Momentarily Side-tracked

by Tamoxifen Side-effects.

We planned to leave today for kayaking in Charleston – but the past 3 days I’ve experienced sharp shooting pain in my lower leg and decided it best to ensure a blood clot was not planning a surprise announcement.

It has been 6 days on Tamoxifen, and I’ve sampled 2 of the side-effects already…. hot flashes (altho mild compared to going through menopause) and muscle pain.  Hopefully that will be it.

But all is well – the doc felt it was in fact just a side-effect and so we leave tomorrow for some paddling fun and sun. I joke that I have two new floatation devices, but I will wear my PFD.

I found out that there is a test that can be run to determine if you actually derive full benefit from Tamoxifen.  It is called: Cytochrome P450 2D6 Genotyping.

CYP2D6 (cytochrome P450 2D6) acts on one-fourth of all prescription drugs, including the selective serotonin reuptake inhibitors (SSRI), tricylic antidepressants (TCA), betablockers, opiates, neuroleptics, antiarrhythmics and a variety of toxic plant substances.

Some 7-14% of the population has a slow acting form of this enzyme and 7% a super-fast acting form. Thirty-five percent are carriers of a non-functional CYP2D6 allele, especially elevating the risk of adverse drug reactions when these individuals are taking multiple drugs.

Drugs that CYP2D6 metabolizes include Prozac, Zoloft, Paxil, Effexor, Hydrocodone, Amitriptyline, Claritin, Cyclobenzaprine, Haldol, Metoprolol, Rythmol, Tagamet, Tamoxifen, and the over-the-counter diphenylhydramine drugs, Allegra, Dytuss, and Tusstat. CYP2D6 is responsible for activating the prodrugs codeine and other opioids into their active forms. The analgesic activity of the drugs is therefore reduced or absent in CYP2D6 poor metabolizers. (Note: Evista does not need CYP2D6 to work).

A recent review indicated that Asians, Pacific Inlanders, African and African Americans have higher percentages of reduced functional or non-functional CYP2D6 alleles (between 40% and 50%) than do Europeans (26%). Good info to know if you fall in those groups.

Getting back on track…… so, I’m going to put my kayak in the water (with the help of my husband and friends), and see if I’ve regained sufficient flexibility to roll.

That reminds me of one of my favorite children’s book – The Little Train that Could.  And as I set up for that first roll, I’ll be thinking “I think I can, I think I can, I think I can”.  ..  and be thankful that I can at least be where I am, surrounded by wonderful family and friends, near and far….




1 Comment (+add yours?)

  1. Helene Jeanette
    Nov 10, 2011 @ 23:29:13

    You’re already on a roll! “Nothing is softer than water, yet nothing can resist it.” Go play in the irresistible water!


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