Stopping Tamox and starting AI plus OS- how to do it?

elleredux

Hi everyone,

A recent D & C due to uterine issues caused by tamoxifen plus the recent data out of the SOFT and TEXT trials has my MO recommending the switch.

He sent a script for Aromasin to my pharmacy, and the nurse will be calling me next week to schedule my first injection for OS. He didn't really give me any specific instructions for changing medications, and I am wondering what is typical. Do people take a break between tamoxifen and AI's?  Should I have the shot before switching? My bloodwork in June indicated menopausal, but my MO is concerned that I still may be having spikes of estrogen, hence the recommendation for the shots to suppress ovaries. When I started tamoxifen, I did it slowly, breaking the pill in half and taking that for about a week before going up to the full dose. I'd like to do that with the Aromasin unless there is a reason not to.

Golden01

My experience probably doesn't apply as I am post-menopausal. I just switched from Tamoxifen to an AI (which was the plan, 2.5 years onTamoxifen and then 2.5+ years on an AI). My MO had me take a week off between stopping the Tamoxifen and starting the AI. Saw him yesterday, after a month on the AI, with no significant problems. Recovering from a hystersocopy/D&C due to problems with Tamoxifen. 

exbrnxgrl

these sound like great questions to ask your mo. Give the office a call!

songbird68

11momto3 Sorry to hear you have uterine issues. I hope you recover quickly.

I can't help about the break between switching from tamox to AI as I haven't done that yet. I'll be doing that next month. I'll check back here to see what you did:)

It makes sense to me that you would have the shot before switching, because tamox is suitable for both pre and post menopausal women, whereas the AI's are only for post meno women - probably what you have been thinking?

But I don't know what your MO will say. Hopefully you can start slowly with it

x x

TwoHobbies

I am also on ovarian suppression.  I was told I should start the AI the day after the shot and I started on the full dose. You don't want to be on an AI unless you are menopausal or your ovaries are suppressed.  I wouldn't take anything unless you talk to the nurse and she says go ahead.  .

elleredux

Thanks for the responses!

I am planning on giving the doctor's office a call on Monday, but was just wondering what was typical. I hadn't really expected the switch of meds to take place until after my first OS shot, but the pharmacy called to let me know the Aromasin was ready to be picked up. Didn't realize the doctor had already sent it over!

voraciousreader

11mom...I started o/s before I started Tamoxifen.  This was my time frame...Surgery, O/S, radiation, Tamoxifen.  When I stopped the O/S following 2 years of O/S and Tamoxifen, the doctor did blood work to see if I was in menopause.  Once that was established, I stopped the Tamoxifen.  The oncologist then told me to wait 3 weeks before starting the letrozole.  He said it would take several weeks to get the Tamoxifen out of my system and he wanted to begin the aromatase inhibitor "fresh."

voraciousreader

btw... Doctors and pharmacies are now electronic.  All the doctor has to do is key in the prescription and press "send" and it is instantly at your pharmacy.  Recall that when you filled out your paperwork, you were asked which pharmacy you use.

elleredux

thanks voraciousreader, now that you mention it I do remember reading something about stopping tamoxifen for a while prior to starting AI's. I had bloodwork which indicated menopause in June, but last week started bleeding profusely and needed a D & C. Gyno thought it was "just" tamoxifen related due to uterine lining thickening and small polyps. MO wonders if may have had estrogen spike which could possibly mean it was a period. So since I'm not sure what's going on with my menopausal status I am going to wait until after my OS shot to start the Aromasin. That will give my body a little time to get rid of the tamoxifen anyway.

elleredux

Just in case anyone is following the topic I thought I'd post an update. 

I called the doctors office and the nurse called me back saying that I'm supposed to stay on the tamoxifen for 3 months after starting the Zolodex. Something about seeing if I tolerate Zoledex before switching me to Aromasin. Not sure why my MO sent the rx for Aromasin to my pharmacy though.  It sure sounded at the appointment like he was switching me now. The nurse said she'd double check with Dr and call me back. I guess there is no "typical" way to do the switch.

elleredux

Ok, scratch that! The nurse called back today.  The doctor did want me starting Aromasin right away. Getting first Zoladex shot next week. Keeping my fingers crossed for no bad side effects!!

voraciousreader

hmmmm.....I guess there are all kinds of philosophies and protocols....