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Differences in SEs with Tamox from different manufacturers

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  • cycle-path
    cycle-path Member Posts: 64
    edited January 2012
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    Ok ladies, I've been looking at the inactive ingredients in all the different versions of Tamox (US brands only). I've spent a lot of time on this and don't want to spend a lot more on it at the moment, so maybe I'll have some more thoughts later. But here's what I think right now.

    If you are having constipation on Tamox, you should try Mylan.

    If you're having depression, loss of energy, or forgetfulness, you should try Teva.

    If you're having bloating or gas, you should try something other than Teva.

    If you are gluten intolerant, try Mylan.

    If you're having diarrhea, nausea, or vomiting, try something other than Mylan.

    Later I'll go back through some old posts and see if this seems to bear out what's been said here. Any thoughts or comments are welcome!

  • proudmom_wife
    proudmom_wife Member Posts: 176
    edited January 2012
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    cycle-path - thank you for researching the inactive ingredients, it is really interesting.

    When I was taking using Tamoxifen by Teva I had bouts of constipation, bloating and gas. I haven't had that for over 2 months now, since I switched to Tamoxifen by Mylan. Never thought of it being related. Perhaps it was related ... or just a coincidence.  Nah, I am going to say it was related.Wink

  • Chevyboy
    Chevyboy Member Posts: 10,258
    edited January 2012
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    I took Tamoxifen for 14 months...and during that time it seemed I would have the normal SE's, but they would only last a couple weeks, and then go away....except for the leg cramps every night. 

     I really felt good while taking it .... I hope it works out for all of you.

  • gentianviolet
    gentianviolet Member Posts: 105
    edited January 2012
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    Chevyboy

    I also had leg cramps.......I take magnesium because the calcium constipates me and I found that if I upped my magnesium the leg cramps went away.  Haven't had a problem for over 1 1/2 years.

    Good luck, hope this information works for you too because it hurt like hell.

  • cycle-path
    cycle-path Member Posts: 64
    edited January 2012
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    Proud Mom, yep, from what I saw when researching the inactive ingredients, the Teva could certainly do that. 

    I think it's probably a matter of being what the pharmaceutical companies call a "sensitive individual." (I like to think of myself as one!) Most of the inactive ingredients are there to hold the pill together or to help it dissolve in your stomach or whatever, and there isn't much of it. But there may be enough to bother a "sensitive individual."

    Interestingly, a lot of bodybuilders apparently take supplements composed of various among the inactive ingredients in many pills. So sites that talk about these supplements are useful in looking up side effects.

    For example, Watson, Barr, and Teva all contain croscarmellose sodium, which is discussed here: http://www.livestrong.com/article/314779-croscarmellose-sodium-side-effects/ 

  • Chevyboy
    Chevyboy Member Posts: 10,258
    edited January 2012
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    Hi cycle....I followed your link and found a lot more about Tamoxifen...I saw pictured, I think 6 different kinds of the drug from the different manufacturers.  Mine was from Watson, but it said "Barr" on the pills.

    And they all mention hair loss as a possible side effect....I looked for the DHT I saw mentioned, and that DOES cause hair loss...maybe like the nerves in my ears?  Guess it doesn't matter now, because my hearing will never come back.   And yes, body-builders DO take Tamoxifen also!

    A friend of mine lost her hearing over a year...just gradual...THAT is a different type of hearing loss.... and usually age related.....  I just lost mine overnight.... from "certain drugs".....

    And I didn't know there were different types of Tamoxifen!!   But at this point I'm too afraid to try any of the others...

    gentian....I also tried Magnesium for the leg cramps, but after 3 days I broke out in hives.... EVERYwhere!  Ha!   I think I'm like cycle....we are just "sensitive"....Ha!

    So I think some of us will do great on Tamoxifen, but some of us have wierd side effects and just can't handle it.

  • LuvLulu07
    LuvLulu07 Member Posts: 596
    edited January 2012
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    cycle-path   Thanks for the thoughts on SE's from the different types of Tamox.  Gee, let's see - what do I want to put up with?  lol   Seriously, I appreciate the research on SE's that you've done, it will help getting started and knowing what to expect. 

    My rx here in Europe will be Teva, and unless I want to hand carry several months from the States, that's my only option, I think.  

    Question about starting Tamox - I am (was) multi-focal - had 2 masses in one breast.  I'm considered estrogen positive, but not a big number with either mass - I think that the highest was 67, something like that.  Does anybody know if Tamoxifen is effective with this? 

    Thanks ~ Joy

  • cycle-path
    cycle-path Member Posts: 64
    edited January 2012
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    Chevyboy: I think 6 different kinds of the drug from the different manufacturers. Mine was from Watson, but it said "Barr" on the pills.

    That drugs.com list shows several pills that are no longer on the market. For example, it shows the AstraZeneca pill -- the original branded drug -- which is long gone.

    Watson and Barr are the same pill. I think Barr is manufacturing them for Watson, but it might be the other way around.  

    And I didn't know there were different types of Tamoxifen!! But at this point I'm too afraid to try any of the others... 

    Well, you've had a significant side effect and IMO that's a reasonable thing to worry about! The thing is, when you have an SE you don't know if it's from the drug itself (the active ingredient) or one of the inactives. Some of the SEs, such as hot flashes, are almost certainly coming from the drug itself. 

    Joy: Gee, let's see - what do I want to put up with? 

    I think you already do understand this, of course, but just in case: some people ("insensitive" people - ha) won't get SEs from any of these. The list I gave is intended for people who already have an SE.

    One thing I can see from my research is that the stories of fewer SEs on the original branded drug from AstraZeneca make sense -- the list of inactive ingredients in that drug is very short and very innocuous. It contained only magnesium stearate (they all have that), starch (not a problem unless you're very gluten intolerant), mannitol (which is in a lot of gum and candies), and carboxymethylcellulose calcium (one ingredient for which I saw no potential SEs). 

    I always like to caution that I have no medical training other than putting on bandaids and that my advice is worth what you're paying for it, but if I were trying Tamox for the first time I'd see if I could get Mylan. It seems to have the fewest ingredients with potential problems.  

  • Chevyboy
    Chevyboy Member Posts: 10,258
    edited January 2012
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    If only our Oncologists could have explained the differences in the "brands" of Tamoxifen!

    I don't know WHAT I took for the first year, but by the time I quit taking it, it was from  Barr/Watson!  I just assumed Tamoxifen was from Astra Zeneca...but not so....and it makes sense that each manufacturer would vary the ingredients...... 

    Thank you soo much cycle, for this thread, and for making us all aware of what we are taking!   It helped me understand a lot more....!

  • LtotheK
    LtotheK Member Posts: 487
    edited January 2012
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    This is great, thank you so much, everyone!

    Some other information from the Mayo Clinic, I researched the sugar/cancer connection a lot:

    Cancer causes: Popular myths about the causes of cancer

    Myth: People with cancer shouldn't eat sugar, since it can cause cancer to grow faster.

    Fact: Sugar doesn't make cancer grow faster. All cells, including cancer cells, depend on blood sugar (glucose) for energy. But giving more sugar to cancer cells doesn't speed their growth. Likewise, depriving cancer cells of sugar doesn't slow their growth.

    This misconception may be based in part on a misunderstanding of positron emission tomography (PET) scans, which use a small amount of radioactive tracer — typically a form of glucose. All tissues in your body absorb some of this tracer, but tissues that are using more energy — including cancer cells — absorb greater amounts. For this reason, some people have concluded that cancer cells grow faster on sugar. But this isn't true.

  • phxsunshine
    phxsunshine Member Posts: 156
    edited January 2012
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    I'll put in my 2 cents.  I had been taking Mylan brand since Sept 2010 with hot flashes and tissue paper skin being the 2 side effects that were very bothersome.  Over time the hot flashes diminished, took supplements for the skin, and I was doing pretty good. Over the summer, I had to switch to Teva brand, as Mylan was unavailable at my pharmacy and I thought nothng of it.  The hot flashes became insane, followed by cold flashes.  It wrecked my sleep.  After phoning around, I found the Mylan brand and was able to switch back.  This past Fall, Mylan became unavailable at any pharmacy I called, so it was back to Teva.  After a month I couldn't breathe right, felt like I had pneumonia. My Oncologist took me off the tamoxifen for 3 weeks, my primary care physcian sent me to a Pulmonologist, who determined my lungs are fine. I saw him 2 weeks after I'd stopped taking the Teva brand.  75 hours and 4 doses of resuming the Teva brand and those lung symptoms came roaring back - it was Christmas Eve.  Awesome.  Luckilly, the next week my pharmacy was able to order the Mylan brand for me this past month, and I've been OK again.  Now the pharmacy just phoned to tell me the Mylan brand is unavailable and so I'm going to try the Watson brand.  I have my regular Oncology check up on Valentine's Day and I'm thinking he may switch me to  Arimidex at that time, so I'm hoping I can tolerate the Watson brand for a few weeks.  Just glad to see this post, I thought I was crazy for awhile there, til I realized it wasn't me, it was Teva brand.

  • ALittleBitBritish
    ALittleBitBritish Member Posts: 415
    edited January 2012
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    I am glad to hear I can continue eating sugar, life without chocolate just aint' worth livin'! Smile Mylan is my manufacturer of choice.
  • cycle-path
    cycle-path Member Posts: 64
    edited January 2012
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    phxsunshine, have you thought about trying an online pharmacy? If the Watson doesn't work out you might want to research that.

  • peggy_j
    peggy_j Member Posts: 89
    edited January 2012
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    Great topic. Chevyboy, which brand were you on when you had your hearing loss? Did it actually occur overnight or were there prior symptoms? I've had a few episodes of disequilibrium but it comes and goes.



    Re: sugar : we may be getting off-topic here but I've also read that you can't starve the cancer cells. One book said they are greedy, gobbling all the sugar they want so you'd starve you good cells before stopping the cancer cells.

  • LuvLulu07
    LuvLulu07 Member Posts: 596
    edited January 2012
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    Started Tami Teva 5 days ago - no big SE's yet.    I switch to Teva in Europe once this Rx runs out - wonder if I'll notice a difference?  

  • CookieMonster
    CookieMonster Member Posts: 90
    edited January 2012
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    I'm getting ready to start Tamox, probalby around the beginning of Feb. I haven't read all of the info here yet, but I'm wondering, how do you get a particular brand of Tamox? I've never requested a particular brand of drug before and I don't know if I can just ask for one type at the pharmacy or what? I'm planning to use a mail order pharmacy, I think, unless there's a reason not to do so.

    Thanks for any info.

    -Judy

  • cycle-path
    cycle-path Member Posts: 64
    edited January 2012
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    Call up the pharmacy and ask them which manufacturer's Tamoxifen they dispense. 

  • bgirl
    bgirl Member Posts: 435
    edited January 2012
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    On Mylan - SEs seem manageable so far except my vision.  Any one else experience vision problems on Mylan or any other manufacturer.  I do wear glasses, only a year old and were fine before tamox.  Now my distance vision is ok and I can take them off and read close up, but my middle vision about 12-18 inches keeps fading in and out.  Was okay until 2 weeks after I started tamox and seems to be getting more frequent.

  • cycle-path
    cycle-path Member Posts: 64
    edited January 2012
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    bgirl, I know I've seen reports here of vision problems on Tamox. You might search the boards for "vision" or "eyes" or "optical".

  • coraleliz
    coraleliz Member Posts: 158
    edited January 2012
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    bgirl- Saw the eye doc last week for vision problems related to Tamox. I was on it for 3 months. I only need glasses for reading but wear progressive lens so I don't have to keep taking the glasses on & off. My distance vision is less clear, things look a little foggy. My reading looks smudgey. I tried stronger over the counter readers but they don't help. What I was told is that I'm having "accomadation"issues brought on by Tamox. He thought I should wait 3 more months before changing glasses. Was told that my eyes are done adjusting to this drug yet. I'm on the Teva brand. My MO took me off Tamox for 1 week & I'm suppose to start back at a 10mg dose, but that's because of dizziness. My opthamologist doesn't think my vision issues and dizziness are related.
  • LuvLulu07
    LuvLulu07 Member Posts: 596
    edited January 2012
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    CookieMonster   I started Tamox almost a week ago, didn't check what manufacturer I was getting and so far so good.  I don't think that we know how the SE's will be until the plunge is taken.  Altho if you know that you are gluten insensitive, or have other sensitivities you might check inert ingredients.  Somewhere on these threads they have been listed.    Good Luck.  

    Today the gyn onc let me know that if my ooph is done, Tamox might be switched over to an AI.   I didn't realize that Tamox is considered to be more of a health risk than an AI?  

  • proudmom_wife
    proudmom_wife Member Posts: 176
    edited January 2012
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    bgirl - yep, eye issues, although minor.  Before I started Tamoxifen I had an thorough eye exam as a baseline.  Since then my eyes seems to have gotten a bit worse.  My eye doctor said to wait until my body is done adjusting to the Tamoxifen also.  In the meantime I put moisture drops in them a couple times a day and that seems to help.  

    Edited to add:  My middle vision is the one that seems to have gotten fuzzy too.  Distance is still the same, glasses work fine for that and can't/don't wear glasses for reading.   

  • phxsunshine
    phxsunshine Member Posts: 156
    edited January 2012
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    Thanks cycle-path, that is a good idea.  The Watson went over like a lead balloon last night.  3 ridiculous sweaty hot flashes, I was panting, seriously.  When I woke up at 3AM, my brain hurt and the pain kept roaming around.  Not a headache, but it hurt nonetheless.  I get migraines, and it wasn't that quality of pain or location.  So Watson is going on the reject pile  for me.  I have 4 more Mylan pills and I will take a break til I see my Oncologist in Feb.  This lack of sleep and pain cannot be good for me and I wonder if the net result  is a plus or minus with these extreme side effects.
  • bgirl
    bgirl Member Posts: 435
    edited January 2012
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    Thanks to all for your comments and suggestions regarding vision.  Thought maybe I really was going crazy after everything.  My MO said to drink lots of water when I started Tamox, and it does seem to be worse when I don't drink all the time.  Will maybe try the moisture drops in eyes and see if it does help too.  Only been on a month so will see how it settles out.  My insurance won't pay for new glasses until December, so I hope it doesn't get too bad.

  • CatbirdC
    CatbirdC Member Posts: 235
    edited February 2012
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    I just typed in ... is tamoxifen chemo and got this....

    You mean my tamoxifen is chemotherapy?Posted by Lucy in Uncategorized. 3 CommentsShare

    Yes, tamoxifen (formerly brand name Nolvadex) is chemotherapy! It is used as an antiestrogen and is classed as a  selective estrogen receptor modulator.  This means that IF your cancer is estrogen positive,  tamoxifen will bind or attach itself to estrogen in your blood stream.  The “attachment” prevents the estrogen from being used by the cancer to replicate. (An oversimplified explanation, but easier to understand than explaining the pharmacogenics of binding proteins and enzymes.)  When your biopsy or tumor tissue was evaluated by biopathology, the lab included tests to help determine what was shielding, or providing happy-transportation to the cancer cells.  ER ( Estrogen + or -), PR  (Progesterone + or -).  More recently,  testosterone + or – has been included, as well as testing for a specific genetic receptor  

  • vettegal
    vettegal Member Posts: 5
    edited February 2012
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    I was on the teva tamoxifen for 3.5 years until my insurance changed and I couldn't use Walgreens any ore. Switched to mylan tamoxifen and the side effects have dwindled. It has been one month and my hot flashes are not too bad. I do get the chills before I get a flash. But it's over so quickly now. My joint pain is definitely better. I just lost my job and I got my MO to get me a 90 day supply and I went to giant eagle and it only cost 26.00 I did call koman for a free mammogram and I got the voucher. Now they tell me I have insurance till the end of the month. So I have an appointment for mammogram on the 29 and my other dexa scan (I think) getting fitted for sleeves for my LE in my right arm. Let the insurance pay for it.

  • coraleliz
    coraleliz Member Posts: 158
    edited April 2012
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    I'd like to switch brands, but................I called all the pharmacies(all large chainstores) in my area that are on my insurance list & they are all currently dispensing the TEVA brand that I'm already on. What I was told over the phone was that they have no control over what generic comes into their store & it can change. I went to CVS where I have my Rx filled & asked them if they can order the Mylan brand for me. I was told "no", they get whatever brand is sent to them from the "warehouse". My insurance does not give me a mail order option. So, how did you successfully switch brands??? 

  • Heathersmom
    Heathersmom Member Posts: 4
    edited April 2012
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    BARR brand tamoxifen 11 months - hot flashes, leg cramps, pelvic pressure, thinking was fuzzy and I was forgetful.

    TEVA brand - 5 months - hot flashes (worse than before) depressed feelings, dizziness, ear pressure and ringing, tendon pain.

    I took femara for 15 months in between the two brand of tamox. The side effects were the same as the TEVA brand tamox minus the ear pressure. Had the foggy brain and forgetfulness of the BARR brand tamox.  

    NO LIBIDO ON ANY OF THE DRUGS!

  • proudmom_wife
    proudmom_wife Member Posts: 176
    edited April 2012
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    coraleliz - I go to CVS for my precriptions and spoke with the pharmacy manager and explained to him that I was having issues with the fillers.  He said as long as I request the refrill with the manufacturer I wanted at least one week in advance, they would do what they can to fill it per my request.  So far so good.  He also said if he ran into an issue with it he would ask me to have my doctor specify a manufacturer on the prescription, but have not needed to do that yet.
  • coraleliz
    coraleliz Member Posts: 158
    edited April 2012
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    Proudmom-hmmmm. I'll try again & tell them that I know someone in Northern CA having Mylan brand ordered for them at their local CVS. There is an independent pharmacy that does not take my insurance, I might try. I think it will cost me $20-25 a month instead of $8. As for asking my MO to specify brands, I haven't done that. Thanks

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