Arimidex v. Femara? What is the freaking difference ? :)
Hi ladies,
I'm trying to find some plain language information comparing the two drugs. I'm currently on arimidex and the side effects of joint pain, trigger finger joints, now trigger wrists and pain, etc. are wearying, coupled with the inability to lose weight, bloating, swelling of hands at times, blah blah blah (I'm even bored by it all). I'm a very active person, and don't want to slow down because of this trend.
My MO insists that armidex is her first go-to drug of choice as an AI. She has suggested, rather weakly, about switching to Femara should my SE continue to worsen, but she isn't very enthusiastic about it. I wonder if anyone on this list could explain the difference to me: is it just a manufacturer difference? Is one more potent than the other for ILC, which is what I had? Less side effects from Femara--is that true and if so, does that mean it's less effective?
I hope to hang in there with Arimidex; I'm making serious diet changes to reduce inflammation and hope that will translate to some weight loss (gained about 5-6 since taking Arimidex). But I tried to compare the two by googling quality information about the drugs and couldn't find any difference, so I wonder why my MO is adamant about me staying on this brand.
Thank you!!! Argggggh....it's frustrating sometimes, right? It can all make me feel a bit cuckoo!
Comments
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claire - here is some info. FWIW, my MO prefers letrozole because he believe it to be surperior, but when I developed a trigger he switched me to Arimidex with no problem. I stayed on it for a year and then developed multiple triggers, so I switched back. I figured that if I was going to have issues I would rather be on the drug he prefers. I ended up taking a different brand and have been on it for more than a year now - no problems.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068499/
http://allaboutpeptides.com/what-ai-is-right-for-you-anastrozole-exemestane-or-letrozole/
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Special K, Do you mean a different manufacturer brand of letrozole? And if I wanted to request a different brand of arimidex from my pharma, how would I do this? Are they hard to work with, usually? (CVS). Do they understand why we need to switch, do they need to know that, or can I simply tell them I don't like the TEVA or whatever brand I've been taking and try another one? Do different manufacturing brands really make that much difference in SE?
Thank you!
C
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claireinaz - My MO started me on Arimidex, as I think that's pretty much protocol. Start there, and if all is good, so be it. If not, start changing to different drugs.
I lasted on Arimidex for six months before the SEs set in. I sucked it up, and even though they got much worse, I went a whole year on it. By then, I had not only the irritating SEs (joint pain, trigger fingers, weight gain, etc.) but also some life threatening ones: blood pressure and cholesterol levels off the charts, vaginal pain and bleeding all the time, bladder pain and almost-incontinence from atrophied tissues, and depression so bad I couldn't get out of bed.
When I saw my MO she was horrified that I hadn't seen her sooner. I said "I didn't want to be a weenie!" She told me she KNEW I wasn't a weenie, and that she knew my SEs were from Arimidex. She immediately put me on a two month drug holiday. ALL of my SEs disappeared. All of them!
I was so happy until she said "Go pick up your Femara in the pharmacy." WHAAAAAT?
When I picked up the Femara, the Pharmacist showed me the drug information page for both Arimidex and Femara. Arimidex had two pages of possible SEs, and Femara had only one page. I know, stupid, but that gave me hope.
I lasted on Femara for six months. When the joint pain hit, I started regular Acupuncture treatment, referred by my MO. It actually helped. But then it became obvious that the other SEs were coming back as well, and because of many factors (very early, tiny tumors, no node involvement, and a husband with incurable kidney disease, currently in remission) we made the decision for me to stop the AIs altogether.
I a still a cheerleader for the AIs. I've seen many stories where just staying active kept the SEs at bay. (And prunes... Ruth swears by prunes.....) Also, many women take a short break if SEs are too bothersome, and then resume taking the drug with fewer SEs after that. Finally, I could have started with Arimidex, then gone to Femara, Tamoxifen, then Aromasin. (But I chose not to.) It's crazy, but you could be that woman who reacts to one drug, but has absolutely no SEs on another.
Wishing you the best.... and KEEP MOVING!!!
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I have been on Femara since 2011 with no side effects except hot flashes (reduced with Efexor). I understand from studies that it is the superior drug for preventing ILC recurrence.
When my onc prescribed it, he indicated the two AIs were equal alternatives.
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Hi
I don't know what the difference is........I was given femara (letrozole) and have been on it since 2008.......I had the usual problems with aches & pains but that soon wore off and I asked my onc to leave me on it for 10 years instead of 5.......it's my security blanket...........
OK. I know that I'd be much better without this drug (with regard to side effects)............but it's kept me safe for the past 6 years when many of my friends have had recurrences and secondaries......so I'm happy to stay with it...................
It would be great to have no medication and no side effects..............but I'm thankful that I'm still here & I'm sure that I have letrozole to thank for that.
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has anyone ever tried alternately AI with tamo? I can barely stand the side effects of either generic arimidex or now letrazole. I know that some women give up on AI and use tamo even after menopause. I was on it for my first bc diagnosis. Maybe. 30 day courses of each would lessen the effects
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Claire - yes, I mean a different manufacturer. I started on Mylan generic letrozole, switched to a generic brand of Arimidex - which one I can't recall, but after the year on it and the switch back to Femara I was given Teva brand generic letrozole. World of difference between it and the Mylan. The dyes and fillers do contribute to the side effects, and it was my CVS pharmacist who let me know this. Teva is no longer the CVS regular formulary, but all I do is go in a few days prior to needing the refill, ask them to fill my supply with Teva, they order it from their warehouse, and I pick it up a few days later. There is no difference in my co-pay, and they don't charge for getting it from their warehouse because it is something they keep stocked there. I just briefly explained the situation to them - saying that this brand caused me the least side effects, and could they fill my recurring prescription with Teva. No problem!
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Specialk gave a good explanation about differences in inactive ingredients. Sometimes insurance only covers generics, but you can often get a doc to appeal for you. Some have problems with one generic but not another. I was on Arimidex, generic, for 2 1/2 years until my side effects became too bad. I have been on Femara, generic, since June and it's not bad. My mo had no qualms about switching. My situation is different, as I'm stage IV so I am willing to live with some se's ad long as I remain NED.
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Thank you all...Racy mentioned femara as the better drug when it comes to ILC, but I couldn't find any science on that. I do know that when tamoxifen and AIs were compared in tx post-meno ILC, the AI of course was the better drug. I think if the case for Femara over Arimidex were true for ILC, my MO would have put me on it instead. She's one of the best BC oncologists in our region, perhaps in our state. Racy, can you supply some current science on that? If that's the case, my MO and I need to have a heart to heart REAL SOON.
I take effexor for hot flashes, so those aren't much of a problem. But the rest--yikes. I'm ready to look into alternatives if possible. I just checked my bottle, and the manufacturer now is Acco. Anyone heard of them?
Claire in AZ
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Hi Claire, I don't know how to post links using my tablet but there are definitely studies on this. There may even be some in the research news on this site. Google Femara effectiveness ILC and I'm sure you will find info. My recollection is that the studies are fairly recent (last few years).
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yep, just googled. Info is definitely there including a link to a topic on this site. Worth reading.
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quick review show studies comparing Femara v Tamox and Femara v a different AI. Will look again later when have more time for Femara v Arimidex.
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I've been reading lots of posts about SE's from Arimidex. I've been on it for about 2 years. At first it seemed fine. A little joint stiffness and pain but manageable. But in the second year, things worsened. I got tendinitis in my right wrist, then trigger thumb. After several months of treatment both problems resolved until last week when I developed tendonitis in my left wrist. The OT treating my wrist and trigger finger said they were not due to Arimidex. But I think she's just not familiar with the medication. Additionally, I've been slowly gaining weight, I'm more fatigued, etc. etc - just like everyone else. I can go with it - I don't want a recurrence! But now this - In the two years, my blood sugar went from 79 (normal) to 94 and last fall to 100. My cholesterol is also up. My doctors, including my MO, all just say to lose weight (right!) and play down that all these issues are Arimidex-related. It seems odd to me that my blood sugar would rise so quickly and so dramatically. The only difference in my lifestyle is taking Armidex! I'm trying to lose weight but I'm very concerned that even losing will not turn these numbers around. I feel like I'm trading cancer for diabetes. Anyone with a similar situation?
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Dear nge, yes, a lot of your symptoms sound just like mine. First trigger thumbs, a cortizone shot (painful) helped for three months. Now it's back.Next wrist joint problems (joint "catches" and when it pops, it hurts). Inability to lose weight. A few lbs gained (I'm afraid to look). More easily fatigued, although regular exercise helps like it did when I was getting chemo. So far my cholesterol and bone mass is okay. But I've only been on it for a little over a year.
The hand and foot doc that gave me the shot had no idea arimidex could cause problems; my MO does, though. I feel like I need to print out all the SE and keep it with me to hand out to every doctor I ever see.
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Thanks for responding, clairinaz. Yes, you're right about the list of SE's to hand out. None of the health professionals except for my MO know anything about arimidex. When I say it's the cause, they just say no. When I tell my MO about the joint issues, she says that yes, arimidex makes me "feel" my arthritis more. I can live with these joint issues, but I'm very worried about the blood sugar and cholesterol. I'm joining a weight loss program this month to try and lose about 20-25 pounds but I'm afraid that as long as I take this drug, these problems will persist. Like your trigger finger. If underlying cause is the arimidex, won't these side effects keep returning? Can things like increased cholesterol and increased blood sugar progress into full-blown diseases like diabetes? I'm very worried.
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Well, I just tried to get my pharma to change to another manufacturer. Still don't know what will happen. The tech quizzed me on why I wanted to change; when I tried to explain, he asked what kind of side effects I had. Restraining myself from asking him snarkily how much time he had to listen to the list, I simply said "all of them". I mean come on--he doesn't know *&(& about the drug anyway.
He has to ask his manager, who will call me. I kind of anticipated I'd get push back, though
Claire
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I'll be curious how this works out, Claire. I can't believe the nerve of the pharmacy tech...
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They never called me back. I've got to order more, so I don't know if I'll pursue this any longer. Choose my battles...I may simply suck it up till I see my MO in two months.
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claireinaz-I'm still on tamoxifen but think my MO will suggest switching me to an AI. So, really just lurking here. I tried to get CVS to switch me from the TEVA brand tamoxifen to Mylan brand. The clerk who I asked in person, told me it couldn't be done. I called all the pharmacies within 20 miles(about 15). All but 1 pharmacy was carrying the TEVA brand. The other pharmacy was carrying Watson brand. I asked all the pharmacies if they could order Mylan brand for me, they said no. Except for Kmart, that pharmacist said they could & do so for another customer.
Before I moved my RX over to Kmart, I got a call from the pharmacist at CVS because I hadn't refilled my 3 month RX. I told her that I was taken off the drug for 2 weeks & still had some. I ask her if CVS could order the Mylan brand for me. She told me that CVS had a "contract" with TEVA but she could order it for me. It would just taken 2 days to get. I eventually got the Mylan brand but didn't find it any better. At one point my RX was refilled with Watson brand. For me, three brands, no difference.
So.... not a worthwhile battle for me. Regret jumping thru all those hoops & getting all worked up over it. Just my experience.
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Thanks, coraleliz. I felt the same way. I could try another pharm, but I get my other meds filled there, and it's just not worth the effort. Getting worked up over it: yes.
I feel a little better now that I've changed my diet--really! to eliminate foods that might cause inflammation, and the bloat and fatigue has lessened. Now about those hands and wrists--still not good, but I think I can work with it for a while longer until I see my MO in March... -
Claireinaz- I just started a 1 month elimination/anti-inflammation diet. One of the trainers at the gym is also a nutritionist. So, there are about 20 of us participating. Hoping good things come from tweeking our diets.
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Coraleliz, I just noticed your avatar and it's hilarious! I love it
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For lessening of joint pain it took at least 3-4 months of anti-inflammatory diet for me, so don't be discouraged. Hand pain for two of my friends (non-cancer friends) dissipated within a week. It is so weird to me that CVS is not cooperative with substituting manufacturers. I have absolutely no problem with this - they keep a number of brands of generic letrozole in the main supply warehouse. My local store carries a brand I don't want as their standard formulary so I just ask each time it is about ready to refill if they can get me the Teva from the warehouse - takes 2-3 days and I pick it up from my local store. When I first started on letrozole I received it from Express Scripts - CVS has a $5 co-pay for me, but Express Scripts is a $0 co-pay, and it was mailed so pretty convenient. I was able to get a larger quantity (90 days instead of 30) and was also able to ask for the specific brand I wanted (at the time, Mylan) all I needed was a note from my MO for the specific brand. I have not done this with Teva and Express Scripts because it has been easy to get it at CVS. I don't take any other prescription meds so don't mind the $5 co-pay at this point. Claire - can you use Express Scripts?
coraleliz - once I adapted to the elimination/anti-inflammatory I just stayed on it. The one I did has a 21 day elimination aspect, but I only added back in eggs occasionally and it was long after the 21 days, left everything else out (dairy, soy, sugar, corn, peanuts, gluten). Are these the things you have eliminated? Or some different things?
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Hi SpecialK, I just wanted to weigh in that my mood has lightened so considerably since I started on the anti-inflammation food program *I refuse to call it a diet since it might very well be a lifestyle for me!, I don't really mind that I can't switch my Rx.
Isn't that remarkable? I wonder why I'd feel so much better in my head as well as my body, but it seems true
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Oh yay! I am so happy that you are feeling good and more peaceful!
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Special K-I'm eliminating the things you mentioned. Eggs are allowed though. I'm glad it helped you. I'm only 5 days into it. The nutritionist leading the group also wants us to eat organic when ever possible, prepare our own foods whenever possible or read labels very carefully, eat vegetables with every meal, eat 3 meals a day with no grazing, although a pre or post workout snack is allowed(but not both). There is a private facebook group/page where we post pictures of our meals, ask questions & get feedback. I let my diet slip some when diagnosed with BC(felt defeated).It didn't lead to weight gain, so I hope this doesn't cause me any weight loss.
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I had the same situation with different manufacturers of generic for Arimidex - different side effects with different manufacturers which is very scary to me. TEVA was the best brand for me as well.
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coraleliz - I also try to eat the cleanest sources - grass-fed, pasture-raised or wild caught protein sources, and I follow the clean 15 and dirty dozen rule for produce. I have learned over the last year that following this plan is easiest if I all but eliminate processed foods - I do use some salsas and sauces but read the labels for hidden sugars and corn/soy. I gained on chemo from the steroids and from AIs, and also from not enough exercise from so much surgery - so I did need to lose, which I did. The weight came off slowly - one pound a week for six months before I plateaued. Everyone I know who eats this way has lost, so if you don't want to lose make sure you are eating enough volume.
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SpecialK- Thanks for your input. It's definitely a different way of eating.
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I've been on it for 16 days now...maybe 1 lb gone? But not anything dramatic. I only need to lose about 5- 6 lbs, though, so would that have anything to do with slow weight loss? I'm telling myself that it isnt' about the loss; it's about how much better I feel. And I do feel better. Stopped snacking on carby things at night, and haven't been hungry at all eating this way. I'm nearly to the end of the 21 day elimination period, but I don't really feel like adding back anything, really. Pretty happy the way I'm eating now.
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