Izidakamizwa eziningana zikhansela ngaphandle kwe-Anti-Estrogen Imiphumela ye-Hormone Therapy
I-Tamoxifen imithi yokwelapha i-hormone ethathwe abesifazane abaningi base-premenopausal ngemuva kokuqeda ukwelashwa kwabo kokuqala ngomdlavuza wesifuba we-estrogen receptor. Ukuze uphathe imiphumela emibi ye-tamoxifen (njengokushisa okushisayo) futhi ukusiza ngokucindezeleka, odokotela bavame ukunikeza izidakamizwa zokucindezeleka. Kodwa abaningi abacindezelekayo bangaphazamisa, noma baqede ngokuphelele, izinzuzo tamoxifen.
Yini okufanele wonke umuntu athathe i-tamoxifen?
Ukusetshenziswa kweTamoxifen nge-Cancer Breast
Uma owesifazane eseqedile ukwelashwa okuyisisekelo komdlavuza webele, ngezinqubo zokwelashwa, ukwelashwa kwamakhemikhali , kanye nokwelashwa kwemisebe , angase adinge ukuthatha i-tamoxifen. Kwabesifazane abanesifo se-estrogen se-receptor, ama-hormone therapy anganciphisa ingozi yomdlavuza obuyele (ukuphindaphinda) ngamaphesenti angama-50.
Ukuzikhethela kwemithi kuncike esimeni se-menopausal. Uma owesifazane e-premenopausal, i-tamoxifen ngokuvamile iyisidakamizwa esizikhethelayo. (Kwalabo abama-postmenopausal, noma abama-premenopausal kodwa bathole ukwelapha okukhipha i-ovarian, i- aromatase inhibitor ngokuvamile isetshenziselwa esikhundleni).
Amaseli omdlavuza webele we-estrogen receptor positive aphethwe yi-estrogen. I-Estrogen ekhona emzimbeni (okwenziwe ama-ovari) ibophezela kulawo maseli omdlavuza okwenzeni ukukhula. I-Tamoxifen isebenza ngokubopha kulezi zitholampilo ukuze i-estrogen ingakwazi, ngokuyinhloko ilambile amangqamuzana omdlavuza wokudla kwawo.
Imiphumela emibi ye-tamoxifen ihlanganisa izimpawu ze-menopausal-type ezifana nokushisa okushisayo, i-libido ephansi, nokomama wesisu. Kulabo besifazane abangazange bafinyelele esikhathini sokuqala, ukukhanya okushisayo kungacasula kakhulu, kodwa sifundile eminyakeni yamuva ukuthi imithi ethile yokucindezeleka inganciphisa lezi zitshalo ezishisayo.
Ngeshwa, ezinye zalezi zidakamizwa zokunciphisa umzimba nazo zinganciphisa ukusebenza kwe-tamoxifen.
I-Cancer Isifo Nokucindezeleka
Akumangalisi ukuthi abesifazane abaningi abaye baphathwa ngomdlavuza webele baqala ukucindezeleka. Ukuhlanganiswa kokuxilongwa okusongela ukuphila, imiphumela emibi yokwelapha, kanye nezinguquko ezithombeni zomzimba ezihamba ngemithi yokwelashwa zonke zibeka isiteji somthelela omkhulu ngokomzwelo. Ngeshwa, ngemuva kokuba abaningi besifazane benomdlavuza webele bephathwa (cishe cishe kwezinye izindawo) abanezinkinga zokucindezeleka, kwatholakala ukuthi eziningana zokucindezeleka zinganciphisa umphumela we-tamoxifen. Lokhu kwenzeka kanjani?
I-Tamoxifen ne-Drug Interactions
Ukusebenzisana kwe-Tamoxifen nokusetshenziswa kwezidakamizwa kuvamile, futhi lokhu kuhlanganisa imithi eminingi ngaphezu kwezidakamizwa zokucindezeleka. Njengoba eziningi zalezi zidakamizwa ezivame ukusetshenziswa, kufaka phakathi izidakamizwa ezingaphezu kwemithi efana ne-Benadryl, kubalulekile ukukhuluma nodokotela wakho kanye nemithi mayelana nanoma imiphi imithi, ukulungiselela ngaphezulu, noma ukuphasisa kokudla okucatshangelwayo, ngenkathi ukhona kulesi sidakamizwa. Njengoba abantu abaningi bathatha i-tamoxifen iminyaka emihlanu kuya kwengu-10, lokhu kubaluleke nakakhulu. Khumbula ukuthi akubona bonke odokotela abajwayele lokhu kuxhumana (futhi sifunda kabanzi ngaso sonke isikhathi).
Lokhu kusho ukuthi uma kufanele uhambe ngokunakekelwa okuphuthumayo, isibonelo, ngokutheleleka, khuluma ne-oncologist yakho noma u-pharmist ngaphambi kokuba uthathe noma yimiphi imithi ebekiwe.
I-Tamoxifen isetshenziselwa umzimba emzimbeni ekugcineni. I-Endoxifen inamandla angaphezu kuka-30 kuya kwangu-100 kune-tamoxifen, futhi ibhekene nemiphumela eminingi emitholampilo. I-Tamoxifen ihlehlisiwe ibe yi-endoxifen yi-cytochrome P450 enzyme CYP2D6 (kanye nezinye ezingabalulekile). Noma yimiphi imithi eyanciphisa umsebenzi we-CYP2D6 (futhi kuningi) inganciphisa le nqubo yokuphumula futhi ngenxa yalokho, inani le-endoxifen elikhiqizwayo.
I-Tamoxifen ne-Antidepressants: Ukusebenzisana
Sisafunda kabanzi mayelana nezidakamizwa zokucindezeleka kanye nomphumela wazo kumazinga e-tamoxifen emzimbeni, kodwa kuze kube manje sibonile ukuthi izidakamizwa ezihlukumezayo ezahlukene zingenza tamoxifen ngezindlela ezahlukene. Amanye ama-anti-depressants (afana ne-Prozac ne-Paxil) ayengafuni ngokuphelele umphumela we-tamoxifen. Kulokhu, kungaba njengokungathathi i-tamoxifen nhlobo (futhi kungenayo inzuzo yokunciphisa ingozi yokuphindaphinda).
Ngamanye ama-anti-depressants kukhona ukusebenzisana okulinganayo, futhi nabanye, ukuxhumana okuncane nje. Ngokuphambene nalokho, enye isondlo yokudla ingase imise umphumela we-tamoxifen (kanye nemiphumela emibi), nakuba ezinye izifundo zibonise okuhlukile ..
Ngezansi itafula elifingqa lokho esikholelwa ukuthi kuyiqiniso mayelana nezinkinga eziningi zokulwa nokucindezeleka namuhla. Le yindawo yokucwaninga okusebenzayo, futhi kungenzeka ukuthi sizofunda okuningi esikhathini esizayo esiseduze. Uma ucabangela imishanguzo yokucindezeleka, khuluma ngokucophelela nodokotela wakho, kodwa futhi njalo ubuze ukuthi kukhona okushintshile.
Ama-anti-depressants nokuthi asebenzisana kanjani no-Tamoxifen
| Isidakamizwa sezidakamizwa | Ukuxhumana noTamoxifen | Uhlobo lokuphepha |
I-Paxil (i-paroxetine) I-Prozac (i-fluoxetine) | Ivikela i-antiestrogen inzuzo | Gwema ukusebenzisa |
I-Cymbalta (i-duloxetine) I-Wellbutrin (bupropion) I-Zoloft (sertraline) | Ukuphazamiseka okuphakathi kwe-antiestrogen Qaphela: Izifundo ziqinisekisa ukuthi iZoloft iphazamisa iTamoxifen. | Ukwandisa Ingozi |
| I-Wort Saint John's Wort (hypericum) | Ukuvimbela okunamandla kwe-antiestrogen | Ingozi eyanda |
Celexa (citalopram) I-Lexapro (i-escitalopram) I-Pristiq (desvenlafaxine) I-Remeron (i-mirtazapine) | Ukusebenzisana okuncane Qaphela: U-Pristiq no-Remeron abazange bafunde kahle ukuxhumana noTamoxifen. | Ingozi encane |
| Black Cohosh (Actaea) | Ingavimbela noma ithuthukise inzuzo ye-antiestrogen kuye ngokuthi isifundo. Qaphela: Kunezifundo ezimbalwa nje zokuxhumana noTamoxifen, futhi iningi lenziwe "ku-vitro" (ebhodini hhayi kubantu). | Ingozi encane |
I-Effexor (i-venlafaxine) | Cishe akukho ukuxhumana noTamoxifen | Okukhethwa Kakhulu |
Ngezansi ku-Tamoxifen ne-Antidepressants
Ukwazi mayelana nokuxhumana okungenzeka phakathi kwe-tamoxifen kanye ne-anti-depressants kubalulekile uma ucabangela noma iyiphi yalezi zidakamizwa. Ezinye izidakamizwa zokucindezeleka zihlukumeza kakhulu imiphumela ye-tamoxifen, futhi kucatshangwa ukuthi lokhu kusebenzisana yisisusa sokwanda kwezinga lokufa kwabesifazane abanomdlavuza wesifuba owathatha uPaxil. Njengamanje, inketho ephephile kakhulu kokubili ukushisa okushisayo nokucindezeleka kubonakala sengathi i-Effexor, kodwa kubalulekile ukuqaphela ukuthi le ndawo esebenzayo noma ucwaningo, futhi singafunda kabanzi esikhathini esizayo esiseduze. Njengoba u-cohosh omnyama unedumela lokusiza ngokushisa okushisayo okuhlobene nokuphathwa komdlavuza wesifuba, kodwa kungase kuhlangane ne-tamoxifen, kubalulekile ukukhuluma ne-oncologist yakho nganoma yimiphi imithi, ukulungiselela ukulungisa, noma ukuphakela kokudla okucatshangelwayo.
> Imithombo:
> Haque, R., Shi, J., Schottinger, J. et al. I-Tamoxifen ne-Antidepressant Ukusebenzisana Kwezidakamizwa Enkampanini ye-16 887 Abasinda Ngomdlavuza Webele. Journal of the National Cancer Institute . 2015. 108 (3): djv337.
> Juurlink, D. Ukubukeza ukusebenzisana kwezidakamizwa phakathi kwama-Anti-depressants we-Tamoxifen ne-SSRI. I-British Medical Journal . 2016. 354: i5309.
> Li, J., Godecke, T., Chen, S. et al. Ukungeneka kwe-Vitro Metabolic Phakathi KwabeNtsundu Cohosh (Cimicifuga Racemosa) noTamoxifen Nge-Inhibition yama-Cytochromes P450 2D6 no-3A4. Xenobiotica . 2011 Aug 9. (Epub ngaphambi kokuphrinta).