Being switched from clomid to letrozole

dancerspose · December 2014

Since you ladies are so much wiser than I, I'm hoping you may be able to shed some light on this clomid versus letrozole thing going on in my head. So as most of you know from my signature or comments on other posts yesterday, I did not respond during my first attempt at a medicated cycle. I was on 50mg of clomid for 7 days. It was starting to look like I would respond, but my hormone levels weren't rising and follicles weren't growing. So when my RE's office called to officially cancel my cycle they told me they'd be switching me to letrozole instead of upping the doseage of clomid for the next cycle. I was told the main reason for this decision was because my lining stayed thin, around 4mm, and since clomid can cause the lining to thin they're switching me. I'm sure the medical professionals know what they're doing, but I would have thought that in my instance my lining not thickening could have also been attributed to the fact that my hormone levels weren't rising. I thought it was the increasing hormones that would trigger the lining to thicken. I could be totally off base on this though.

The only reason I'm really questioning the logic is because for whatever reason clomid is really cheap at my pharmacy, but letrozole is not (just over $10 for my course of clomid, but almost $100 for letrozole). I've been trying to do some reading on the differences between the two drugs in terms of side effects and overal effectiveness, and they don't look two different. Any thoughts though?

BunnyBerry · December 2014

If I had a thinner lining, I wouldn't want to risk a round of Clomid the next cycle, just in case. But that's just me.

The RE told me that Clomid and Letrozole work differently - Clomid takes the estrogen out of your bloodstream by binding with it, while Letrozole just blocks your brain from noticing the estrogen so it will keep sending FSH to develop follies. That means that Letrozole keeps estrogen in your body doin' its thang, so lower SEs, thicker and better quality lining.

dancerspose · December 2014

Thanks for the information. Thanks @bunnyberry for that explanation of the two drugs. Do people usually still use progesterone suppositories on letrozole?

I certainly do want to do whatever is going to give me the best chances. Part of my problem is that my RE is (who I really love) is still out until the middle of January. Since NPs and PAs handle all the monitoring appointments it was one of them who called me, after speaking with one of the other docs, but I have no idea which one. I do want to get more clarification on specifically why the decision was made, but I think I need to talk to the doctor to get that. I was also far too emotional yesterday to really think all this through. Since I'm on provera for 10 days I have some time to figure out who to bombard with my questions and all before my next cycle will start.

And thanks @daydreamsam for the tip about goodrx! There's a chance I'll have insurance coverage for the next cycle, but I'm not sure yet so I'm just trying to be prepared.

ETA - oh and @rainbowbridge14I was told I would be on 5mg for 5 days with the letrozole.

BunnyBerry · December 2014

@shafwilson I don't know about progesterone at all, they've never had me take it. But if it was a nurse who "decided" this for you, definitely talk to the RE before making a switch in treatment! I did 5mg Letrozole and had headaches, a few hot flashes, and a nice strong luteal phase.

dancerspose · December 2014

Wow, I had no idea there could be such a huge difference in OOP prescription costs at places. I normally go to my local Rite Aid, and can't believe they're so much more expensive. I did check doodrx and they're way above even the other local drug stores, crazy!

juneroses · December 2014

At my pharmacy, they have been reducing the price as part of its on-label use for breast cancer - I paid $9 for a five day supply of 7.5 per day. I've been pretty happy with it - not many side effects, and my luteal jumped up to 16 days on average. Good luck on your discussion with your RE!

blsav23 · December 2014

I paid $4.47 at Costco yesterday for 5 days of femara 5mg (without insurance). Also, I've read femara produces less follies than clomid it better quality eggs. I had four follicles on Clomid but way too thin lining. I only produced 1-2 follicles on femara but had beautiful lining. I have switched back to femara for IUI #4. Best of luck

babeRN101 · December 2014

From what I understand, Letrozole is a much newer drug (hence more $$) but from what I read, it can be more effective. The NIH released a study this past July showing Letrozole induced more ovulations, had greater live births, and less side effects compared to clomid. So I'm all about it! My RE doesn't jump right to Letrozole tho "because they have always started with Clomid"... Go figure.

deelopi9 · December 2014

They had me take the progesterone on my femara cycle. My SE were lower on Femara than on Clomid. Good luck

janma529 · December 2014

shafwilson said:

Part of my problem is that my RE is (who I really love) is still out until the middle of January. Since NPs and PAs handle all the monitoring appointments it was one of them who called me, after speaking with one of the other docs, but I have no idea which one.

This is exactly what is happening to me right now! When I got the call that my last cycle was being cancelled, I ended up asking the PA to have the other doctor call me. He did and I felt much better after our conversation. I wonder if we have the same doctor...

I'm getting switched for my upcoming cycle as well, but I took 50 and 100mg Clomid before the decision was made. Now I know to shop around before getting the prescription filled!

j&j620 · December 2014

Ugh...AE fail. ^ that was me...

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