FEMARA
Comments
-
Hi WildTulip and ChiSandy.
Your input has helped me a lot, and I will talk to my dr on Friday about switching from Zoloft to Cymbalta. I definitely have arthralgia, especially in my knees, and I've noticed my Zoloft isn't working that well and I get the jitters later in the afternoon.
Deep water aerobics and walking help, as does the hot tub. I've been on Femara for three months and my breast specialist encouraged me to talk to my MO about Arimadex, the third AI that I haven't tried. I'll try the antidepressant change right away, tho. Who knew aftercare would be hard?
It has been two years since diagnosis, and I'm glad to be here. Thanks for your compassion and informed support!
0 -
Cymbalta
Duloxetine (Cymbalta) Side Effects & Withdrawal
The anti-depressant Cymbalta (duloxetine) can cause a host of side effects, but stopping the drug could also provoke unpleasant withdrawal symptoms.
Terry Graedon October 15, 2012 Default 1324 Comments
We have received so many complaints about duloxetine side effects that we have lost count. Far more disturbing are the number of people who tell us how hard it is to discontinue this drug.
Decades ago doctors might have told patients taking a drug like Cymbalta that if they experienced anxiety, irritability or strange sensations after stopping the drug, it was probably their underlying psychological problem returning. Now we know it is withdrawal from the medicine.
The History of Cymbalta:
Cymbalta was originally approved by the FDA in 2004 for the treatment of major depression. It is officially an SNRI-type antidepressant. In doctorspeak that means it is a serotonin-norepinehprine reuptake inhibitor and is somewhat similar to other antidepressants such asEffexor (venlafaxine) and Pristiq (desvenlafaxine).
The FDA also approved Cymbalta to treat nerve pain associated with diabetes in 2004. In 2007 the drug got a green light for anxiety and in 2008 the FDA agreed that it could ease the discomfort associated with fibromyalgia. It was also approved to treat musculoskeletal pain associated with arthritis and lower back pain in 2010.
In other words, here was a drug that could relieve your blues and your aches and pains. And the drug company that makes Cymbalta (Lilly) has been aggressively marketing it as a good way to deal with chronic low back pain and osteoarthritis. Perhaps you have seen the commercials on TV promoting the pain relieving power of the drug with the slogan "Cymbalta can help." It sounds almost too good to be true.
Ah…and there is the rub. Although there is a long list of serious side effects mentioned during the commercial, the video images seem quite reassuring and trump the scary message the FDA requires for this medication. So, let's set the record straight. Here, without visual interference, are a list of potential complications associated with this medication.
Cymbalta (Duloxetine) Side Effects
- Nausea, stomach pain, constipation, diarrhea, decreased appetite, vomiting
- Dry mouth
- Insomnia, anxiety, tremor
- Dizziness, fatigue, sleepiness
- Sweating, hot flashes
- Blurred vision
- Headache
- Sexual dysfunction, lowered libido, erection difficulties, lack of orgasm
- Liver damage
- Serious skin reactions, rash, hives (requires immediate MD assistance!)
- Glaucoma
- Irregular heart rhythms
- Bleeding problems
- Blood pressure problems
- Interaction with other drugs (leading to serotonin syndrome among other reactions)
- Pneumonia
- Seizures
- Depressed mood, suicidal thoughts and behavior, suicide
Such a long list of side effects makes your eyes glaze over after the top 3 or 4. That is why we have included stories from real people so you can better understand what these complications feel like.
Stopping Cymbalta:
Even though such side effects are scary, there is another problem with Cymbalta. When people try to stop taking this drug they frequently report unpleasant withdrawal symptoms. An organization (QuarterWatch) that monitors the FDA's database of serious adverse drug events has noted that:
"We observed a signal for serious drug withdrawal symptoms associated with duloxetine (CYMBALTA), a widely used antidepressant that is also approved to treat arthritis and back pain, anxiety, and fibromyalgia. In the first quarter of 2012 the FDA received 48 case reports of drug withdrawal identifying duloxetine as the suspect drug. They described a wide spectrum of withdrawal effects that began when the patients stopped the drug, including blackouts, suicidal thoughts, tremor, and nausea. Several cases involved hospitalization.
Probing deeper into the scientific record for duloxetine we found that withdrawal symptoms were reported in 44-50% of patients abruptly discontinuing duloxetine at the end of clinical studies for depression, and more than half of this total did not resolve within a week or two. In addition, we identified a serious breakdown at both the FDA and the manufacturer, Eli Lilly and Company, in providing adequate warnings and instructions about how to manage this common adverse effect."
Doctors have taken to calling this "discontinuation syndrome." These clinical words do not do justice to what it is like to stop antidepressants like Cymbalta, Effexor (venlafaxine), Paxil (paroxetine),Pristiq (desvenlafaxine) or Zoloft (sertraline) suddenly.
Sudden Withdrawal Symptoms
- Brain "Zaps" (electric shock-like senstations in the brain)
- Dizziness, light-headedness, vertigo, feeling faint
- Headaches
- Anxiety, irritability, hostility
- Nausea, diarrhea, digestive upset
- Tremor, hands shaking, nerve tingles, strange sensations
- Fatigue, tiredness, lack of energy
- Visual disturbances
Again, a list of symptoms does not do this problem justice. Below you will read some stories from people who have posted their comments to this website. We would love to hear your story, positive or negative. Share your experience with Cymbalta or any other antidepressant below.
Should you wish to learn more about dealing with depression through some other strategies, we offer our Guide to Dealing with Depression. You will also find a whole chapter on prescribing mistakes doctors make when treating depression and fibromyalgia in our book, Top Screwups Doctors Make and How to Avoid Them.
Cymbalta Withdrawal Stories from Readers
– D.G. shares a tragic story:
"My lovely, young daughter-in law, who was about to celebrate her 29th birthday, was prescribed Cymbalta, Klonopin, and Ambien and has committed suicide.
"She told her physician and her therapist that she'd had thoughts of suicide but no one took her seriously. She suffered from depression, as well as an eating disorder, and had very low body weight. She also used alcohol.
"Please remind your readers of the potentially disastrous effects these chemicals can cause when taken carelessly or in combination with alcohol."This from – P.J.:
"I have been on Prozac over the last 20 years off and on and it finally stopped working. The last time I took it about 2 years ago I was taking the generic from Barr – the blue and white capsule. I was feeling as if I were in the deepest dark hole there ever was.
"My doctor put me on Cymbalta from which I had a lot of side effects such as palpitations, feeling constant dread, panic attacks, sweats, lightheadedness and general feeling of not being well.
"She added Abilify which put me over the edge. I was in the worst depression I have ever been in. Finally after living like this for several months, I asked to be put back on Prozac. I was taking the generic from Sandoz. When the prescription ran out I ended up on the big blue and white capsules from Barr.
"Over the last couple of weeks it has been constant crying spells, arguing with everyone and feeling pretty low. I talked to my doctor and she wrote the prescription for Sandoz only generic. The blue and white capsules are like taking a placebo. My doctor said she had had other patients who complained of the same thing and she had to write prescriptions for a certain generic or name brand."0 -
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.
0 -
I am as well. My total cholesterol shot up to 210 and my A1C was at 5.6. That was about 1 1/2 years after I started fermara. Oh and the weight gain, any one else have that happen? So I dieted and lost 14 lbs and retested. Total cholesterol was 195. Same A1C. Vacation time comes and I get home and go for blood work for reconstruction surgery. Glucose was 110 and my AST and ALT levels were high. Wondering if this could have been caused my vacation drinking and not eating right??? Now I have to go for full blood work again it's been six months since last full blood test and I am trying lose but some weight so that my little levels are down. Hopefully!!
0 -
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.
0 -
tangandchris... I never had this problem either with the ast and alt... makes me worry. I have been on fermara since feb 2015 and never had elevations at all. I was in Cancun the week before I had the blood work done and had to drink while I was there of course!!...I don't generally drink at all, but I was away... and its all the sugary drinks which possibly and hopefully is the cause for the elevations. Still haven't gone for the repeat blood work, working hard on losing some weight and not eating any sugar. How elevated were your levels?
0 -
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.
0 -
My health insurance provider was changed this year, to a company comparable to the previous one. It is "good" insurance. But when I tried to refill my letrozole, they said it was excluded from the plan. What the heck! Such a common drug. Has anyone had a similar problem? Brand name Femara, anastrozole, Arimidex, not covered either. There isn't anything else in its class. This does not make sense.
0 -
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”).
0 -
Thanks for your reply, ChiSandy. No, I called the prescription benefits number for the plan, and the lady checked and said it is excluded. I asked about three other drugs for family members, and they are all on the formulary, but not mine. All she could offer me was the phone number for appeals.
0 -
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
0 -
Gained a pound a month 18 in 1 1/2 years on letrozole. Last time I was that heavy was right before delivering my children. Have been on a very low carb diet since August and finally back down in size. Not sure if it was the chemo or letrozole that messed with my metabolism. I was always hungry and shaky like I needed to eat, but tired and no energy . Think all the calories for energy was being stored as fat. Lots more energy mow. And back down 2 sizes to wear my clothes again.
0 -
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.
0 -
Chloesmom, Congrats on losing the weight! I also gained a significant amount of weight during chemo, but have lost it all.
0 -
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
0 -
Can you go on your insurance website, and see if they cover the drug? I would also try to appeal it though if it is not covered. I am a really big fan of the goodrx.com site. You can go on their site and enter in your zipcode, the drug, and what kind of insurance you have, and it will tell you the cheapest pharmacies you can get it at, and whether you should use your insurance, or just use their card or one of their coupons. I am on medicare, and I found that this ointment that I was given a prescription for was $247 at Sams Club with my part D. I asked how much it was without my part D, and it was $188, which was still too much money. I decided I would rather suffer than pay that much. A few days later, I went on goodrx.com, and found I could get it at CVS for $39 with one of their coupons. There coupon would not scan at CVS, and so they scanned a goodrx card, and the price came down to $44. The pharmacist overheard our conversation, and showed me an over the counter ointment that was equivalent to my prescription that was only $33, and so I ended up getting that.
I am on letrezole, and I got it at Sam's Club last month for $12 for a 90 day supply using my part D, and it was teva brand too. I have been taking it for 6 weeks, and so far I have not had any side effects except for a minor amount of joint pain. I had joint pain before I started taking it though, and so I am not sure that the femera caused the increase in joint pain in my hips and knees.
0 -
What's the difference between Femara and Letrozole?
0 -
Letrozole is just the generic version of femara. Some generic versions, such as those manufactured by Sun and Accord, have a lot more additives than femara does, and thus have more side effects.
0 -
Thanks, Peaches.
So my goal is to find Teva brand??
0 -
Teva is the brand I get and has worked well for me and many here. My joint discomfort is much better than when I was on Anastrozole. I do have more hot flashes, but I'll take it over pain, otherwise I'm doing well on it. I've also read the Roxane brand is good and may have the fewest fillers.
0 -
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.
0 -
Thanks all! I called the pharmacist. He had a brand called, "Breckinridge." I asked him to find me some Teva. He said, "ok.""
0 -
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.
0 -
Chi~
If the Teva isn't good to me, I will try Roxane.. Just wrote it down. Thanks again!
0 -
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.)
0 -
Reposting something I wrote earlier because it applies to the current topic of brands:
Mylan and Teva have no talc but do have FD&C colors, while Accord and Novartis have no FD&C colors, but do have talc.
Lactose is the first inactive ingredient for Sun and Roxane. But lactose is only the fourth or sixth ingredient on Mylan, Teva, Accord, and Novartis.
(Edited to correct where I had typed Teva instead of Accord in the second part of the second sentence.)
0 -
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.
0 -
hi
Research indicates that statins are important to our med regime
maybe try reducing dosage instead of stopping alltogther see how this goes
check with gp though
Good luck
0 -
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
0 -
Shetland ~ Important information , thanks. Would you clarify that post?
0
