Femara, Blood Calcium, Bones

Hello lightandwind

My blood calcium kept rising on the femara.  During chemo, my calcium was always in the mid 9's.  After starting femara , every three months they would rise just a little, until this august , I was at a 10.3.  I was taking lots of vitamin d3- 4000 iu etc.  My onc advised me to stop taking the d3 and we retested.  It came down to 10.  Then in September, I switched to Arimidex.  It rose again to 10.2 - still in the normal range.  I do have joint pain not as bad on arimidex as on femara.  I just recently had a ct scan and no bone mets or areas of concern.  So we chalk it all up to arthritis ..

I do get zometa, a bisphosphonate every 6 months.   After my last infusion October 22nd, my calcium is a 9.6.   I take zometa to hopefully prevent bone mets.  The side effects a couple of days after are pretty nasty for me.  Nausea, really really sleepy and I did have a decently high fever last time that lasted over a day.  However, its only every 6 months.  

I am sure others who take bisphos monthly can weigh in and tell their experience/  I do stress about my calcium levels and my liver panel as well. I can certainly relate

There are several clinical trials in phase 3 , that propose that taking zometa every 6 months for 2 or 3 years can prevent bone mets.   Some of the early data from these trials were flip flopped between promising and not so promising.   The latest info I saw back in december 2011 , it looked more promising.  My Onc feels pretty decent about the possibility that it could help.

Yes, osteonecrosis of the jaw is the one big bad side effect that occurs rarely in folks.  But it is a very bad side effect.  The other short lived side effects , that I get, sick, tired, fever, etc.. go away after a few days..

I'll share my story in hopes that any of you with high calcium make sure you don't have hyperparathyroidism, and just blame Femara for raising your blood calcium levels. I was on femara for 10 years, from 2006 to 2016. I was diagnosed with osteoporosis in 2016. I reviewed my bloodwork and my calcium was in the low 10's consistently from 2011 to 2018. It wasn't until it was 10.7 in January 2018 that my endo who treats my osteoporosis suggested to do a PTH (parathyroid hormone level) blood test to rule out hyperparathyroidism. Bone mets was never suspected because with bone mets your calcium is usually above 11 and you usually know you have bone mets when it starts affecting your calcium level. My PTH level came back high and I was diagnosed with hyperparathyroidism. I was referred to a surgeon and had surgery in May 2018, where they removed one enlarged parathyroid gland. Since then my calcium is in the mid 9's. One thing I learned during this time is that it is not normal for an adult over the age of 35 to have blood calcium levels in the 10's and that high calcium over many years can cause all sorts of problems in your body, including heart disease, and definately osteoporosis. I thought my bone loss was from taking Femara for 10 years but now my doctors think it was from hyperparathyroidism. I have also been taking bisphosphanates since 2007. I read the studies about these drugs possibly preventing bone mets so welcomed them. I took Fosomax from 2007 to 2014, RECLAST from 2014 to 2016, and Prolia from 2016 to present. The reason the drugs didn't help with my osteoporosis was because of my hyperparathyroidism. I am still taking Prolia and probably will continue for some time.

Hi there, Tracy2327, welcome to BCO! We hope you find this community to be a supportive place. We're sorry to hear of the issue you're having with your calcium levels. Hypercalcemia is listed as a possible, albeit uncommon, side effect of the medication. Hopefully your continued monitoring keeps your calcium at good levels!

The Mods

Ts tge truhanks for your reply. My PTH was 44. Normal range. My IONIZED calcium was normal too. I was old ionized calcium is the true indicator of hypercalcemia. I see docto rmonday