As promised, here’s a comprehensive list of drugs and supplements that readers use to help battle peripheral neuropathy (PN) symptoms:
Acetyl L-carnitine – Important amino acid that might help. It has the added benefit of being credited with helping improve memory in Alzheimer’s patients–those of us with chemo brain can use all the help we can get!
Acupuncture – Patients that have tried acupuncture swear by it. Can help minimize numbness, pain and tingling caused by PN. Results may vary based on skill of the acupuncturist. Not always covered by insurance, so can be expensive.
Alpha Lipoic Acid (ALA) – Base amino acid; first choice of many myeloma specialists to help combat PN. Controversial because myeloma cells gobble the stuff up in lab tests. Can really help if taken in large enough doses; may be best if you take several grams a day.
Amit (2%), keta (0.5%) and lido (2%) – Some patients swear by this topical treatment, applying the ointment before bed. Popular with Mayo Clinic specialists.
Cocoa butter – Many patients swear by it. Biggest issue may be finding someone to apply it!
Cybalta or Lyrica – The two most commonly prescribed medications to help control PN pain.
Evening primrose oil – Mayo Clinic suggests trying it on their website.
Exercise – Many patients (including me) report that PN symptoms are less severe during exercise. Whether its improved circulation or the distraction, exercise works like magic for some. Benefits can also be cumulative. In the long run, moving helps.
Fentanyl patches – Time release pain medication sometimes prescribed to combat painful PN.
Gabapentin (Neurontin). Primarily an anti-epileptic drug, gabapentin is also used to treat nerve pain. Most commonly prescribed drug to help minimize numbness and tingling caused by PN.
Heat Shock 90 Inhibitors – Dr. Ken Anderson, a well known multiple myeloma expert from Boston, suggests that if you add a heat shock 90 inhibitor (HSP90) you can decrease neuropathy and enhance the efficacy of Velcade. I don’t know much about this. Check with your myeloma specialist about it.
ICE – As with any injury or inflammation, icing an area often helps. Some myeloma specialists even propose that Velcade has PN impact to an effected area if you ice it while receiving treatment. Not clear how that would be done sub-q; guess you’d start icing 15 minutes before and continue 10 or 15 minutes after. Worth a try.
Kataline and Amitriptyline – can be effective numbing painful neuropathy when applied to the feet after soaking them in warm water. Requires a prescription.
Lidoderm Patches – As anyone with peripheral neuropathy will tell you, PN gets worse at night. Placing Lidoderm patches on the bottom of your feet may help.
Magnesium – Magnesium can be taken orally or rubbed on the skin of affected areas. Several brands of magnesium oil are available for topical use. A half dozen patients I know rave about magnesium oil. They massage the oil on their legs when they get up in the morning and before bed. I take a lot of magnesium; as much as 500 mg in the am and again at night. It has the added benefit of helping keep me regular, despite taking low doses of oxycodone daily. You’ll know if you’re taking too much; the diarrhea will stop as soon as you reduce the dose.
Medrol (methylprednisolone) – Medrol is a synthetic (man-made) corticosteroid that may help reduce inflammation of the nerve linings. Come to think about it, I have less PN symptoms on dex days.
MetaNX – An extra strength prescription vitamin B supplement.
Neuragen – You can use it as often as four times a day. Available at Walgreens.
Nortriptline – Given in small doses; another prescription option.
Omega 3 supplements – Fish oil and other omega 3 supplements are worth a try.
Oxycodone – Oxy is used in different ways (sometimes time release) to help dull PN pain.
Therapeutic massage – Not only does it feel good at the time, regular sessions may help improve circulation and reduce numbness.
Vitamin B – Can be taken orally, although Vitamin B12 injections may make more dramatic difference.
Vitamin’s C (folic acid) and E – Helpful if a patient doesn’t get enough of these vitamins in their diet. Many topical creams include Vitamin E. As with alpha lipoic acid (ALA), be careful taking too much Vitamin C on Velcade infusion days.
Did I miss some? The great thing about blogging; I can add more with a few clicks of my keyboard. I’ll tackle another worrisome side effect of multiple myeloma therapy–cramping–later this week.
Feel good and keep smiling! Pat