Tuesday, May 20, 2008 Nan asks

Q: Tamoxifen side effects / Lunesta for sleep

I'm starting tamoxifen tonight and am supposed to take one pill a day for five years. I'm mildly terrified because I had such bad hot flashes and terrible trouble sleeping when undergoing chemo. After trying Ativan and Ambien, both which either didn't work or gave me bad dreams, I started Lunesta and it's the dream -- literally -- of all time, the only thing that works for me. Should I be concerned about taking a Lunesta when/if I need it? I don't find any advice on this combination online or in the materials provided by my pharmacy. My oncologist knows I take Lunesta when I need to, and she didn't say anything about it.

There is a homeopathic (sub-lingual) that they sell at Whole Foods and pharmacies by Boiron that's good for hot flashes associated with menopause. I found that to be helpful during chemo.... I'm 38 so not menopausal yet but I did have six rounds of chemo...

Thanks!

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Answers (5)

PJ Hamel, Health Guide

5/20/08 10:55pm

Nan, I'm sure your doctor would have mentioned if there was any trouble with the tamoxifen/Lunesta combination. Hot flashes are a possible side effect of tamoxifen, but not all women have them; hopefully you'll luck out and not have any! I know it's stressful, starting a new drug, but please don't worry - millions of us take tamoxifen. The most common side effect I've heard of is weight gain. Some women report depression, too, so be aware of that. Just be sure to stay in close touch with your doctor; tamoxifen has been the drug of choice for ER-receptive survivors for over 30 years, so there's lots and lots of history, and (s)he will work with you to make sure your experience is as easy/positive as possible. Good luck! - PJH

PJ Hamel, Health Guide

5/20/08 10:59pm

Nan, one more thing - make sure the homeopathic medicine at Whole Foods doesn't contain genistein (chemical element of soy), OK? Research shows that it might promote a cancer recurrence. Soy in its natural form (soy milk, tofu, etc.) is fine; but some of these "natural" drugs break it up into its chemical parts, and one of those, genistein, isn't good...

Angi

5/21/08 11:31pm

I agree with PJ - I was told NO homeopathic drugs, no soy. Unfortunately we just have to learn to live with the hotflashes. Try sleeping in a tank with your hair up if possible - as the worst hot flashes come at night. Shower lukewarm - carry a bandana with you to wip away sweat and so you can wet it and use to cool off if needed.

Lunuesta I hear can still be addicting even tho some reports say it isn't. It also can wear out it's effectiveness. I've been through them all and none worked for me. My doc now has me on Trazadone - and it knocks me out ALL night. Someimes I find that I don't even roll over, I sleep so heavy. So always something to keep in mind if this one fails you later. Chemo for me caused horrid insomnia that I still battle 3 yrs later - Trazadone works miracles for me (but I'm sure it can carry risks of dependency as well).

Good luck with the hot flashes & sleep!

Angi

nancy

12/15/08 4:27pm

Hi Nan. It looks like I caught this thread too late but I'll send this out and see what happens. I will be 41 this month and I just had a bilateral mastectomy two weeks ago. I will do four rounds of Adriamycin and Cytoxin starting in Jan. '09 then will have four rounds of Taxol. My ILC is ER+, PR+ and HER2-. The oncologist plans to start me on Tamoxifen after I finish chemo. I have several concerns about both the chemo and the tamoxifen treatments. First of all, I am in the first good relationship I have ever had. I have never been married and he and I have been together for not quite two years. Neither of us has children. I was hoping to start a family late but was warned by some cancer buddies that I will go through menopause due to the chemo. I hope this is not as absolute as they seem to think. Also, I have had horrible insomnia for about twenty years. I do everything I am supposed to in order to sleep well (except exercise regularly - I am too tired!) including using lavender products at bedtime, but it has been years since I have slept through the night. In the years just prior to my diagnosis my sleep went from about 6 hours per night down to about 2. I am convinced the insomnia has contributed to my poor health. I just started Lunesta last month and it works for me! It is the only thing that has. Even with that I am up about an hour each night but at least I fall back to sleep. I am glad to see your message here and the answers from everyone. It gives me some hope that maybe I can try another drug to deal with the estrogen if I need to, or can perhaps try a different sleep med if there are problems later with the Lunesta. I am not that much older than you are. My periods have been light for years but I have them like clockwork. Maybe with any luck I will still have them after the chemo. I suppose the estrogen blockers will do me in on that front but I am holding out some hope anyway. It may sound silly, but I am already mourning my sex life. My mastectomy scars are like something out of a horror movie, I am much smaller now and I expect I can say goodbye to my libido too. Oh well. I plan to exercise as much as possible as soon as I have healed a little more. My guy exercises religiously and I have a background in dance. Now that I have had some rest I think I can get back on track with that. I am really hoping so. Something like a 'normal' life after treatments would be a big bonus. I hope your meds are working out for you. Good luck with everything! - Nancy

Onita

7/ 9/09 2:33pm

I too had trouble sleeping during chemo and tried Ambien, Ambien CR, Lunesta, and also resorted to Lortab. All the sleep aids seemed to lose their effectiveness after a while. Then my doctor recommend an over the counter sleep aid called Melatonin. I started out with a 1 mg pill and eventually cut it back to 0.5 mg (1/2 tablet), and it worked extremely well! I would highly recommend the Melatonin. Just experiment with your dosage to see what works for you. You might need more or less than I did.

Q: Tamoxifen side effects / Lunesta for sleep

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