Femara side effects?

[DeborahNC]

I have only been on Femara two weeks, but have developed pressure headaches, brain fog, hearing disturbances (as if I were at the oceanside, waves crashing).

Can those of you who are on it or have been please tell me of your experiences? I am weakly ER+ (it was not quanitified) and wonder if the good I will receive will be worth the side effects.

[DeborahNC]

No one here is on Femara?

[sarah]

Dear Deborah,
Sorry you feel you've been ignored. I just got back on-line.
I've been on Femara for about 16 months. Since chemo/Herceptin I've had some odd side effects. Not sure who to blame for the side effects but I know that my oncologists strongly suggested taking it at bedtime to avoid side effects so unless you've tried that, try that. If you read the side effect label it just about includes everything. If you're worried about anything talk to the pharmacist, your oncologist and general practioner, you never know who'll come up with a way to deal with some of the problems. I've just accepted the side effects I have as part of the price I pay to stay alive. One of the most annoying for me - caused by the cortisone during chemo - is cataracts which I'm putting off doing anything about for all long as I can still drive safely but reading is a real bore and I'm a big reader. Also fatigue still hounds me and weight gain. Also hot flashes!!!!
I do get headaches but they pass and achy bones and skin rashes and.....but from what???? I haven't had the waves crashing yet.
I do hope you find an answer to your problems. Since more than just HER2 people take Femara - in fact more non-HER2 people probably do since HER2 is generally PR and ER negative, you might try a regular breast cancer site to see if they have any suggestions.
Sorry not to be able to be more helpful.
Good luck and keep fighting and stay strong,
try taking it at night and see if that helps.
sarah

[DeborahNC]

Thanks for that suggestion, Sarah. I hadn't heard that one. Yes, the label lists a plethora of side effects, so it's like 'choose one.'

I know there are others on the board who are on Femara. Sometimes it gets really discouraging on a support site when one posts for support and after 30 views of the post no one bothers to reply.

Thank you for taking the time to help. I hope you can get the cataracts taken care of. I don't know what I would do with myself if I couldn't read! It's a major, major part of my life.

All the best to you and thanks again for your reply.

[Cheryl E]

I have been on Femara for almost 3 years. No weird side effects, just the normal. I will have hot flashes if I drink coffee or have wine/beer and I need to do moderate excercise every other day to avoid joint stiffness.

Cheryl

[Jean]

Deborah,

I am not taking Femora - was taking Arimidex - had to stop when I started TCH chemo - and I am certain I will go back to Arimidex after I complete my chemo.
But I strongly advise what Sarah told you regarding taking the medication in the late evening. When I first started Arimidex after about three weeks I began to have extremely heavy headaches. I stopped the Arimidex for two weeks and gave my body a rest then started the Arimidex again only this time I took it at 10PM each and every night. The headaches stopped and I did much better.
Did have joint and bone aches - but I also found that exercise helped keep me
limber which helped to deal with the joint pain. Wish you luck - on Femora.

Regards,
Jean

[sarah]

Deborah,
Hope the time change helps. I wonder why doctors don't suggest this more often???
I never know what's an important side effect versus a not important one. while on Taxol and Herceptin, my feet and ankles swelled enormously plus a petscan showed fluid in the lungs! and all my doctors including the bigwig oncologist thought nothing about this although I was worried for my heart! I suppose since my Muga and heart sonogram were good, they just said those were normal side effects!!! so after that I decided not to worry! they only became extremely worried when I developed a tennis ball lump in my neck area!!! then I was given anti-coagulant shots to do twice a day - myself!!! and other stuff!!!
Keep up the good fight
sarah
PS I'm still reading all the time but it's harder. We'll have to exchange names of books we've loved!

[heblaj01]

Deborah,

Once you hopefully overcome the side effects you mentioned using the advice in previous replies in this thread, you should be concerned about the longer term potential threat of weakening bones. So have at least your annual bone density test done. Even better would be to monitor more frequently the trend in bone resorption with the help of urine (or serum) test for NTx (Ntelopeptide) or Ctx markers or some other markers.

Femara is a very potent estrogen suppressor which in some cases leaves so little as to make undetectable the serum levels of estrogen.

If you respond well to the drug you should have tumour markers way down in 3 to 6 months

If you cannot live with the side effects ask your onc if it is feasable to reduce the dosage (oncs usually don't like it because they lack data on the efficacy of reduced dosages unless they are willing & able to find the detailed clinical trial regimens )

[kat in the delta]

My sister had to switch because of the joint pain of femara to aromasin. Kat

[Becky]

Did the joint pain go away when the switch from Femara to Aromosin was made?

Thank you in advance

Becky

[R.B.]

Side effects.

http://66.102.9.104/search?q=cache:D...ient=firefox-a


It is reported above as an aromatse inhibitor. eg inhibits P450.


P450 is reported to derive from COX which is a product on the fat pathway.

Oestrogen results in the secretion of growth factors.

Fats are needed in growth to create cell membranes etc.

Does aromatase inhibition intervene in the fat elongation pathways eg production DHA and EPA in some.

You might like to read Smart Fats or the updated version M Scmidt. Spaciness tinitus etc is reported as being potentially improved by intake of omeg threes EPA DAH and balancing omega three six.

If you have time to read it you may find it thought provoking. It can be found second hand on the WEB for a few dollars.

Please discuss dietary changes with your advisors.

RB

[R.B.]

I did a search on "fat syntesis P450" and this was on of the trials that came up.


This is a huge subject and every dooropened leads on to more. I do not pretend to understand the implications of this.

But I do not that it seems to suggest that P450 (Aromatase) may be involved in fat synthesis as well oestrogen regulation.

IF it is blocking aspects of fat synthesis it could have wider implications - see posts on omega three and six.

The impact of any potential blocking could be mitigated by ensuring that the body has an adequate intake of long chain fats particularly DAH and EPA.

Please discuss any dietary changes with your medical advisors.

RB

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
1: J Pharmacol Exp Ther. 2006 May;317(2):732-8. Epub 2006 Jan 18. Related Articles, Links
Click here to read
Induction of renal cytochrome P450 arachidonic acid epoxygenase activity by dietary gamma-linolenic acid.

Yu Z, Ng VY, Su P, Engler MM, Engler MB, Huang Y, Lin E, Kroetz DL.

Department of Biopharmaceutical Sciences, University of California San Francisco, San Francisco, CA 94143, USA.

Dietary gamma-linolenic acid (GLA), a omega-6 polyunsaturated fatty acid found in borage oil (BOR), lowers systolic blood pressure in spontaneously hypertensive rats (SHRs). GLA is converted into arachidonic acid (AA) by elongation and desaturation steps. Epoxyeicosatrienoic acids (EETs) and 20-hydroxyeicosatetraenoic acid (20-HETE) are cytochrome P450 (P450)-derived AA eicosanoids with important roles in regulating blood pressure. This study tested the hypothesis that the blood pressure-lowering effect of a GLA-enriched diet involves alteration of P450-catalyzed AA metabolism. Microsomes and RNA were isolated from the renal cortex of male SHRs fed a basal fat-free diet for 5 weeks to which 11% by weight of sesame oil (SES) or BOR was added. There was a 2.6- to 3.5-fold increase in P450 epoxygenase activity in renal microsomes isolated from the BOR-fed SHRs compared with the SES-fed rats. Epoxygenase activity accounted for 58% of the total AA metabolism in the BOR-treated kidney microsomes compared with 33% in the SES-treated rats. More importantly, renal 14,15- and 8,9-EET levels increased 1.6- to 2.5-fold after dietary BOR treatment. The increase in EET formation is consistent with increases in CYP2C23, CYP2C11, and CYP2J protein levels. There were no differences in the level of renal P450 epoxygenase mRNA between the SES- and BOR-treated rats. Enhanced synthesis of the vasodilatory EETs and decreased formation of the vasoconstrictive 20-HETE suggests that changes in P450-mediated AA metabolism may contribute, at least in part, to the blood pressure-lowering effect of a BOR-enriched diet.

PMID: 16421287 [PubMed - indexed for MEDLINE]

[R.B.]

****************** "Similarly, because aromatase is productive for a multifunctional physiological factor, estrogens, impaired metabolisms of bone, carbohydrate, and fat etc. result from the deficiency." *****************

I will look for links try and access full article but the above would suggest that intervention inthe aromatase pathways have the potential for a very wider range of side effects.

On the balance of probabilities we will see more long term effects with time.

I would reiterate my previous comments on fats.

RB














1: Nippon Rinsho. 2004 Feb;62(2):368-72. Related Articles, Links

[Aromatase deficiency]

[Article in Japanese]

Harada N.

Department of Biochemistry, Fujita Health University School of Medicine.

Aromatase, a key enzyme in estrogen synthesis, is tissue-specifically regulated in various tissues and plays an important role through endocrine and intracrine estrogen production in various physiological functions. Therefore, aromatase deficiency caused crucial impairments of physiological functions in the gonadal tissues as well as extra-gonadal tissues. Because aromatase is protective for androgenic exposure by catabolizing, virilization of a pregnant mother and pseudohermaphroditism of a baby girl consequently result from the deficiency. Similarly, because aromatase is productive for a multifunctional physiological factor, estrogens, impaired metabolisms of bone, carbohydrate, and fat etc. result from the deficiency. We discuss the etiology, clinical symptoms, and therapeusis by classifying it into two types of complete and incomplete aromatase deficiencies.

Publication Types:

* Review


PMID: 14968547 [PubMed - indexed for MEDLINE]

[DeborahNC]

The linked articles read as if too much AI is not an ideal situation. As I am only weakly ER+ this makes me wonder if any AI will be of much benefit or could even do more harm than good.

I will definitely be discussing this with my onc next visit. I'm going to put Femara on hold until then.

[Kim in CA]

Dear Deborah,

Would have replied sooner, but have had trouble accessing the site.

I have been on Femara a little over 4 years. I am only slightly ER+ (less than 10%) but a BC specialist I consulted for a second opinion at UCSF thought it would be a good thing to add to the arsenal.

I also take it at bedtime and don't know if that makes a difference, but side effects don't seem too bad(or else I have just gotten used to them!)

Anyway, I do think exercise is of huge benefit. I think it definitely helps with joint stiffness, and as you know weight bearing exercise is so important for our bones. Also, don't know if it's the exercise or the fish oil that I have recently added to my diet, but a recent Muga scan showed the best score I have had in my almost 5 years of being on Herceptin.

Off subject here, but my husband and I are planning a trip to N. Carolina next month to check out possible retirement places. I am a huge horse addict and have a friend that moved her dressage training barn to Pinehurst last year, and she says she absolutely loves it there. She said this would be a good time to come to see if we could cope with the heat! I am in Northern CA and we live in an area the neighbors call Pneumonia Gulch because we get so much wind and fog in the summer! So, it would really be a change for us, but sounds like an adventure too.

Take Care, Kim in CA

[Ora]

I have been on Femara for 3 months. The only side effect I've had so far is hot flashes - really bad ones. I like the idea of taking the drug at bedtime because I don't seem to have hot flashes as much during the day as during the night. Might help. Good luck in your treatment.

[Susan Rankin]

Hi Kim,

I live in Concord, NC. Pinehurst is a lovely resort. Golfer's paradise! I think you would love the area. The summer can be very hot, but the fall and spring are very comfortable. Our winter season is usually mild, not too cold.

Susan

[Susan Rankin]

Hi Deborah,

I have been on Femara now for over six weeks. I originally started on Arimidex in May of 2005, and had Herceptin weekly for one year starting in June 2005. I finished a year of Herceptin on June 20 and I can say I am feeling better.

I still have the joint pain on Femara but not as bad as I had on the Arimidex. Hot flashes were horrible when I first started the Femara but they have calmed down considerably. My runny nose while on chemo and Herceptin has improved greatly. I really think I am feeling better on the Femara but it has taken at least five weeks for me to feel this way.

I will see my oncologist on Friday to see if he thinks I should stay on the Femara and then will post.

Hang in there.

Susan

[kat in the delta]

Yes, my sister has no joint pain taking the aromasin. She could not take the Femara & even told her ONc. that if she cont. Femara she needed Pain pills ....But, the switch to Aromasin has been good---no pain for her. Kat in the delta

[kat in the delta]

I talked my surgeon who only has her own breast clinic--top notch female MD and she said that if it was enough to show up as even "weakly" positive that she would advice taking an aromatose inhibitor-----I was also Weakly Positive and just asked her that same "?", and I am calling my Onc today. Kat in the delta