High cholesterol while on Ibrance and Letrozole.

[Discocat]

Hello

I'm wondering if anyone has been prescribed cholesterol medication while taking Ibrance and Letrozole...or has found someother way to lower their cholesterol levels?

I've been on this combo for around 2 1/2 years with monthly Zoladex implant too.

From what I can see from some brief research...the aromatase inhibitors cause raised cholesterol as a common side effect...but cholesterol meds are not recommended while taking Ibrance due to possible complications.

On my last visit to the oncologist almost three months ago we had said to check levels again before the next meeting ...which will be on the 20th of February.

So I'll be having some extra blood work done at my next blood tests in a few days to check cholesterol and sugar levels again.

I'm worried that I'll have to change my treatments...which are working well in every way apart from the cholesterol.

Do you think having my ovaries removed would be an option to reduce estrogen levels? Or would I still need to take hormone blockers even after that?

I will discuss my concerns with the doctor next week...but was hoping some of you might have an experience of a similar situation?

Any ideas?

[Totheriver]

I have been on this treatment for almost 5 years ago. About a year ago I started Lipitor for high cholesterolbut do Zometa evert three months instead of zoladex. Noel have progression in two tumours in my spine. Had 5 rounds of radiation and will see after scans in March whether I have to change meds. Hoping not. This was still my first line of treatment. I will ask my oncologist if it could be be because I started cholesterol meds. I had not heard that before.

[Discocat in reply to Totheriver]

So far I haven't had it explained by my oncologist...but on my previous meeting she mentioned that cholesterol meds are contradictory to my meds without telling me which one...its my own research that shows a possible reaction with Ibrance...so please don't take my word for it....I'm equally in the dark and also worrying that I might need to change meds.

Good luck to you with your scans.

I also do Zometa every 3 months.

The Zoladex is an Estrogen blocking implant that I get every month to keep me in a menopause state so I can take the Letrozole.

[Totheriver in reply to Discocat]

Thanks for your reply. I am going to ask about it. Hope things go well for you too💕

[AvidBooklover]

I was on a generic statin before being diagnosed with MBC. Been on Ibrance and Faslodex for almost 5 years. My cholesterol actually was the lowest in years at my last physical!

[Discocat in reply to AvidBooklover]

Thanks for responding.

Did you do anything to help to reduce your cholesterol? Or do you still take the statin?

I've been trying to adjust my diet. I have oats and more fibre. I only use olive oil to cook with and I've cut back on dairy. I don't eat meat but I have some fish...but I'm avoiding shrimps and prawns and eggs due to their cholesterol levels and I'm adding more dark greens into my meals and eating nuts. I also drink green tea and lots of water daily.

I was diagnosed at 50 yrs old and was not yet menopausal....which is why I'm on Zoladex. I'm hoping things might balance out in more time and that the cholesterol increase might still be from the induced menopause? Although it might also be from the actual medication itself and not the process....I'll have to ask the oncologist.

Hoping to see some reduction when I do the tests.

[AvidBooklover in reply to Discocat]

I was not super actively working on this. I have been riding my recumbent bike for an hour many days during the week and I think that has helped. I have been eating mixed rice for lunch with veges many days. Since the holidays been skipping dessert except for frozen fruit bars and occasionally dark chocolate. And menopause may be the reason for increased cholesterol. I still take the statin. I am 67 and it was humorous that I finally have this under control.

[Discocat in reply to AvidBooklover]

Wow. Great that your levels came down without statins!I'm missing 🧀 cheese😁

[AvidBooklover in reply to Discocat]

No it was with statins...still on one and I eat cheese! I think exercise chgd things.

[love2golfwell]

I had elevated cholesterol on Arimidex and have it as well on the Letrozole. However the ratio of good cholesterol to bad is good just the overall number is high. My oncologist does not check my cholesterol levels, I have to do that through my primary care doctor. I did not know there would be a problem taking a statin with Ibrance, but I don't think I would take them anyway as I know they can cause muscle pain. My husband tried 3 different statins and was not able to take them because of the pain he experienced while on them. Best of luck to you when you speak with your doctor. Please keep us posted. Sending hugs and prayers.

[TammyCross]

My cholesterol levels went up on anastrozole for the first time in my life. My primary doc was very eager to put me on statins. (I read a lot about statins at the time on this board -- people had different experiences with different ones, but some seemed fine with it.) I resisted -- statins are not good for you, on top of everything else. She gave me three months to try to get cholesterol down (sorry, I am ignorant about cholesterol -- there was one high number, bad cholesterol?). I talked to the oncology nutritionist and she said it is very hard to lower cholesterol through diet.

My primary doc forgot about re-testing in 3-4 months. It has been a year. I will see here in March and she might remember. I am now on exemestane, which can also cause high cholesterol, but the site I checked said it doesn't usually need treatment, unless one already had high cholesterol. I will see what happens when I see primary next month. Interested in what you decide. My primary's concern is that I already have risks for stroke. (I am well past menopause, so it is the medication, not menopause.)

[Aprilfoolz1]

I also have elevated cholesterol (219 total) but my good cholesterol to bad cholesterol ratio is pretty good. However, my former pcp wanted to out me on a statin STAT as my father had a single bypass in 1971 and a quad in 1998 plus other heart issues (he's almost 89). As I am on Ibrance I didn't want to go on a statin unless it was dire My pcp told me about a test called a Coronary calcium scan , which I had to pay for out of pocket but it was $100 I think ? It evaluates the amount of calcified (hard) plaque in your heart vessels . I had none! If the test had shown plaque build up I would have seen a cardiologist.

See if you can get this test ordered to see if you have plaque buildup and if a statin is completely necessary .

[Discocat in reply to Aprilfoolz1]

Thank you I'll look into that.

[Proudmetsmama]

yes! I had to go on cholesterol medication!

[Discocat in reply to Proudmetsmama]

Thanks for responding....how did you find that combination? Did you have increased muscle tension/pain? That seems to be a statin side effect.

I read your bio info and we are around the same age. My son was 17 when I was first diagnosed....he's settled into his 2nd year at university now...living in London.

Life goes on.... and I'm so proud and happy to see the milestone moves he's been through.

Wishing you many happy years with your kids!!! And continuing success with all meds and treatments.

Zoe

xxx

[lovnmycat]

Hi Discocat,

I have the same problem. My cholesterol started rising after taking Ibrance and Letrozole for 18 months. I also see a functional medicine Oncologist and we did a lot of blood work and it looks like it is medication induced high cholesterol. He doesn't seem as worried because looking at other things he felt it was better to avoid additional medication. Just know he ran a lot of cholesterol tests and found my good cholesterol was high and my A1C and everything else was good. I have struggled with weight gain while being on these meds and in general with going into a quick menopause. Hope this helps.

[Discocat in reply to lovnmycat]

Hi

Thanks for responding. I got my blood tests back but I haven't seen the oncologist yet...that's on Tuesday. I've managed to get my cholesterol down a bit. It was 278 before 3mnths and now is 235....sorry can't remember the good cholesterol stats.

Hoping the oncologist will see this as a good start and that we'll keep monitoring it without medication.

Wishing you all the best!

We seem to be in a similar situation and around the same age too....the immediate menopause sucks and my weight is so hard to shift...I seem to be losing the same 5 kilos over and over.

Zoe

xxx

[lovnmycat]

I’m hovering right about that 230 number too.

[Discocat in reply to lovnmycat]

I'll let you know if I manage to reduce it anymore. I see the oncologist every 3mnths and plan to try harder in the run up to the meeting in May.I wasn't as determined as I could have been recently...with Christmas treats and as I also got sick with covid and a cold too.

My Doctor has a similar opinion as yours, and is also very adamant that I should try not to take any extra meds as I've had issues with my liver enzymes at the start of my diagnosis....so she wants to try to keep the load on the liver as low as possible.

[hurricaneheather]

mBC dx July 2015. treatment: Ibrance, Anastrozole, and Zoladex. Aug 2015. the cholesterol increased noticeably beginning in 2016. the primary is not 'concerned' about the increase. the metabolic doctor had me take Sertraline for 21 days, in 2022. there was a small decline in the cholesterol. he has not had me take it again.

[Discocat]

Thanks for everyone who responded.

I had my meeting today with the oncologist and she's very happy with all the bloodtests. Currently the cholesterol levels are borderline...and my good Cholesterol could do with being a bit higher....in general she said that with the meds that I take the raised Cholesterol is to be expected and she's fine with the current stats so I'm going to continue with my revised eating and may be next time that I see her.... in another 3 months... I might get the figures even better.

She suggested trying to add more walking to help with heart health.

Also my next scans that would have been in May have been scheduled for July to be on the same day as annual Mammogram...so that they'll be 8 monthly instead of 6 monthly... because of the continuing good blood tests and stable previous scans.

[DianaTrapani]

I was on Anastrozole for almost six years. Over the first four, my PCP was tracking my cholesterol, as it was slowly raising. I made severe diet changes, but it continued to increase. I started with 10 mg of Lipitor, which greatly controlled my levels. Then, after the metastatic dx and treatment, we switched from Lipitor (contraindicated) to Zetia, 10mg which is working just as well.

Blessings

[awesome4ever in reply to DianaTrapani]

Yes it' s very interesting that Ibrance and Kisqali are both contraindicated with Lipitor? However Verzenio is not. Since they are all kinase inhibitors you would think they would all be the same.

Thankfully though the other oral treatment options such as Afinitor, Xeloda, Lipitor or any of the statins are ok to take.

My cholesterol is also rising since I've been on Afinitor (11 months)and we have been monitoring it. Looks like I'm going to have to take the plunge soon and add a statin to my medication profile.