FEMARA

BB ,

Hi there,

yes I have problems with high cholesterol - revealed at my last lot of blood tests. Never had this before. I have to get the test repeated in about 2 months.

My weight is the highest it has ever been and I don't know if its the meds or not. I've always had the weight struggle, but now worse than ever. I am now making more of an effort in eating better and exercising more, so we'll see if anything changes. My AST and ALT's are elevated too, I've been told NAFL is the culprit. Also never had this issue prior to BC treatment.

Thinkingpositive-My numbers weren't crazy elevated, not even 10 points higher but enough to make MO make me do extra testing. Also enough to make me worry

So, I found out in the last couple of weeks I need a total knee replacement on my right knee, I have bone on bone arthritis now and my left while not as bad is moderate. I'm telling you.....I never had this before all this treatment. I emailed MO's nurse today to see if there is a connection between arthritis and chemo, she hasn't answered me. I know I have arthritis in my feet now too just from the pain I'm experiencing, I haven't gone to a foot specialist yet. It's unreal and quite frankly depressing, 43 years old and dealing with major health problems all over the place.

WTF??? I figured out why when I switched to a different carrier for Medicare Part D (Humana) than I'd had for my regular insurance (United) my generic letrozole wasn’t covered…my pharmacist absentmindedly kept submitting the ‘scrip to United, which of course (justifiably) denied it because I was no longer their insured. I found this out only when I called Humana angrily, and the customer service rep said it was a Tier 1 generic, dirt cheap but they never had an Rx submitted to them. Called the pharmacy back, and the other pharmacist (the owner’s daughter) discovered her dad, even though my Humana card was in the system, had never tried getting an auth. from Humana. She instantly got approval, and my monthly cost dropped from $30 to $9.

Perhaps your carrier requires a prior auth? I would bypass your pharmacy and call your new carrier. Or maybe you can access its formulary via its website—it’s utterly bizarre that it wouldn’t be covered (at least as a generic) because it is so relatively cheap and standard-of-care. Did your pharmacist mistakenly submit the scrip to your old, now cancelled, insurer the way mine had?

Another possibility is that you might have to switch to another in-network (or—ugh—mail-order) pharmacy: for instance, were I to get my letrozole from Kellogg Cancer Center’s pharmacy I would have to go totally out of pocket. And if I filled my scrip at Walgreen’s or Wal-Mart (“preferred in-network”) instead of my neighborhood indie (“non-preferred in-network”), I might be stuck with a version with more side effects but it would be as low as $5 or even no co-pay. (CVS, where I get all my other prescriptions, is also “non-preferred in-network,” but they--like the mail-order company, Walgreens, Costco & Wal-Mart—told me “you get whatever mfr. our distributor sells us”).

Shetland Pony, please let us know what happens. My heart goes out to you. I had a friend post on Facebook yesterday that she can no longer get a life saving med for a blood disorder she has "because her platelet count is normal." That's what the medicine is for to keep her count normal! Ugh. She's looking at $14,000+ for a three month supply. I really hope your doctor can help you with this. It's insane

Chloesmom~ I am trying to psych myself up about saying goodbye to those carbs!!! I know something has wrecked my metabolism.BC (before cancer) I could eat anything!! I need spring to come around so I can get back outdoors and exercise. Winter is when I gain.

Shetland, that really surprises me since it is in fact such a standard drug. I wouldn't rule out the possibility that the person who told you it wasn't on the formulary is wrong: I was given similar information from my insurer over the phone about a year ago that turned out to simply be incorrect. I'd file the appeal ASAP and ask your doc to weigh in on it as well. File the appeal AND have your MO call.

I guess the 'good' news is that it is an inexpensive drug (at least in generic form). I just went to refill a month's supply (which is all my insurance will let me have at a time, so be sure that isn't part of the issue as well, just a minor inconvenience to go back every month rather than every three months...). Anyway, my employer had changed insurance providers, and when they rang it up, it showed as no insurance (because the old one had expired and they had no information on the new one). Cost even without insurance was about $26, but that was for BOTH letrozole and for a month's supply of Rx strength Vitamin D I was refilling at the same time (I whipped out the new insurance card and it went down to $8 for both). Still, just as I wasn't going to pay even $18 extra for the two prescriptions, you should definitely follow up! Good luck!

Octogirl

What's the difference between Femara and Letrozole?

Thanks, Peaches.

So my goal is to find Teva brand??

Gardengypsy, you might want to see if you can get the Roxane letrozole. It has the fewest additives of all, fewer even than brand-name Femara.

BosumBlues, I think high cholesterol can be a side effect of Letrozole...all brands. There are recent published reports that statins can decrease breast cancer recurrence, so I suppose there's a silver lining if you'd decide to say on one, but who really wants to take ANOTHER medication to deal with the side effects of other medications. Uuugh.

To follow up about letrozole being excluded from my insurance plan -- My amazing oncology nurse had submitted whatever was needed to appeal and I was going to get the prescription, but then we found out from my scan that I need to change treatments anyway. A nurse who knows how to deal with such things can save her patient a lot of trouble and worry. She got my new stuff approved with lightning speed. (I'm going to Faslodex and Afinitor, unless I opt for a trial.)

I am already on 40 mg of atorvastatin, because I have genetic cholesterol problems. The last time I had my cholesterol tested a few months ago, it was 201. I hope it does not go up a lot after being on letrozole a few months. I was concerned about going on the letrozole in the first place because I was afraid it was raise my cholesterol some more, and I asked one of my sisters who is an endocrinologist, and is a lip specialist about that, and she told me that they might have to raise the amount of atorvastatin I take. She said that all AI's have to potential to raise your cholesterol. I have been more careful about what I eat, because I am trying to lose some weight, and so maybe that will keep my cholesterol in check.

Bosum~

Indeed, everything can change in a minute.

What's needed these days is a collaboration between different specialists so that everyone involved in your "Survivorship Care Plan" is on the same page - it should be Integrative.

Today, my onc upped my dose of Gabapentin. We'll see how I do with 300 3x a day=900

The trigger thumbs were all better but now back for 3rd time. MO wanted me to quit the letrozole after the first time. But its better than the other 2. I am afraid to quit so just soldier on. If the cancer comes backat least i can say i tried my level best