You are here

Beefeater 24 gin

Categories:

Hi everyone

I have been on imatinib 400mg since May and seem to be doing well without too many side effects.  Muscle cramps are controlled with tonic water and calcium/magnesium supplements.  Recently, a well-meaning friend who knows my regular tonic water intake gave me some Beefeater 24 gin to have with my tonic water.

I don't drink much alcohol but have started again, in moderation, once I reached my MMR, with no adverse events.  However, after having some of this Beefeater 24 gin, I was hit quite hard:  felt extremely ill and exhausted, with a weird kind of malaise that I could not explain.  This has not happened with any other alcohol consumption.

Then I saw that it contains various special ingredients:

"The 12 ingredients used are Japanese Sencha Tea, Chinese green tea and then Seville orange peel, grapefruit peel, lemon peel, juniper, coriander seed, liquorice, angelica root, almond and orris root. It is called Beefeater 24 because the botanicals are steeped in the spirit for a full 24 hours."

I wonder whether these quantities of Seville orange and grapefruit peel could be responsible for how I have been feeling recently?  And most of all, I sincerely hope that I haven't caused any negative effects to my response (next PCR test in December) after consuming this gin.  Although, I'm guessing grapefruit allows us to absorb more of the imatinib, right?  So if anything, my response might be better? (I'm hoping that this is the case and that trace elements of grapefruit peel could be used for a better response... imagine this were true?)

Just mentioning this as a warning: check the ingredients on all products, no matter how unlikely they are to contain grapefruit!

Best wishes

Martin

 

Hi Martin,

I found your post thought provoking and having just had a disturbed night with cramp as a side effect from imatinib would like to add a few comments Over the 12 years that I have been on Glivec I have tried tonic water,regular hydrating and regular liquid intakes plus daily stretching exercises but there is no universal solution I have found.I must admit that the addition of a little gin to the tonic improves the taste.On a more serious note there is a debate about just how much alcohol we should take both in general and also as patients undergoing targeted biological therapy ;I have found that some alcoholic drinks such as wine tend to be dehydrating and this can exaggerate the likelihood of cramps arising.

I googled "imatinib and grapefruit juice" and it seems to be well documented that grapefruit juice does modify the effect of tki s;I came across an academic article that was titled "Can grapefruit juice decrease the cost of imatinib for the treatment of CML" and there was a media article in the Daily Mail back in 2012 suggesting that grapefruit juice can give cancer drugs a dramatic boost in effectiveness.I have come across the CML-IQ site which I believe is based in Canada and they in their newsletters have run some articles  on-"The grapefruit effect :all you need to know".This latter reference goes in to some detail and it seems that grapefruit juice keeps some of the vital ingredients of imatinib circulating around in the body for longer and hence multiplies the effect of the drug.Apparently the so called half life of imatinib and of some of its components is quite long so if we maintain regular daily doses we are never without it within our organs.Dasatinib has a shorter half life it is reported.

Over the years there has been speculation regarding whether the dose of imatinib might be increased to 600,800 or 1000 mg daily especially to counteract any resistance or to encourage a more rapid/deeper response.I believe that I have read that some trials were held in Australia to test the extent to which patients might tolerate enhanced doses.As we know some find 400mg difficult to tolerate and 600 is a big challenge;apparently very few medium to long term are able to tolerate 800mg because of high grade side effects and 1000mg seemed to be quite toxic.

I did read a comment from practice notes/blog from Professor Jane Apperley of Hammersmith who commented that some in retrospect thought that a daily dose of 400mg imatinib was a little underpowered.Subsequent tki s are of course are  well known to be a little more powerful hence for some the side effect profile is more challenging.

So in conclusion I suggest that something in the gin that you enjoyed interacted with imatinib so as to make it more potent but to enhance side effects.Overall it seems that we as CML patients need to monitor very closely other drugs that we ourselves use and in some cases foods and supplements.

I wish you well

John

 

Hi John

Thank you so much for your extremely detailed reply to my post!  I so appreciate the time and trouble you have taken to reply to me - I have been able to locate every article you mentioned and all this confirms what I suspected: the gin interacted with the imatinib to make me feel terrible, but possibly resulted in a better response!  This is all very interesting and I will report back when I have my next PCR test.

All the best to you!

Best wishes

Martin