Apparently they havent changed the ingredients in the Accord brand.
I emailed Novartis, the manufacturer of Femara, about why its costs so much, and why chemists cannot seem to source it. Doctors don't seem to want to prescribe it, because of the cost, which is why they prefer to prescribe the cheaper generics.
This is the reply from Novartis. The layout changed slightley when i copied and pasted it:
Thank you for contacting us for information regarding the availability of Femara® (letrozole) tablets. I
understand that you would like to know why Femara is higher in cost than letrozole manufactured by
other companies. You would also like to know how you can obtain Femara if you have a prescription for it.
Femara was the original brand of letrozole manufactured and the price set at that time reflected the
research and development costs associated with bringing a new medicine to market. Once a medicine has been available for some years, development of generic formulations of the medication is permitted
and, sometimes, the generic formulations are less expensive.
If you have a prescription for Femara and your pharmacist is having difficulty sourcing the product, I can
confirm that there are no stock issues with the product and would suggest that the pharmacy telephone
our Customer Services Department on 0845 741 9442, who should be able to advise them further.
I hope that this information proves to be of use to you. If you require any further assistance, please do
not hesitate to contact me.
Medical Information Department
Novartis Pharmaceuticals UK Ltd
I seems to be such an individual thing, as what suits one person, can have awful side effects for another. Ths makes it difficult in saying one is better over another for any individual. Its gonna be trial and error for us all it seems, unfortunately.
Glad you found one that suits you lisabeeb.
I am in my 8th year of having hormone treatment after a mastectomy. 5 years of Tamoxifen and now in my 3rd year of Letrozole. I can't take either Cipla or Accord as they make me headachy and sick with a bitter taste in my mouth. sun pharmacy is the one I take and I have no side effects.
Thanks Dawn for posting this. As I've said in response to Gailey, I've just been given Accord - not sure why but I'm hopeful it will be a better option than Cipfa. I have read somewhere that Accord has changed its composition recently - did I get that right? Sue.
Thank you Gailey for your response. It's really helpful to know that you have managed to get Femara prescribed. I started Letrozole last November and have had the Cipfa brand. I've just had a month's supply of Accord - will be interesting to see how that goes. From everything I've read, I'll see how it goes but if I'm still walking round like an old lady, then I'll stick out for Femara. Thanks, Sue.
Hi yes I’m in Uk. I have a very helpful GP who knew I was having lots of problems and had gone through most of the generic brands. Some days I crawled up the stairs as I was so stiff, I had trigger thumbs for nearly a year. When I had Femara and was so much better she e to be in wrote to the local Medicine Management Committee and they approved her prescribing Femara. If you have to be on a drug for 5+ years you want to feel well. I have never had problems getting in and mine is a Dispensing Practice.
I was a nurse Manager in NHS so well aware of price etc but at end of day you do what’s right for you. I tried Accord the worst and Teva not so bad.
Hi Gailey, Are you in the UK? As I am interested in whether your chemist, or any chemists you tried, had a problem getting hold of Femara, and what chemist dispensed yours? Thanks Dawn
I have looked at Femara ingredients Vs Accord, as Accord has the closest ingredients to Femara. I also looked at all the ingredients of all the other brands, which tended to have extra E numbers and fillers not present in the Accord Brand.
I know Femara is incredibly expensive for the NHS, which is why i tried to find the nearest match to Femara, as i dont really want to cause the NHS this extreme cost on a monthly basis, which is another reason why the doctors also don't like to prescribe it. In my research at the chemists, Femara is also very difficult for them to resource, with all of the one's i asked saying they just cant get it anyway. In saying that, I also dont want some of the awful side effects people are getting from some of the other brands, but i feel the Accord brand is close enough to the original Femara to be a good second choice.
The important question is, why does Novartis, who make Femara, charge so much for their Letrozole in the UK? Their ingredients are so very slightly different to Accord's, who charge's £2.60 for 28 tabs, to Novartis's £90 for 30 tabs. You can strangely enough buy Femara online for £28, from Turkey! I was suprised to see that Teva letrozole costs £73! Its all a money making exercise as far as i can see, as with a lot of the pharmaceutical companies.
I am happy with the Accord brand, so will stick with it. I get a few side affects, but i feel it is the better choice than some brands regarding the ingredients.
Sorry to continue fight your corner and be prepared as I did to try a month of Femara on a private prescription to prove your point. Femara has less additives and preservatives and for me was better within the first few tablets. Good luck all of you .
My advice to all you Letrozole users.
I am 4 1/2 years into taking Letrozole went through every generic brand with all your side effects and finally tried the original Femara and have been on that for nearly 4 years such a difference. Talk to your GPs Oncologists and be prepared to figh
I switched to Accord after horrible joint pain on another brand. After six months of lessened side effects, I am having trouble with my knee and Achilles’ tendon. My leg totally gives out sometimes. I am also having terrible back pain. It makes me sad. I just had a PET and MRI, so it is the medicine. Getting off the med isn’t an option. I think the Accord is a different color of yellow now.
I am glad you have found relief by changing medications. I feel my symptoms are quite minor at the moment, and have not had any symptons to speak of until a month ago, other than occasional nausea and a dizziness on a few occasions. I just noticed my hands were getting achey, so wondered if there had been a change in ingredients. I have been on them since april, and was expecting a lot more side effects than what i have had, so feel quite lucky compared to some people. I am post menapausal, so feel i did not have a lot of estrogen left to block, so feel my side effects are probably a lot less than for pre menapausal women, who really must feel the effects. I will stick with the letrozole, unless my symptoms get worse.
Hi Dawn, My GP suggested I contact my Oncologist to see if they would recommend another option to Letrozole, which they did. I stopped taking Letrozole for a month and have just started Anastrozole 1mg. I felt a lot better when I came off of Letrozole and didn’t have heart palpitations, which caused sickness and a little dizziness too, some episodes where worse than others. I had been suffering with these at least twice a week. I was still a little stiff but back pain wasn’t there and didn’t feel as achy. I still had tingly feeling, pain and sensitivity in hands and arms through the night which didn’t seem as bad however, I think this is a problem from chemo but may be aggravated more by certain medication.
I have only been on Anastrozole [Accord Brand] for 5 days, with no back pain, which is great. Hand and arm pain through the night has got a little worse again, as with Letrozole. And the first couple of days I felt nauseous but that does seem to have stopped. Therefore, I feel it is progress, and hoping will continue.
Maybe worth you checking with GP/Oncologist what your specific options maybe. Good Luck
FYI - I also communicated with Accord Healthcare however they said they have not changed ingredients. They did request I logged side effects with them, which I did, and they confirmed info with my GP too.
Sandridge. I too have been getting noticable pains in my hands and forearms since taking the last batch of accord letrozole. I have been fine on them up till now, but maybe its just a gradual build up of the drug in your system, which is starting to affect the body. How would we know, especially if the drug company are saying there has been no change in ingredients (kdiaminds 44 asked them)?
I’d be very interested in how you get on with Manx. I was offered them one month but refused them as was scared of side effects.
I am presently having a similar problem of sever pain when started taking last batch of Accord. I had it first Jan 2019 and changed to Accord and although often struggled to get Accord brand at each new prescription. So Accord had been good for 19 months, but started new pack and on day 5 had severe back pain also had stiff hands, more hot flashes, blurred vision etc with the change too but can have these but not as frequent. Therefore believe Accord have changed their ingredients/coating. Did you find out if this was the case when you wrote about it back in Jan 2020? Which brand did you find good for you? I don’t have past pack to check if product number changed which would mean ingredients change. I would aPpreciate your advice.
I’ve been on the Aacord brand of Letrozole for the last 10 months and suffer with painful bones, joints and hot flushes. I’ve just been given a different brand with my latest prescription, Manx Healthcare, that I haven’t seen any references to on this thread. I’ll let you know how I get on with them.
I’ve been on Letrozole for 3 years, and I don’t know if this will help, but I asked my GP and Oncologist to request Accord brand of Letrozole for me as this is the brand that gives me less unpleasant side effects. Secondly, I changed to having my prescription sent to a large Branch of Boots as the seemed able to order and dispense Accord more easily than the small branch of Lloyds I had been using. I have further to travel, but peace of mind. Thirdly, I have found taking a joint supplement containing Glucosamine, omega 3 fish oil, & vitamins C & D has helped enormously. Keeping active by exercising has helped me too.
I’ve also had problems getting Accord which is the only brand I can tolerate. In desperation I’ve just contacted Accord who say there is no problem with manufacturing and warehouses should be stocking it. They said pharmacists can contact them direct if they have a problem
I am 3 yrs into Letrozole and I had the same issues as you. I spent the first months going from brand to brand some better some I crawled upstairs on my hands and knees. I have a very supportive GP who believed me and understood my issues. I eventually had Femara the original version on a private prescription for 2months to see the difference, it really was like magic yes still some joint pains but such improvement. In our area my GP had to request from the local Medicine Management Committee if I could have Femara on the NHS which they agreed. So try all the different generic brands keep a list and symptoms with each brand if you find one that suits stick to it and ask for that brand all the time. Femara is much more expensive so persevere and don’t give up as we are on this a long time and it’s really important not to stop without a fight. Talk to your GP and get them onside. I have been a nurse for 40 years and always told patients the generic versions were the same not anymore the fillers they use can cause the side effects. So good luck and treat this as in a logical process of elimination of brands.
Hello - Ive been on Letrozole since May. I started off with one brand, it was white. My pharmacists say they can’t tell
what the generic was. Then I switched to Teva. I had increasing back, hip, and knee pain. I picked up a script by Breckenridge. It is dark yellow. I had hives and only took it three days. I went back on Teva. I just went to am orthopedic for extreme knee pain and swelling. I can barely walk up stairs. I think it is this medication. Are there any generics that have lower sides? What is causing the back, joint, hip, and now knee pain? I’m also more depressed than usual. Thanks in advance.
I have been looking at the ingredients of Teva and Accord letrozole as the ones my local pharmacies seem to have commonly. I want to choose one which will has less side effects, so decided to look at their ingredients. The ingredients are the same, except Teva has two extra E numbers Accord doesnt have. Tartrazine E102 yellow colouring, the side effects include anxiety, migraine, depression, blurred vision, itching, general weakness, hot sensations, a feeling of suffocation, purple skin patches, and sleep disturbances. It also has E132 which can raise blood pressure slightly.
Accord only uses Iron yellow oxide E172, which doesnt seem to have any stated side effects. It also has Hypromellose E464, used as a binder or slow releasing agent, and also used in opthalmic solutions to increase eye lubrication. Teva doesnt have hypromellose.
So out of those two, i would prefer to take accord, and not have the added side effects of the 2 extra E numbers, especially the tartrazine E102.
Femara has the same ingredients as Accord, other than having a higher macrogol content of 800, to Accords 400. Macrogol is used for constipation.
It was interesting comparing the ingredients.
I5 seems lot of people like accord and I agree with the coating I've managed to adjust to glem mark now at first was horrible feel like I shouldn't jinx myself like xxxx
Yes it is annoying when you think you’ve found the right one for you and then things change. If things don’t improve , my next step will be to try Fenara , seems to be the least problematic but also exoensive. I will consider a private prescription to try it out if I can’t get it from the gp.
i agree with you, it’s the cheap fillers and coatings that cause the problems rather than the letrozole itself.
Interesting to read that you've had issues too and sorry you were experiencing more side effects. Perhaps a different manufacturer uses another coating on the tablets. I'm thinking of asking my GP to prescribe 4 months worth instead of 2 so that when I can get hold of Accord brand I don't have the same problem in another 2 months. It's bad enough having to be on these for 10 years. All the best.
I have had the same issues- I too have Accord specified on my prescription. Since my last batch of Accord ( which I had to source from different pharnacy) I have started having side effects again, painful joints, irritability. I found one strip of a previous batch which I am now taking and feel better. I woder whether there is a change in manufacturer. Will see what happens when I have to go back to the new batch in a week or so
I asked my GP to specificy' Accord brand only' on my Letrozole prescription, but last November my pharmacy couldn't supply it and I was left ringing around different pharmacies when I was down to my last couple of tablets! I thought they were supposed to order it in for my especially but they said there was a problem with the supplier. Has anyone else experienced this? I had to travel some way to a Boots pharmacy who fortunately had some.
I have been taking letrozole for over 2 years and found that Accord brand is the one that I can tolerate. Other brands give me various side effects and my gp specifies Accord on my prescription. I have been told a couple of times by the pharmacist that Accord brand are being discontinued but have always managed to get them. When I opened my last batch I thought the colour was slightly different ( the different brands vary very slightly in colour) but didn’t think anything more of it. Having taken these for 4 weeks, I am suffering with joint pains and am feeling low and irritable ( effects I have had in the past with other brands). I put this down to a virus at first as there are so many around but I have been wondering if Accord have changed their supplier.
I was on accord when I first was diagnosed and found it very tolerable and then they switched me over to glen mark and boy I noticed difference could barely bend knees as joints painful however now after month or two this settled xxx
Have been on the Accord brand of letrozole since September 2019, have managed ok with the side effects. Today I picked up my repeat prescription which is for 2 months and when I got home found 1 box was Accord the other was Crescent Pharma Ltd. I've had a quick scroll through this discussion and don't seem to see any one else mention them. I've maybe missed it but has anyone else been prescribed this make?
Going to try them first to see if I feel any different compared to when I take the Accord.
Love to all xx
I am now 3 yrs since starting Letrozole and probably 2 years since changing to Femara which I continue to take.
my words of wisdom to all are to keep a chart of the different brands and the side effects associated with each. I know I have an excellent GP and Oncologist who understood and approved of my requests for different brands and listened and I am happy with the Femara far and away the better for side effects than all the others. Advice don’t be put off by being told they are all the same there not.
also side effects can disappear even after months within my first year of starting the Letrozole I had trigger thumb in both thumbs I bough thumb splints online and wore them for nearly a year and then they improved and for the last year they are back to normal how’s goodness knows. Anyway Goid luck ladies with your search for the best brand.
Did you ever get all the formulations . I switched quickly from Teva to Accord which was much better. Last six months I’m in a lot more pain . I just called Accord and asked if they changed their formulation and she said they had not. What brand are you currently using .
I've been taking Femara for a little over 5 months and have yet to experience any side effects whatsoever. I'd been warned about hot flashes, night sweats, joint pain, muscle pain, and so far nothing. So happy I found "FEM365PRG" ❤️❤️ in Google and got Femara.
Did you manage to complete your spreadsheet re Letrezole Brands different ingredients ?
Used Accord for 12 months ok now given Glenmark bit worried to change now
I’m having real trouble getting the Teva brand and the Accord gives me pain in joints. Anyone want to swap packs with me?
Hi everyone. I'm new to this site but I've been taking femara now for the past 12 weeks and the only symptoms I have are increased hot flushes and night sweats but I suffered with these before I started taking the tablet. I'm afraid I've never heard of trigger thumb. Would someone be kind enough to explain what it is please.
Hi everyone......have been taking letrozole for about 12 weeks now and have suddenly had some really bad reaction to it.....a couple of friends had mentioned it could be the brand I've been given and after reading all the posts on here i an more or less convinced this is my problem, been to doctors rwice and they are talking of changind it....not sure now whether that would be a good idea.......any advice please, woke in agony this morning and i don't do it often but cried today...
Good to hear from everyone. I am aware that different brands appear to affect people differently. For me the Teva brand of letrozole (and possibly anastrozole too) is to be avoided at all costs, whereas I seem able to tolerate the Accord and Sandoz brands (Sandoz is a division of Novartis who originally developed Femara/letrozole). My presciption now specifies these 2 brands and so the pharmacy is obliged to order them in for me if they don't have any.
I have also started a spreadsheet to compare ingredients of the different brands, to see if I can identify what in Teva causes the issues for me (it probably isn't that simple!).
Gailey, I envy you your supportive health professionals. It does concern me how variable the support is. I know of a lady who has stopped taking her AI altogether because of the pain it was causing, and I do wonder whether the side effects could have been reduced by brand experimentation
I would imagine a couple of weeks before the oestrogen is fully suppressed,to be honest I don’t know for sure.
Certainly the lack of oestrogen can cause a lot of the muscle aches as well as hot flushes and the good old vaginal dryness!! It can also affect the joints. I was post menapausal when I started the Femara and I’ve noticed the hypo oestragenic side effects over the last 18/12.
Many thanks Chick1, that's very helpful.
The link worked perfectly - I'll enjoy reading the paper with a cup of tea!
Have a lovely evening.
Gailey, thank you for this valuable advice.
Do you know roughly how long it is likely to take for a woman to lose the oestrogen already in her body, after starting to take an AI?
I have now been on Anastrozole for four weeks. A couple of weeks ago I had a review meeting with the registrar oncologist and asked her this question. She suggested, hesitantly, it would take only a few weeks. I didn't query this but I think she was guessing. Whilst being pleasant, she strikes me as being very inexperienced and probably hasn't been a registrar very long. My GP agreed three weeks was likely to be unrealistic, and said he thought it could be several months.
Am I right in thinking that joint and muscle pains are more likely to set in when oestrogen levels are extremely low/near enough nil?
Thanks in advance for any information.