FEMARA
Comments
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Chisandy, that's outrageous isn't it? What is the drug company's name for Femara. Some people here in the IV group are taking Ibrance, that's another drug where the price is huge! Something like $11,000 a month.
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Marijen - Novartis is the company who developed Femara and owns the brand name 'Femara'. When I went on it (a bit over a year before it became available in generic form) I was told that it was $900 for a month. Don't know for sure how much it was then as I get my care through VA so I pay $8.00 for a month for any script I get - not based on cost.
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Inactive ingredients in Femara by Novartis:
- SILICON DIOXIDE
- FERRIC OXIDE RED )
- HYPROMELLOSES
- LACTOSE MONOHYDRATE
- MAGNESIUM STEARATE
- STARCH, CORN
- CELLULOSE, MICROCRYSTALLINE
- POLYETHYLENE GLYCOLS
- SODIUM STARCH GLYCOLATE TYPE A POTATO
- TALC
- TITANIUM DIOXIDE
Inactive ingredients in Letrozole by Teva:
- SILICON DIOXIDE
- FD&C BLUE NO. 2
- INDIGOTINDISULFONATE SODIUM
- ALUMINUM OXIDE
- FD&C YELLOW NO. 5
- FERRIC OXIDE YELLOW
- LACTOSE MONOHYDRATE
- MAGNESIUM STEARATE
- CELLULOSE, MICROCRYSTALLINE
- POLYETHYLENE GLYCOL 3350
- POLYETHYLENE GLYCOL 4000
- POLYVINYL ALCOHOL
- SODIUM STARCH GLYCOLATE TYPE A POTATO
- STARCH, CORN
- TALC
- TITANIUM DIOXIDE
Inactive ingredients in Letrozole by Sun Pharma
- LACTOSE MONOHYDRATE
- CELLULOSE, MICROCRYSTALLINE
- STARCH, CORN
- POVIDONE K30
- SODIUM STARCH GLYCOLATE TYPE A POTATO
- SILICON DIOXIDE
- MAGNESIUM STEARATE
- HYPROMELLOSES
- FERRIC OXIDE YELLOW
- TITANIUM DIOXIDE
- POLYETHYLENE GLYCOLS
- TALC
http://dailymed.nlm.nih.gov/ 0 -
I am stage iv and I take 125mg of Ibrance daily for 3 weeks and 1 week off to rebuild tanked white blood cells. That is pretty standard. The cost is $ 9somethingK a month but I have insurance that dropped to to $288.00 and i got in on the Pfizer co-pay program so in the end I am currently only paying $10.00. Scary.
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Ellen, the Povidone K30 in the Sun formula is a form of iodine, resembling Betadine. The FD&C “food" colors in the Teva are not present in Femara or Sun, who use mineral pigments. (Food colors can impact sensitive individuals). Teva also contains aluminum and a disulfonate sodium (which when used in shampoos can strip dye and keratin from hair). But why does Teva have a lesser tendency to cause severe side effects than Sun? Look at the order of ingredients--they must be listed in decreasing order of amount. The first inactive ingredient in both Femara and Teva letrozole is silicon dioxide--essentially, microfine sand, which is pretty inert and is usually excreted without being absorbed--but Sun letrozole's first ingredient is lactose monohydrate, present in all 3 formulations but in a greater amount in Sun's than in the other two formulations. Lactose is cheaper than silicone--and it’s SUGAR. The lactose-intolerant are likelier to experience digestive-related SEs on Sun's formulation; and even those not clinically lactose-intolerant will more likely see the effects of ingesting sugar (insulin spikes & subsequent crashes, irritability, impairment of fat metabolism and increased fat storage) if they take Sun's letrozole. With estrogen-deprivation lowering metabolism in general, Sun's formula adds insult to injury.
ONLY the ACTIVE ingredients in generics are identical to the original brand name. Anyone who tells you that all inactive ingredients are inert, not dose-dependent and identical across formulations is LYING to you.
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Manufacturers' co-pay programs are not available to those on Medicare Part D unless they go wholly out-of-pocket. I’m gonna get a nasty surprise when after my 90-day supplies of Dexilant and Benicar run out I will have to refill them under Medicare,
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So interesting...
I just grabbed my Letrozole and it's made by Breckenridge... The inactives listed below...
LACTOSE MONOHYDRATE MAGNESIUM STEARATE HYPROMELLOSE 2910 (6 MPA.S) POLYETHYLENE GLYCOL 8000 CELLULOSE, MICROCRYSTALLINE SILICON DIOXIDE TITANIUM DIOXIDE FERRIC OXIDE YELLOW STARCH, CORN TALC SODIUM STARCH GLYCOLATE TYPE A POTATO 0 -
I think the discussion was that someone experiencing sudden se could have gotten a different generic brand of Letrozole. That some formulations might agree with some better than others. The Teva recommendation was by a couple of long time, very knowledgeable, frequent posters in the stage iv group. For me, I've had Sun Pharma and Teva both and I have fewer hot flashes on the Teva but maybe I have just gotten used to the drug. I don't know. I just thought that being aware that the fillers can be different and you can ask for a particular maker is good to know. There may be more makers of letrozole also--
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There are 13 manufacturers of letrozole listed at http://dailymed.nlm.nih.gov. Search for letrozole, Click on a manufacturer. Scroll down to Ingredients and Appearance.
Have fun looking yours up. I just saw one that had mannitol listed as the first ingredient and it's sugar. They are all different seems like and made around the world too.
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My letrozole is made by Roxa Labs
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my Letrozole was made by Teva and my Femara, Novartis. I can't begin to tell you the difference it has made. Keep in mind I'm in Canada. I would be paying around $220-240 if I had to pay out of pocket. I'm shocked at the amounts you are quoting here.......good luck to those wanting to try it.....fingers and toes crossed for you
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Mannitol isn't a sugar per se, but rather a sugar alcohol. It's used in some diet candies & cookies in lieu of sugar and in addition to aspartame for both flavor & texture. Its chief side effect? Flatulence and, uh, “anal leakage." Not surprising it's sometimes used in laxative preparations.
Scottlee, Chicago is only a day's drive from Ontario--it might be worth taking a little jaunt over the bridge next time I play in the Detroit area with a Canadian doctor's scrip in hand (DH no doubt has colleagues from his med school & residency days, or maybe my own MO might have friends or colleagues across the border). Or perhaps I could kill two birds with one stone and look for an echocardiography CME course for him in Vancouver, Montreal or Banff (with a medical visit for me, and a trip to the drugstore, while he’s in the scientific sessions). Would be much more expensive than if I were a Canadian using Nat’l Health, but still cheaper than pharmacies Stateside. (And I doubt that’s the kind of “drugs” ICE’s dogs are sniffing for coming back across the border to the US).
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I am in Ontario too, my Letrozole is by Pharmascience. Cost is CAN$98.22 for 60 tabs, which thankfully is covered by my drug plan
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I just called my prescription drug plan (Medco) and a 90 day supply of Femara will cost me $138, 90 day supply of Letrozole is $20. If I get it monthly from a retail pharmacy a 30 day supply of Femara is $656 and the Letrozole is $10 for 30 day supply. WOW. I am going to try the Femara from Medco and see if the SE are less than with the generic Letrozole. I was taking a half of a tab of the Letrozole (and felt so much better) and got an earful from the NP in my oncologist office about how there are no definitive studies on that dose, etc.. but yet I read from the FDA website insert for Femara that anywhere from 0.5 mg to 2.5 mg was effective. I want to be compliant with my medication so I am willing to pay a little more and take the full dose and hopefully have less side effects
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I think I have asked this before but I' going to ask again to see if I get more replies.....Has anyone had severely rising liver enzymes on Letrozole?
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When I showed DH Costco’s e-mail about Femara vs. generic letrozole costs, he gasped. He was expecting the difference to be 10X more. Considering what Femara costs in Canada, he says he will talk to his many patients who claim to buy their meds “from” Canada: whether they actually go to Canada to buy them (there are below-radar “through-the-grapevine” groups who organize bus day trips for seniors to Detroit/Windsor, roughly a 6-hr. trip each way) or they buy from questionable online sites and strip-mall storefronts here purporting to deal with Canadian pharmacies but really getting inferior and even counterfeit drugs from India. If they’re taking the prescriptions he writes across the border personally for Canadian docs to reissue and then physically buy their meds at brick-and-mortar stores in Canada, he says he would like to take a jaunt out there himself (hopefully bringing me along). We’re looking for CME courses and meetings in Montreal, Toronto, Halifax, Vancouver or Victoria around the time my first 90-pill supply of branded Femara is about to run out. He’s also going through his U. of Wash. Med. alumni directory to see which of his med school classmates ended up in B.C. or any other province. At any rate, he says $300-400/mo for branded Femara from Canada is doable for us.
(BTW, it looks like Benicar may soon be going off-patent, and Avalide already has. Since Avalide seemed to work well for me, I might switch to its generic once I go on Medicare. The only satisfactory alternative to Dexilant would be to buy a shitload of generic OTC lansoprazole--half the prescription strength, double the dose, take that BID, and get up 4 hrs after bedtime to pop another capsule. Thanks, but no thanks).
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So my Letrozole from Roxane Laboratores only has about six inactive ingredients, maybe that is why it doesn't bother me so much? It looks like Brand Femara has more inactive ingredients?
I get my Letrozole through Safeway, it's about $5 a month. I could buy it by mail order maybe, three months at a time, not sure. Safeway is a preferred retail provider through Medicare Silverscript Choice Plan, no deductible. I was informed by a rep that the preferred retail price can be lower than the Standard pharmacy price. More dumb luck, Safeway is within walking distance. However, with more expensive prescriptions I would definitely shop around the area to get the best price. Not convinced Costco does have the best prices, but it could differ by state?
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What I am interested in, is getting a letrozole pill with the smallest amount of lactose, and without any really bad other ingredients. Has anyone already worked on this question? It sounds good to go with a brand that has fewer extra ingredients, but not if some of those are particularly bad ones. ChiSandy, are you saying that drug labels are like food labels, so the lower lactose is on the list of ingredients, the less it has compared to other ingredients? Still no way to know the absolute amount of lactose. Also, I wonder if drugs from certain countries are more trustworthy than others?
Ellelou, thanks for the list of ingredients and the link. I had checked on this question before, but lost my notes.
(Artist, normal liver enzymes here.)
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Thanks Shetland
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Anybody notice any change in their teeth or their mouth with Femara? I'm thinking mine are getting yellow.... : (
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marijen. I am experiencing the same. I just thought it wss the fact that I have not gone to the dentist since before I was diagnosed for a cleaning. I am petrified of the dentist so I just keep putting it off. I have heard chemo affects teeth. Not sure if that true.
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My Letrozole is from Accord (I think). I have had few side effects, but I have only been on it since mid October. I will have labs in January, so I'll find out about my liver enzymes then.
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KBee...mine is from Accord too. Very few SE's if any for me. I've been on it for a year.
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Thinking positive, yes I looked it up and chemo can change tooth color. But Femara is not really chemo. Yellow teeth is not OK with me. I am seeing the dentist Monday and so I'll ask. Kbee, I just want to say again, it is amazing what you have been through. I hope I don't have to go there, as have many. I have an occult primary and that scares me. Now I think I'm finding lumps, like in my jaw, in my elbow, in my other armpit, in my tailbone, I know it's crazy but.... On the otherhand, I was told two days ago that I have never looked better. With the main tumor out (lymph node) who knows, how hard my body was working to contain it. Just thoughts for now. Thinking positive!! I've read the book!
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I know radiation can affect the teeth as well. I got one cavity along my gumline on one bottom tooth. I thought it was weird, but my my dentist said some people get cavities along the gum on every tooth top and bottom after radiation.
As for se on femara, I'm not sure. I think my back ache is a lot worse, but I always find it difficult to assign such things in a cause-and-effect way. I've only been on it a month, so I guess time will tell. My onco said to definitely keep on eye out for se, because he had a couple of other options to try if this doesn't work.
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Oh great, radiation is next for me. Good to have a heads up. How long after radiation did the cavities show up
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Sorry, I finished radiation five years ago and so much has gone on in between I don't recall. It was caught during my regular check-up, so probably within 9 months. You might want to call your dentist and see (a) if it's a concern and (b) if there's anything you can do to help protect your teeth from it...
I hope your rads go well!
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I have read where some people do better on one generic versus another. Ellalou, I think Teva was mentioned as a good one for letrozole. I'll take my first letrozole tomorrow. It's from Sun Pharmaceuticals. Fingers crossed.
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Marijen, I finally got an answer about strontium from my PCP. Her reply had gotten lost in a black hole on their portal. Anyway, here's what she said.
We don't know that much about the long term side effects of supplementing strontium at the levels recommended, there are two large trials showing improvement in bone strength using strontium however. I would be cautious with the dosing and suggest 50 mg twice a day or 100 mg once a day. I would also make certain you are getting lots of dark green leafy vegetables such as kale and spinach as these are high in naturally occuring strontium and calcium.
I'm going to keep taking it until there's more information available, I guess.
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I use a rinse from the Oratec corporation called Therasol and got thru chemo with no dental issues. You can research and order it online. I brush with it after regular brushing and using a waterpick. Be sure to check with your doctor since it does contain alcohol. Love, Jean
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