Zometa/Xgeva -pros/cons/side effects and decision

I got a fever and felt like I had the flu for three days after my first Zometa infusion a couple of years ago, but have never felt like I had a side effect since.  My doc said that was normal, but it did stink.  The upshot is that my DEXA has improved my scored from the "osteoporosis" range to the "osteopenia" range.  I am only 38 and broke my arm badly last year so I understand why that is a big deal .

Naturegirl, I've been on Zometa every 3 months for a year. I just had the flu like symptoms the first 2 times. Otherwise, no se's. You can combat the flu symptoms by taking Benadryl and ibuprufen (sp?) before and after treatment. My MO said I'll be getting infusions for another year.

Edit: There's been no cost as insurance covers the treatment.

I am pretty sure my doc uses the brand name (Zometa), but I am not sure.  The first year she had me do infusions every 3 months, but since my DEXA improved so much, I am just on every six months now.  Also, she says it will help prevent metastatic tumors in the bones.

Hi SpecialK,

Did your bone density improve on Prolia?

Best Usha

Initially my first onc mentioned calcium but not D. The time problem I encountered was more the process at MD Anderson. You see the onc., he orders the infusion, there is a two hour window before they would check you in. Then you had to wait for the IV placement, go back to the window and wait for a room........you get the picture.



The actual infusion was about 30 minutes. I had read that going faster than that made the SE's nastier.



I believe that it's recommended to take Calcium and D3 with any of the bisphosphanates.

slosha - I don't know yet because I have not had another bone density scan.  My onc did say it can take a couple of years to improve, but I would be satisfied with no further loss, keeping me osteopenic, but stable.  I will most likely not have a scan for another 6-12 months.

I'm not getting Xgeva, but am getting Zometa, so you'll need more help on this.  

My MO was really concerned about a drop in calcium in the blood in the days after the shot.  I was told to up my calcium intake and take a couple of Tums if I started to feel light headed or ill.  The drug pulls calcium out of your blood into the bones, so can cause serious problems if you don't have enough. I noticed more muscle cramping/pain in the next month, so always made sure I didn't skip my calcium.  I was taking about 2000iu Vit D, plus the D in the 1500mg Calcuim pills.  I don't take as much calcium now.  

Hi Ladies!

I was IV w/bone mets outta of the box...have been doing Xgeva shots once I was thru with CTH in Sept '11.  My onco never did discuss options between Zometa and Xgeva...so this is interesting reading.  I finally got a BASE bone density a year ago...will be getting another in May.  I was 'pinia.  So I was happy.  We will see what the next one says.  And someone mentioned the dental/jaw se of xgeva...true...so I also took the info to my dentist, she is now informed and will keep an eye on me.  But I was ALSO told to get any dental work done B4 I started it.  I don't have any se's from Xgeva, or at least that I can blame solely on those shots.  Speaking of the burning/stinging....sometimes it does and other times it does not....and the diff for me is the NURSE who injects it.  In my chemo pod, some of the nurses are rotated in/out like a revolving door and after almost 2 years..I thot it was the norm (stinging), but it is not.  Ask them to slow down the push and mayb find a 'more' fatty area in the stomach.  I have lots of that...lol...but truly, the nurse that pinches up a bit of bellyfat...makes the shot much more tolerable. OO  and I started on 2000iu of D...got bloodwork done sametime as my density....tooo much D....so quit that but try to keep up with the calcium.  I live in sunny climate, so I try not to wear sunglasses too much.  D is absorbed 'most readily' thru the eyes.

Hope this helps!  Love, prayers, positive energy to all,

Sue

My MO started me on Xgeva in December 2012 shortly after my bone mets dx. He never even suggested zometa. I always receive the shot in the back of my arm and the nurses always gently pinch it so it goes into a fatty area. The shot is also pushed slowly and I have never had stinging or soreness.



I am one of the rare folks who consistently gets side effects but they seem to vary in intensity. Usually they begin about 36 hours after the shot and I feel like I have a mild flu (full body aches, more fatigue than normal, but no nausea) for a day or two. The nurse and MO both said the timing of the symptoms coincide with about when the injection would have had time to circulate systemically. They were the worst after the first injection and have never kept me from doing whatever I need to do, but now I do plan around them a little so I can take it easy if I need to (i.e. I get the shot on Thursdays so I have the weekend to be lazy if necessary).



Coincidentally, I happened to have had a bone density (DEXA) scan a month before my BC dx. so already knew I had osteopenia bordering on osteoporosis. My next DEXA will be later this year. My dentist is aware of the Xgeva and has discussed a long term plan for preventing any dental issues. My MO didn't mention a pre-Xgeva dental exam and necessary work, but should have. I have had no jaw issues or pain thus far.



Both my MO and the drug manufacturer's literature recommend a calcium supplement of 500mg. a day, and low blood calcium is a listed side effect. At my MO's request, I also take 2000 i.u. of D3 to offset my below normal levels. My levels have risen from 20 to 30 in about four months, but they want it to be no lower than 40 to 60. I hope that more outside time will help now that spring is here.



BTW, the manufacturer of the shot has a payment assistance program that my cancer center enrolled me in. It offsets my out of pocket costs by paying for the balance, after insurance and my office visit copay. Since my cost would have been about $400/mo., I was very grateful to the center for enrolling me!



Hope this helps your decision.

I was dx with bone mets 10 and half years after initial dx. My Tx is monthly zometa and letrozole. 24 hours after zometa infusion I get huge bags of fluids. My Onc believes zometa is a great drug for bone mets.

I too was dx stage IV right from the start. While on chemo, from end August to march this year, I had zometa infusions once every 3 weeks. The first infusion was put through in 15 minutes. My head was spinning for a week! I felt really off, like my blood pressure had dropped very low. I told the onco about this, he recommended trying pushing the infusion over 45 minutes. I tried this, and never had any more problems. Once chemo was finished my onco changed me onto xgeva once a month. He gave me a prescription for vit D and calcium at the same time as the prescription for xgeva, telling me that its important to take them every day. So far I've had 3 shots with no problems or se's. Hope this helps!

Nicky