Femara vs Arimidex vs Aromasin -What is for Who?

ktmimi2

I was wondering if anybody's Onc. has told you why you are specifically taking Femara over Arimidex? Is Femara for the lowest stage of BC? For example: I am taking Femara. I have ER+, Stage 1, Non Lymphoma BC. My Onco score was 18. My tumer was a 2cm lump. I didn't think to ask my Onc why Femara vs Arimidex. Seems like most women are taking Arimidex. I will ask my Onc but I would love to hear what you ladies have to say. So far (12 days) I have no SE. I read that Femera was for Advanced Early Stage BC ER+.......Advanced being the key word concerned me. What is your take? Thanks!!!

my3girls

I did not take Femera Ktmimi2.  I did however take Arimidex and Aromasin. I was on tamoxifin for a year, and then had a hysterctomy, so she switched me to the Arimidex.  I had a difficult time with it. I was on it though for over 6 months. I couldn't take the pain and tiredness etc. It never got better for me. She tried the Aromasin...and withing 2 weeks.....I was so tired, it was hard to come to work everyday. I told her, I can't do these AI's. I had my ovaries removed, so I thought, just put me back on the tamox. It still blocks the estrogen. She mentioned Femera as a last try for an AI, and I said no. she never said one was stronger than the other.  They are all fairly new drugs, compared to tamoxifin.  I have been back on the tamoxifin for 5 months......and I feel like my old self again. Well...old as in not pre-bc. haha. I hope that you can tolerate the Femera, and I would just call my oc and ask her about the difference between all 3 AI's. 

All the best to you.

1rarebird

I haven't started my hormonal therapy yet, but when I last discussed it with my oncologist he said that he would likely want me to take Arimidex. When I ask why that A/I and not one of the the other 2, he replied that it was mainly because "he" had the most experience with it because it had been approved and used longer and he had helped with the ATAC trials that of course were looking at Arimidex vs tamoxifen.  These were not the reasons I was looking for, rather I would like to hear why one is better than the the other. 

I guess the take home message for me on this is that if you want to know something, doing the research on your own is sometimes the best way to get an answer. But I still don't know which A/I is best for me.

bird

karen1956

ftmimi2.....I think what AI your onc Rx dpends on his/her preferance....I think the thinking today is that if you are post-menopausal go AI's instead of tamox, but my onc says that tamox is still a very good drug.  He started me on Arimidex.....I've tried all 3 plus tamox.....My sequence was Arimidex, Femara, tamox and Aromasin....a little different than my3 girls.....I really think Bird hit it on the head......the oncs Rx what they know best and I think often, Arimidex is often the first choice.  I don't think there is a best, just what is best for one particular patient.....I had much worse joint pain on the Arimidex, but other side effects are worse on the Aromasin....and oh my, the tamox caused such GI problems!!! and then remember some gals have no problems at all.  Hugs....Karen

otter

I started on Arimidex 18 months ago, right after finishing chemo.  At that time, my med onco said there really wasn't much difference in the 3 AI's -- one worked pretty much the same as another.  Her words were, "So far, it looks like they're pretty much interchangeable."   She said she liked to start women on Arimidex, because it had been on the market the longest and oncos knew more about it.  (She asked me if that choice was okay with me.)  Then she added that, if Arimidex didn't agree with me (if the SE's were intolerable), switching to Femara or Aromasin might help. That was because, even though their mechanisms of action (suppression of estradiol synthesis) were the same, the SE's of the 3 drugs could sometimes be different in the same person.

At about that same time, I had been reading some papers that said Femara was slightly better than Arimidex at suppressing estradiol production.  But, my onco said nobody really knew (yet) if there was a difference between Arimidex and Femara as far as clinical effectiveness.  She said that was the goal of the "FACE" clinical trial, which was comparing Femara and Arimidex in women with BC.  She said everybody was eager to see the results, which wouldn't be ready for several years.

So, I'm still taking Arimidex, assuming that the results of the FACE trial will be out by the time I need to make a decision at my 5-year point.

otter 

Harley44

I started on Tamoxifen for 2 years, and my onc's plan was for  me to switch to an AI after 2 years.  So, now I'm taking Femara, as I asked my onc if I could try it, and as far as I know, there is no difference in the AIs, except that the Femara and Arimidex work in the same way, but Aromasin works slightly differently, and I'm not sure exactly how...  Also, I've read that Femara works slightly better than Arimidex at helping prevent recurrence.  This is just based on what they know so far.  I've only been taking Femara for 1 week.

Otter,

Are you thinking of continuing an AI AFTER you reach your 5 year mark??   I thought the drs. were telling us to still only take the hormonals for 5 years, and nothing more.  Although, my onc told me that we could continue taking them indefinitely.  When I questioned him about it, he said that they don't really know...  the story of my life! 

Hugs

Harley

NatsFan

My onc liked Femara as he said in his experience it had the fewest s/es, so he wanted to start me on that, and switch to another only if the s/es got too bad.

But as everyone else has said, it seems that each onc has his or her own preference.  And it does seem that so far they're pretty interchangeable as far as effectiveness - it's just which one gives the fewest s/e to the patient.

ktmimi2

Hello BC Girlfriends,

I haven't been checking my posts for quite awhile. I started taking Femara per my Onc and all was going great. I didn't have any side effects....short of taking it for one month. My Onc gave me one month free while they got approval from my lovely Insurance Co. (Blue Shield PPO) I got a call about the third week into taking Femara from my Onc's office saying that Blue Shield would not approve the Femara,  but they would approve Arimidex. They called in the prescription and  started taking it in November. Around three weeks into it I had NO appetite (not such a bad thing) nausea and the pain in my neck was not fun. Then the pain started in my legs where I had sleepless nights so I started popping 1/2 of a vicodin just to sleep. I had an appointment schedule with my Onc in early Dec. which got canceled and rescheduled to Jan, 2010. I just dealt with it thinking that my body would adjust...um, not so much. So January comes and I am bitching to my Onc about the Arimidex and the side effects I was having and he wondered why I was taking the Arimidex and not the prescribed Femara. I told him the Insurance would not approve the Femara and I thought he would come unglued. His staff didn't tell him about the denial. He told me to go home and throw out the Arimidex and he WOULD get approval for the Femara. He gave me two months of Femara free while he took matters into his own hands. He GOT approval.....big surprise. He was definitely on a mission for me, however, I have been taking my Femara for about three weeks and the bone pain is worse. Does anyone have this? Do you think that my body is readjusting again? It is tuff to deal with at night. Wine helps a little...just kidding. Thanks for writing to me. I love this website and that us sisters can talk to one another. It helps so much. Any feedback on side effects, please let me know. Happy New Year all! Looking forward to a much healthier year with clean scans and tests after one year diagnosed.

wallycat

Last time I was in, I suggested we switch to an AI from tamoxifen...we are still hoping I am menopausal and that tamoxifen isn't masking no periods for 2 years.

I asked for samples and he suggested any of them.  I insisted on Arimidex.  That is what he gave me.  I think he considered any of them equal.

mimi1964

Hi I'm new on this thread, but my med onc told me the first time (and only time I have seen him so far) in Nov of last year that he was going to start me on Femara when I go back to see him on Feb. 23rd this month.  He waited till after I finished up rads and it's been 2 wks.  He really didn't speicify why he was choosing that specific AI, I guess like many of you have said, it's his preference?  I'm not sure.  I assume he is wanting to prescribe an AI because I am menopausal.  I am 45 and had a total hysterectomy almost 8 yrs ago that included removal of my ovaries.  I suffered through some terrible and I do mean terrible hot flashes this past summer before I was diagnosed with BC.  I have had them off and on for yrs but the last yr was the worst.  Since I've had my surgery I've not really had any, but they have gradually started again, but they are mild and I only occassionally have them.  I already have terrible vaginal atrophy and my gyn was about to restart me on HRT because of it when I was dx with BC (I had stopped taking HRT about 4 yrs ago against his wishes).  So I am definitely on the fence about taking any of these drugs.  How are you ladies doing with the meds?  I had actually thought of asking the onco to give me Tamox instead of an AI.  What do ya'll think?

Renee

ruthbru

Al's have a better non-reoccurance rate than Tamox; plus usually less SE (although that is not true for everyone. I'm on Armidex (just because that's the one my onc. has the most experience with), no problem with SE.

7timewinner

I was taking Arimidex for a little over 4 months...had joint pain that was always present but tolerable, and exercise helped alot. Recently, however, I began to have VERY severe mood swings, so my onc  told me to stop the Arimidex for a month to see if that was causing the problem. Indeed, just one week off, and I felt much more like my old self again.

I will soon try the Femara...and hoping that the SEs are gentler.

Nadine

trigeek

I am on Femara too(almost a year now), the side effects to get better with fish oil, cosamine supplements and activity. Remaining problems I am tackling are weight gain and insomnia.

After 5 years of AI I really do not feel comfortable how should I say flying solo.. why don't they prescribe us tamox after 5 years of AI.. ? Just curious.

suz54

i am wondering the same thing. it's costing me a lot on femara and i am willing to switch brands (or formula) to make it more affordable for me….if it works just the same.

Kicks

When this thread was started in Feb 2010, Femara was not available in the generic form -letrozole - and it was VERY expensive.

Mousero3

My friend is on a program with Novartis that makes her Femara free for one yr. She was not sure if is is renewed at the end of the yr or not.

cndble

When I asked my MO why she chose Letrozole over the others she said, "I find it works better for our 'overweight' patients." My boyfriend and I just laughed. Chemo (or should I say the steroids given with chemo) packed on 20 pounds, so yes, now I am considered overweight!

jeannemg

I am meeting with my MO on 12/5 to discuss hormone therapy. What are some good questions to ask to make sure I am covering all of my bases. Very nervous of what mediacation she will recommend.

Thanks for any input.

Jeanne

dtad

cndble...I'm so sorry you were treated that way by your MO. Its so insensitive. They prescribe these powerful drugs that make it very difficult to lose weight and exercise. To blame you is simply not fair!

marc85

Both femera and aromasin demonstrate an increased aptitude for crossing the blood-brain barrier, making them capable of adversely affecting neurosteroid balance to a greater degree than anastrozole. Along with enhanced blood-brain permeability, letrozole also suffers from a reduced clearance rate, allowing concentrations within the brain to climb even higher. While exemestane clears more quickly, its permanent deactivation of aromatase makes it equally problematic in this regard, as the body must first produce additional aromatase before proper neurosteroid balance can be restored.

Due to its greater specificity of action (less apt to interfere with non-target tissues), anastrozole has the clear advantage in this area. It does not penetrate the blood brain barrier as readily, making it much less likely to cause side effects such as sexual dysfunction, libido issues, or depression. "

In my opinion anastrozole is better for that reason. Side effects are minimal, due to most guys only taking low doses of anastrozole.

pillcomparer.com

Taco1946

My MO switched me to fermera after 8 months on arimidex. I was getting bad headaches and she thought it was worth a try on a different AI. She has said from the beginning that she will work with me to find the one that has the fewest SE which leads me to believe that she feels there isn't much difference in effectiveness. So far, so good.

Yself

I recently had a second breast cancer after 12 years. I had chemo (adrimycin and neulasta for white blood count) which could account for the second cancer and the congestive heart failure I have now.. I was on tamoxifin until I had a blood clot 8 days before my five years were up.I was not put on another estrogen blocker. My new onc (former one retired) did not want me to take radiation because of my age (82) and my heart problems. I was so stunned, I did not tell him my heart doctor had already given me the OK to have radiation. He insists I take femara in spite of the fact I have arthritis and back pain. Radiology doctor has no problem giving me radiation. Oncologist says femara is the best..

Has anyone had another breast cancer after taking any of these meds?