cells are low, choose freshly cooked food and clean drinking water, and avoid raw street food.