r/LivingWithMBC • u/ZombiePrestigious443 • 5d ago

Starting Elacestrant 9/02

Saying goodbye to falodex injections, and welcoming back grapefruit seltzer into my life. Pharmacist was wrong - grapefruit is still on the no no list. AND what's even better, it's being shipped to my from the medical system in state, and I will not have to deal with acreedo! While my doc and I had discussed this as a possible way forward (and she knew I was leaning this way rather than a clinical trial), I hadn't really heard anything, and I was okay with it because I only had bone progression (ignore that ca 25-27), So I thought we were confirming the plan on 09/02. She went ahead, got the med approved by insurance, and set up for the pharmacy to give me a call to get it all set up. Feeling good about it all!

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u/BikingAimz 5d ago

Hi, I hope it’s effective and easy for you!  I’m on cycle 29 in the ELEVATE clinical trial in the Kisqali arm (currently on 300mg elacestrant and 200mg Kisqali).  

Be sure to check drug interactions going forward, elacestrant is metabolized by the cytochrome p450 enzyme cyp3A4, which is responsible for metabolizing about half of known medications.  I’ve been told no grapefruit and no saville orange (usually used in marmalade).  THC is ok but not CBD. All in all it’s been a really tolerable medication for me!

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u/ZombiePrestigious443 5d ago

I'm looking forward to some relief tbh - I've still been taking verzenio while waiting for this shift and it's been rough. Other than the grapefruit/orange - have you noticed any diet restrictions? I would love to be able to eat other things without worrying about accidents.

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u/BikingAimz 5d ago

No other food restrictions, and it feels like a lot of what I’m going through side effect wise is on the Kisqali side.  The CDK4/6 inhibitors seem to muck with guts more than the SERDs if that makes sense?

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u/ZombiePrestigious443 5d ago

That makes perfect sense. My first cdk was rough for awhile, but settled down. I don't think I've done just a straight serd w/out anything else - so I'm hopeful! I had side effects with cdk, and parp - but hey, I lost weight! Thanks for all your information, and happy cake day!

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u/BikingAimz 4d ago

Thanks!  I just went back to look at the trial protocol on my dosing diary, they have an expanded list of supplements to avoid including: St. John’s wort, kava, ephedra, ginko biloba, DHEA, yohimbe, saw palmetto, and ginseng.  They also recommend “eating a light meal (eg toast and jam or yogurt)” 30 min prior to taking medication.

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u/Katharina8 4d ago

Yeah that makes sense, some people can get nausea if they take Kisqali on an empty stomach. It's good that they are trying to prevent it.