Yawancin magungunan magunguna suna shafe magungunan ƙwayar cutar ta Estrogen na Hormone Far
Tamoxifen wani magani ne na kwayar cutar hormone da yawancin mata masu auren mata suka dauka bayan sun gama maganin su na farko don ciwon ciwon ƙirjin nono na ciwon estrogen. Don kula da illa masu tasiri na tamoxifen (kamar walƙiya mai zafi) da kuma taimakawa tare da damuwa, likitoci sukan rubuta rubutun antidepressants. Amma duk da haka mutane da yawa masu amfani da antidepressants zasu iya tsoma baki, ko warwarewa, amfanin amfanin tamoxifen.
Menene ya kamata kowa ya dauki tamoxifen san?
Tamoxifen yana amfani da cutar nono
Da zarar mace ta gama da maganin ciwon nono, tare da hanyoyin kwantar da hankali irin su tiyata , chemotherapy , da radiation far , tana iya buƙatar ɗaukar tamoxifen. Ga matan da ke dauke da ciwon sukarin mai ciwon estrogen receptors, maganin hormone zai iya rage hadarin ciwon daji na dawo (komawa) ta hanyar kimanin kashi 50.
Zaɓin magani ya dogara da matsayin mazaopausal. Idan mace ta kasance mai tsauraran zuciya, tamoxifen shine yawan miyagun ƙwayoyi na zabi. (Ga wadanda ke da 'yan jarida, ko kuma wadanda suka kasance masu tsauraran matakai amma sun sami maganin kutsawa na ovarian, ana amfani dashi mai amfani da aromatase a maimakon haka).
Kwayoyin ciwon daji na masu ciwon daji wanda ke da karfin kwarjin jijiyar estrogen ne masu ciwon estrogen. Estrogen gabatar a cikin jiki (wanda ovaries ya sanya) ya ɗaura ga kwayoyin cutar ciwon daji don haifar da ci gaba. Tamoxifen yana aiki ne ta hanyar daura ga masu karɓa don kada estrogen ba zai iya ba, da gaske yana fama da ciwon daji na abinci.
Hanyoyi masu tasiri na tamoxifen sun hada da menopausal-type bayyanar cututtuka irin su walƙiya mai zafi, low libido, da kuma busassun bushewa. Ga matan da ba su kai ga mazauni ba, zafi mai zafi zai iya zama mummunan hali, amma mun koyi a cikin 'yan shekarun nan cewa wasu magungunan antidepressant zasu iya rage waɗannan walƙiya.
Abin takaici, wasu daga cikin wadannan antidepressants kuma iya rage tasirin tamoxifen.
Ciwon daji da damuwa
Ba abin mamaki bane, yawancin matan da aka magance su don ciwon nono na ciwo ciki. Haɗuwa da ganewar kwayar cutar, sakamakon illa na jiyya, da canje-canje ga siffar jikin da ke tafiya tare da magani duk saita mataki don babban tasiri. Abin takaici, bayan da aka kula da yawancin matan da ke fama da ciwon nono (kusan a wasu wurare) tare da antidepressants, an gano cewa da dama antidepressants iya rage sakamako na tamoxifen. Yaya wannan yake faruwa?
Tamoxifen da Drug Interactions
Tamoxifen da hulɗar miyagun ƙwayoyi suna da mahimmanci, kuma wannan ya hada da magungunan da yawa da suka hada da antidepressants. Tun da yawa daga cikin wadannan ana amfani da kwayoyi, ciki har da magungunan kwayoyi irin su Benadryl, yana da mahimmanci don yin magana da likita da likita game da kowace magani, rigakafin kan-da-counter, ko karin abincin da kake dashi, yayin da kake a kan miyagun ƙwayoyi. Tun da mutane da yawa suna daukar tamoxifen na tsawon shekaru 5 zuwa 10, wannan ya fi mahimmanci. Ka tuna cewa duk likitoci ba su da masaniya game da waɗannan hulɗar (kuma muna koyon ƙarin duk lokacin).
Abin da ake nufi shine idan idan ya kamata ku je kulawa gaggawa, alal misali, tare da kamuwa da cuta, magana da likitanku ko likitan magunguna kafin shan duk magunguna da aka tsara.
Tamoxifen yana cike da jiki a cikin jiki don ƙarewa. Endoxifen yana da sau 30 zuwa 100 sau da yawa fiye da tamoxifen, kuma yana da alhakin mafi yawan magunguna. Tamoxifen ya rushe don ragewa ta CYP2D6 enzyme cytochrome P450 (da sauran wadanda basu da muhimmanci). Duk wani kwayoyi wanda ya rage aikin CYP2D6 (kuma akwai da yawa) zai iya rage wannan tsari da sabili da haka, adadin endoxifen da aka samar.
Tamoxifen da Antidepressants: Abubuwan hulɗar
Har yanzu muna koyon ƙarin game da magungunan antidepressants da kuma tasirin su akan matakan tamoxifen a cikin jiki, amma har yanzu mun lura cewa daban-daban antidepressants na iya tasiri tamoxifen a hanyoyi daban-daban. Wasu antidepressants (irin su Prozac da Paxil) sun kusan ƙaranci sakamako na tamoxifen. A wannan yanayin, zai zama kamar ba shan tamoxifen ba (kuma ba tare da amfani da ragewa a hadarin komawa).
Tare da wasu antidepressants akwai hulɗar matsakaici, kuma tare da wasu, kawai haɗin hulɗa. Ya bambanta, ɗayan abincin abincin da zai ci gaba zai haifar da tasirin tamoxifen (da kuma sakamakon illa), kodayake wasu binciken sun nuna akasin haka.
Da ke ƙasa akwai teburin da ke taƙaita abin da muka gaskata gaskiya ne game da magungunan antidepressants a yau. Wannan wani yanki ne na binciken bincike, kuma yana iya yiwuwa mu kara koyo a nan gaba. Idan kuna la'akari da maganin maganin antidepressant, kuyi tattaunawa da likitanku sosai, amma ku yi tambaya akai-akai idan wani abu ya canza.
Magunguna da kuma yadda suke hulda da Tamoxifen
| Drug antidepressant | Haɗi tare da Tamoxifen | Tsaron Tsaro |
Paxil (paroxetine) Prozac (fluoxetine) | Ya hana amfanin amfanin antiestrogen | Ka guji amfani |
Cymbalta (Duloxetine) Wellbutrin (bupropion) Zoloft (sertraline) | Tsarin kutsawa tare da amfani da antiestrogen Lura: Nazarin ya tabbatar da cewa Zoloft ya shafe tare da Tamoxifen. | Ƙara Hadarin |
| Saint John's Wort (hypericum) | Ƙuntataccen haɓakar amfani da antiestrogen | Ƙarin Haɗari |
Hanyar (Citalopram) Lexapro (escitalopram) Pristiq (desvenlafaxine) Remeron (mirtazapine) | M dangantaka Lura: Pristiq da Remeron ba a yi nazari sosai don hulɗar da Tamoxifen ba. | Rashin Halin |
| Black Cohosh (Shari'ar) | Zai iya hana ko inganta haɓakar antigenrogen dangane da binciken. Lura: Akwai ƙananan bincike don hulɗa tare da Tamoxifen, kuma mafi yawancin an yi "in vitro" (a cikin lab kuma ba cikin mutane ba). | Rashin Halin |
Mafarki (venlafaxine) | Kusan babu dangantaka da Tamoxifen | Mafi zabi |
Ƙashin Riga a kan Tamoxifen da Antidepressants
Sanin game da hulɗar dake tsakanin tamoxifen da antidepressants yana da mahimmanci idan kuna la'akari da waɗannan kwayoyi. Wasu magungunan antidodin karfi sun shafe sakamakon cutar tamoxifen, kuma ana tsammanin wannan hulɗar shine dalilin da yasa yawan yawan mata da ciwon nono suka karu da suka dauki Paxil. A halin yanzu, samfurin safest duka biyu don walƙiya mai zafi da rashin ciki ya bayyana Effexor, amma kuma yana da mahimmanci a lura cewa wannan yanki ne ko kuma bincike, kuma za mu iya koyon ƙarin abubuwa a nan gaba. Tun lokacin da cohosh baƙar fata yana da ladabi na taimakawa tare da walƙiya mai zafi da aka danganta da magani na nono, amma yana iya yin hulɗa tare da tamoxifen, yana da mahimmanci don yin magana da likitan ilimin likitancinka game da duk wani maganin maganin magani, rigakafin kan-da-counter, ko karin abincin da kake tunani.
> Sources:
> Haque, R., Shi, J., Schottinger, J. et al. Tamoxifen da Antidepressant Drug Interaction a cikin wani Cohort of 16,887 Waɗanda ke tsira daga cutar kankara. Journal of the National Cancer Institute . 2015. 108 (3): djv337.
> Juurlink, D. Sauke Harkokin Drug tsakanin Tamoxifen da SSRI Antidepressants. British Medical Journal . 2016. 354: i5309.
> Li, J., Godecke, T., Chen, S. et al. A cikin Vitro Metabolic Interactions tsakanin Tsarin Black Cohosh (Cimicifuga Racemosa) da Tamoxifen ta hanyar Tsarin Tsarin Cytochromes P450 2D6 da 3A4. Xenobiotica . 2011 Aug 9. (Epub gaba da bugu).