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Heartburn is a typical side effect of chemotherapy medicines used to treat leukemia–but before you reach for antacids like you may have in the past, know that your cancer changes things. Antacids may affect how your leukemia treatment works. The relief you get from them may also mask heartburn as a warning sign of cancer in the gastrointestinal tract. If you experience heartburn, tell your doctor so it can be treated safely.
Antacids during leukemia treatment may affect cancer medicines.
The esophagus moves the food you eat into your stomach, where it’s broken down by stomach acids. Sometimes, these acids travel backward into the esophagus causing heartburn, also known as indigestion or acid reflux. The main symptom of heartburn is a burning feeling in your throat or chest. Antacids neutralize the acid to ease discomfort, but they can also cause unintended reactions with chemotherapy drugs in your system.
Dasatinib (Sprycel) is one type of oral targeted therapy called a tyrosine kinase inhibitor (TKI), and it’s affected by antacids. Studies show taking antacids while on this therapy can make your body absorb much less than the intended dose, so antacids are usually discouraged.
Imatinib (Gleevec) is another type of oral chemotherapy that can cause heartburn, but research has shown antacids don’t affect how the body absorbs it.
Relief from antacids may mask serious gastrointestinal issues.
Leukemia affects the gastrointestinal tract of up to 25% of people with leukemia. It can cause:
- Hard masses to form in the stomach
- Swelling of the spleen, liver or intestines
- Ulcers in the intestines
Symptoms of these conditions can feel the same as ordinary heartburn, but they need to be treated differently. Your doctor can do a thorough assessment.
Understanding antacid recall and alternatives
The U.S. Food and Drug Administration (FDA) issued a recall of the antacid ranitidine (Zantac) in April 2020 because it contained a chemical that may cause cancer. It’s a reminder that over-the-counter doesn’t necessarily mean totally safe, especially if you have a serious condition like leukemia.
There are a couple of other alternatives to acid-neutralizing medications that work at the cellular level:
- H2 blockers like famotidine (Pepcid) and cimetidine (Tagamet) prevent the production of acid in the stomach in the first place
- Proton-pump inhibitors (PPIs), including lansoprazole (Prevacid) and omeprazole (Prilosec) prevent the gastric proton pump from producing acid
Every medicine, prescription or non-prescription, comes with benefits and risks. Weigh them with your doctor to find the best heartburn solution for your situation.
