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Stage III and Verzenio

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  • kathrynw1thasea
    kathrynw1thasea Member Posts: 89
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    Hi seeq,

    Thank you for sharing your experience. A question I am nearing the end of my two year course on Verzenio and I expect my MO to recommend that I stay on it indefinitely because I have a high risk of recurrence. My biggest concern is worsening of side effects. I’ve developed runny eyes that affect my sight for a few hours each day and I’m having more trouble with mood lately. Have you experienced or heard of others who experience changing or increased SE the longer they take Verzenio?
    Thanks again for coming to this forum to share your experience!

  • seeq
    seeq Member Posts: 1,084
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    @kathrynw1thasea

    I recall one person who had increasing trouble with severe diarrhea, but I'm sure that was before the 2 year mark. You can always consider a dose reduction if your SEs get worse - or if they just start to wear on you. I think it was one of the later Monarch studies that showed a lower dose was equally effective in Stage IV, so maybe something for you to talk to your MO about?

    There are getting to be more people on Verzenio over two years, because there are just more people on it, and more people using it as the first-line treatment. Stage IV stays with a treatment until it stops working or the SEs are intolerable. When I started, I was told 24 mos is average PFS, but that was almost 4 years ago and it's still working for me, so I'm pushing the curve out. 😀

    There's at least one other person here who's still on it after about 3 years. Probably more, but one I can think of.

    There have been a few people with watery eyes. Someone mentioned using Systane drops, but I'd check with your MO first. The only mood issue I experienced was caused by changing from HRT to estrogen blockers 😯, the shock of the dx, and the extreme fatigue in the beginning. It all smoothed out after awhile.

  • lenn13ka
    lenn13ka Member Posts: 103
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    A month into Verzenio. Started out fine but now I am into the vicious cycle of the big D and constipation, stomach cramps and bloating if I do take Imodium. Trying to see if I can get off this cycle by eating/drinking better. I am on 150 2 times per day.. Any tips appreciated. I am on Verzenio and Exemestane with hopes that the combo shrinks a chest wall tumor so surgery and radiation can be an option for me down the road.

  • seeq
    seeq Member Posts: 1,084
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    @lenn13ka - if you're not already taking multi symptom Immodium, that might help. I've added simethicone (e,g. Gas-X, Phazyme) to help with the cramping. Also half or quarter doses of Immodium may reduce the constipation and cramping. I've used the liquid Immodium to make it easier to get smaller doses.

  • kotchaj
    kotchaj Member Posts: 210
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    Hi @lenn13ka,

    @Seeq is right on the money with her recommendation for the multi-symptom Imodium. I finished two years of V in February and the multi-symptom Imodium was what enabled me to stay on the 150 X 2 dosage. I also had a prescription for Lomotil from my doctor and used that as well. It helped to slow things down through my intestines, which made a big difference. The two together were a game changer for me. I also used the Gas-X to help with the stomach cramps. Those did calm down for me the longer I took it.

  • kafich
    kafich Member Posts: 4
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    @kathrynw1thasea

    I am not stage IV nor stage III, but I can report on worsening fatigue especially during my second year with Verzenios, and I think I have read of another person who suffered a sudden increase in fatigue after 9 months or so. In my case, the fatigue increased slowly / in steps, and exercising as frequently recommended for cancer related fatigue had no positive effect on it. I never tried a dose reduction though, as the 2-year mark was getting closer each time I noticed the fatigue has gotten worse. I sticked with 150mg twice a day, and just finished the two years of adjuvant therapy, now waiting for my body to recover.

    I also believe that the constant battle in my bowel over time has taken its toll, even though the diarrhea remained manageable with increasing amounts of loperamide. After 1.5 years I had developed a VIT B12 deficiency, which seems to be common or at least a possible side effect of Verzenios.

    On teary eyes I can only report that I know this side effect, too, but didn't find a remedy.

    Despite all the nasty and/or annoying side effects, I agree with seeq that there is always the option to ask for a dose reduction when necessary. I probably should have done this with my worsening fatigue, and certainly would if I had been asked to take these pills for more then 2 years.

  • kafich
    kafich Member Posts: 4
    edited April 4
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    @lenn13ka

    I was also struck hard by the diarrhea at the beginning, but learned to control it with preemtive loperamide and psyllium husk (e.g. brand name Metamucil, but there's other options, too). I started with a tea spoon of Metamucil once a day, but quickly increased to twice a day. The magic of psyllium husk is that it works both against diarrhea AND constipation, making the sharp ridge between the two wider and more comfortable to navigate. It works by soaking up liquid and producing bulk in the bowel. Make sure to keep a distance of at least two hours before and after any important medication.

    For me, psyllium husk alone was not sufficient to control the diarrhea (apparently for some folks it is), but it became at least manageable with regular loperamide - I started with 1 loperamide each day and adjusted whenever the equilibrium did not work anymore.

    I plan to post a complete summary of my experience with Verzenios on the "Abemaciclib Verzenios for All Stages" board in the near future, but not today.

  • moderators
    moderators Posts: 7,980
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    @kafich we really appreciate you sharing your experience, and we welcome you warmly to our BCO community. 😍

  • kafich
    kafich Member Posts: 4
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    Thanks mods, I myself profited a lot from reading other people's experiences with these drugs.

  • mia.koko
    mia.koko Member Posts: 4
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    I started Verzenio 02/08/2023 . 150 mg 2 times a day. My side effects briefly

    Diarrhea - manageable, have episodes but not very often, maybe because before diagnosis I was always constipated. The first 7-8 months was totally fine then started having D . I don’t take medicine for that
    Fatigue is also manageable

    Blood test was done every 2 weeks at first and now every mouth. The results are close to normal ,so my doctor keeps me on the same dosage.

    My biggest SE is hair lost. After chemotherapy my hair started to grow but when I started V it started to fall out. I have only 50% of my hair . My nails are very brittle . I am using some remedies, but no effect.

    Teary eyes is another huge issue. Nothing helps….Sometimes I have runny nose with this. Very annoying…

    Diagnosed 05/2022 Stage 3A grade 2 right side ER+PR+HER2-

  • lenn13ka
    lenn13ka Member Posts: 103
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    Thanks for all the Verzenio tips everyone. I will try those and have also switched up the timing of my exemestane to evening so now not taking the same time as Verzenio in the morning . Seeing if that helps at all.

    I took Palbociclib for almost two years in a clinical trial back in 2015. I don’t remember these kind of side effects..

  • kathrynw1thasea
    kathrynw1thasea Member Posts: 89
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    A huge “thank you” to everyone sharing their experience with Verzenio. This has been very helpful to me. I’m learning new techniques from y’all that I haven’t heard anywhere else.
    It’s much appreciated!