Letrozole (Femara)

i had my 6 month check up in December and i told the oncologist i could no longer tolerate the bone pains I was having with Arimadex as well as the rest of the side effects difficulty sleeping, depression, hot flushes, night sweats/chills headaches weight gain etc etc. But the pain in every joint of my body was the worst she said I could try Femara but it would probably just be the same or maybe worse! but to give it a shot and if it didnt work out I could go back to the Arimadex, The pains have improved greatly, every thing else seems to be the same sleep is worse but I am a lot happier on Femara and who knows I havent been on it full month yet so other things could improve too :) fingers crossed joints permitting that is lol Unfortunately studies have not been done to directly compare the Aromatase Inhibitors. The side effects for these medications may be different from patient to patient.

Here are some of the differences between these medications:
- Differences in chemical structure.
- Aromasin is a steroidal compound.
- Femara and Arimidex are non-steroidal compounds.
- Aromasin is the newest aromatase inhibitor, therefore there is less scientific data about this medication.

Here are a couple of other articles on this subject:
http://www.breastcancer.org/news_research/ask_expert/2005_12/question_09.jsp
http://www.healthcentral.com/breast-cancer/c/78/17222/aromatase-faqs

Both you and your physician will be monitoring the potential risks of letrozole.

The risks that may cause the most concern are:
- Decreases in bone mineral density (BMD).
- Increases in cholesterol.

The patient should be aware and notify the physician of any changes in how they feel, particularly paying attention to bone pain and liver pain (upper right quadrant).

The way to monitor these risks are through the following:
- bone density test
- complete blood cell counts (CBC)
- thyroid function tests
- monitoring serum electrolytes
- monitoring cholesterol and liver function tests, kidney function, and blood pressure.

There will also be the physical assessment of the patient. This will include blood pressure readings, pain assessment, gastrointestinal upsets, and hot flashes.

When initiating letrozole treatment, patients may experience dizziness and fatigue. Until your body adjusts be cautious before performing work that requires mental alertness, such as driving.

For more information, see the follwing links:

http://www.rxlist.com/femara-drug.htm
http://www.webmd.com/drugs/drug-4363-Femara+Oral.aspx?drugid=4363&drugname=Femara+Oral Both you and your physician will be monitoring the potential risks of letrozole.

The risks that may cause the most concern are:
- Decreases in bone mineral density (BMD).
- Increases in cholesterol.

The patient should be aware and notify the physician of any changes in how they feel, particularly paying attention to bone pain and liver pain (upper right quadrant).

The way to monitor these risks are through the following:
- bone density test
- complete blood cell counts (CBC)
- thyroid function tests
- monitoring serum electrolytes
- monitoring cholesterol and liver function tests, kidney function, and blood pressure.

There will also be the physical assessment of the patient. This will include blood pressure readings, pain assessment, gastrointestinal upsets, and hot flashes.

When initiating letrozole treatment, patients may experience dizziness and fatigue. Until your body adjusts be cautious before performing work that requires mental alertness, such as driving.

For more information, see the follwing links:

http://www.rxlist.com/femara-drug.htm
http://www.webmd.com/drugs/drug-4363-Femara+Oral.aspx?drugid=4363&drugname=Femara+Oral

There is no dosage adjustment of letrozole for patients with normal kidney and liver function. The physician will monitor for kidney and liver function using kidney and liver function tests and change medications if needed.

- With mild to moderate impairment of the liver, the dose of letrozole will not be changed.
- For post menopausal women taking Letrozole with liver problems (cirrhosis and severe hepatic impairment), as determined by liver function tests, the dose recommended for this patient population is 2.5mg every other day.
- There is no change in dosage requirements for patients with a creatinine clearance of the kidneys greater than or equal to 10ml/min.

For more information on this subject, see the following links:
http://www.rxlist.com/femara-drug.htm
http://www.drugs.com/dosage/letrozole.html There is no dosage adjustment of letrozole for patients with normal kidney and liver function. The physician will monitor for kidney and liver function using kidney and liver function tests and change medications if needed.

- With mild to moderate impairment of the liver, the dose of letrozole will not be changed.
- For post menopausal women taking Letrozole with liver problems (cirrhosis and severe hepatic impairment), as determined by liver function tests, the dose recommended for this patient population is 2.5mg every other day.
- There is no change in dosage requirements for patients with a creatinine clearance of the kidneys greater than or equal to 10ml/min.

For more information on this subject, see the following links:
http://www.rxlist.com/femara-drug.htm
http://www.drugs.com/dosage/letrozole.html

Letrozole (Femara) may be employed for breast cancer in these circumstances:
- Early adjuvant treatment for hormone receptor positive (HR+) breast cancer in post-menopausal women. It is unknown how long letrozole should be taken, but the duration of the clinical trial was 5 years. Adjuvant treatment is the administration of letrozole after surgery, radiation, and/or chemotherapy.
- Extended adjuvant treatment for hormone receptor positive (HR+) breast cancer in postmenopausal women who have received 5 years of adjuvant tamoxifen treatment. The ideal length of treatment is not known, as the international study of 5,187 postmenopausal women discovered that when letrozole was taken after completing five years of tamoxifen therapy, there was a decrease in breast cancer recurrences. Treatment may be discontinued if there is a relapse.
- As first or second-line treatment of breast cancer that has advanced in menopausal women after anti-estrogen treatment. Administration may be continued until the breast cancer tumor worsens or metastasizes.
- Locally advanced or metastasized breast cancer with hormone receptor positive or unknown hormone origin.

Here are a couple of other sites to visit for more information.
http://www.ncbi.nlm.nih.gov/pubmed/15161328
http://www.cancer.gov/cancertopics/druginfo/letrozole Letrozole (Femara) may be employed for breast cancer in these circumstances:
- Early adjuvant treatment for hormone receptor positive (HR+) breast cancer in post-menopausal women. It is unknown how long letrozole should be taken, but the duration of the clinical trial was 5 years. Adjuvant treatment is the administration of letrozole after surgery, radiation, and/or chemotherapy.
- Extended adjuvant treatment for hormone receptor positive (HR+) breast cancer in postmenopausal women who have received 5 years of adjuvant tamoxifen treatment. The ideal length of treatment is not known, as the international study of 5,187 postmenopausal women discovered that when letrozole was taken after completing five years of tamoxifen therapy, there was a decrease in breast cancer recurrences. Treatment may be discontinued if there is a relapse.
- As first or second-line treatment of breast cancer that has advanced in menopausal women after anti-estrogen treatment. Administration may be continued until the breast cancer tumor worsens or metastasizes.
- Locally advanced or metastasized breast cancer with hormone receptor positive or unknown hormone origin.

Here are a couple of other sites to visit for more information.
http://www.ncbi.nlm.nih.gov/pubmed/15161328
http://www.cancer.gov/cancertopics/druginfo/letrozole

Letrozole (Femara) is an antineoplastic agent. Antineoplastic agents are anticancer medications. Letrozole is also categorized as a nonsteroidal aromatase inhibitor. Aromatase inhibitors do not allow the aromatase enzyme to convert androgen into estrogen in the tissues. By blocking estrogen production in the tissues of the body, the estrogen receptor [ER]-positive and/or progesterone receptor [PR]-positive) breast cancer cells cannot grow. Letrozole (Femara) is an antineoplastic agent. Antineoplastic agents are anticancer medications. Letrozole is also categorized as a nonsteroidal aromatase inhibitor. Aromatase inhibitors do not allow the aromatase enzyme to convert androgen into estrogen in the tissues. By blocking estrogen production in the tissues of the body, the estrogen receptor [ER]-positive and/or progesterone receptor [PR]-positive) breast cancer cells cannot grow.

I am on Femara. I unfortunately have other pills as well. I have them all set up in a pill container for 2 weeks at a time, I take mine at night faithfully with my other meds. I sometimes still get nauseous from Femara so this way I sleep right through it. I would suggest taking it at a time of day that you WILL remember. I find having cancer you just do NOT forget to take it for the fear of cancer returning. Oh and definitely as JK Jones stated above, take calcium and Vitamins D as well. I am on Femara. I unfortunately have other pills as well. I have them all set up in a pill container for 2 weeks at a time, I take mine at night faithfully with my other meds. I sometimes still get nauseous from Femara so this way I sleep right through it. I would suggest taking it at a time of day that you WILL remember. I find having cancer you just do NOT forget to take it for the fear of cancer returning. Oh and definitely as JK Jones stated above, take calcium and Vitamins D as well.

When initiating treatment with Letrozole, here are some topics to be aware of and inform your physician:
- What allergies you have and if you've ever experienced an allergy to Letrozole.
- Your medical history including if you have any issues with cholesterol, liver disease, bone complications, history of stroke or blood clots, heart disease, high blood pressure, or kidney issues.
- Any other medications you are taking and this includes prescription medications, all over-the-counter products you are taking, vitamins, and herbal remedies as they might contain estrogenic components or promote estrogen activity.
- Any other medications that you are taking that contain estrogen such as hormone replacement drugs or hormonal contraceptives which includes all birth control products such as contraceptive pills, patches, rings, or injections.
- If you are taking tamoxifen or raloxifene.
- Women who are perimenopausal or recently menopausal should employ contraception methods until postmenopausal status is achieved. Letrozole is harmful to the fetus.
- If you are pregnant or breast feeding. When initiating treatment with Letrozole, here are some topics to be aware of and inform your physician:
- What allergies you have and if you've ever experienced an allergy to Letrozole.
- Your medical history including if you have any issues with cholesterol, liver disease, bone complications, history of stroke or blood clots, heart disease, high blood pressure, or kidney issues.
- Any other medications you are taking and this includes prescription medications, all over-the-counter products you are taking, vitamins, and herbal remedies as they might contain estrogenic components or promote estrogen activity.
- Any other medications that you are taking that contain estrogen such as hormone replacement drugs or hormonal contraceptives which includes all birth control products such as contraceptive pills, patches, rings, or injections.
- If you are taking tamoxifen or raloxifene.
- Women who are perimenopausal or recently menopausal should employ contraception methods until postmenopausal status is achieved. Letrozole is harmful to the fetus.
- If you are pregnant or breast feeding.

As the name implies, the action of Aromatase Inhibitors is to inhibit the production of estrogens by stopping the conversion of androgen into estrogen. Aromatase inhibitors operate by blocking the aromatase enzyme that converts androgen to estrogen. Post-menopausal women get estrogen from the conversion of androgen into estrogen in the tissues of the body. In contrast pre-menopausal women get estrogen from the ovaries. By inhibiting the production of the estrogen, the estrogen receptor [ER]-positive and/or progesterone receptor [PR]-positive tumors in the breast cannot grow. As the name implies, the action of Aromatase Inhibitors is to inhibit the production of estrogens by stopping the conversion of androgen into estrogen. Aromatase inhibitors operate by blocking the aromatase enzyme that converts androgen to estrogen. Post-menopausal women get estrogen from the conversion of androgen into estrogen in the tissues of the body. In contrast pre-menopausal women get estrogen from the ovaries. By inhibiting the production of the estrogen, the estrogen receptor [ER]-positive and/or progesterone receptor [PR]-positive tumors in the breast cannot grow.

If you have forgotten to take your letrozole dose, take it as soon as possible. But if it is close to the time for the next dose just take the next dose and continue your usual dosing times. In order to remember to take your letrozole, consider taking it at the same time everyday. Letrozole can be taken with or without food.

Do not take more than one dose of letrozole a day. If you have forgotten to take your letrozole dose, take it as soon as possible. But if it is close to the time for the next dose just take the next dose and continue your usual dosing times. In order to remember to take your letrozole, consider taking it at the same time everyday. Letrozole can be taken with or without food.

Do not take more than one dose of letrozole a day.

All three aromatase inhibitors are generic. There are three aromatase inhibitors:

Anastrozole (Arimidex) is a 1mg oral tablet taken once daily.
Letrozole (Femara) is a 2.5mg once daily oral tablet which may be taken without regards to meals.
Exemestane (Aromasin) is a 25mg. once daily oral tablet which should be taken after a meal. All three aromatase inhibitors are generic. There are three aromatase inhibitors:

Anastrozole (Arimidex) is a 1mg oral tablet taken once daily.
Letrozole (Femara) is a 2.5mg once daily oral tablet which may be taken without regards to meals.
Exemestane (Aromasin) is a 25mg. once daily oral tablet which should be taken after a meal.

Letrozole is categorized pharmacologically as an Antineoplastic Agent and as an Aromatase Inhibitor. The action of Aromatase Inhibitors is to inhibit the production of estrogens by stopping the conversion of androgen into estrogen.

- Aromatase Inhibitors operate by blocking the aromatase enzyme from converting androgen to estrogen in women who have gone through menopause.
- Post-menopausal women get estrogen from the conversion of androgen into estrogen in the tissues of the body.
- In contrast women who have not gone through menopause receive their estrogen from the ovaries.
- By inhibiting the production of estrogen, the estrogen receptor [ER]-positive and/or progesterone receptor [PR]-positive tumor breast cancer cells cannot grow. Letrozole is categorized pharmacologically as an Antineoplastic Agent and as an Aromatase Inhibitor. The action of Aromatase Inhibitors is to inhibit the production of estrogens by stopping the conversion of androgen into estrogen.

- Aromatase Inhibitors operate by blocking the aromatase enzyme from converting androgen to estrogen in women who have gone through menopause.
- Post-menopausal women get estrogen from the conversion of androgen into estrogen in the tissues of the body.
- In contrast women who have not gone through menopause receive their estrogen from the ovaries.
- By inhibiting the production of estrogen, the estrogen receptor [ER]-positive and/or progesterone receptor [PR]-positive tumor breast cancer cells cannot grow.

Here are some options to consider:

1) Getting financial support for Femara. You may be eligible for financial support to help purchase Femara. One program specifically is the Femara Cares Program at http://femara.com. You may want to ask the community about other financial support programs.
2) Stay on Arimedex and treat the side effects. The medications to treat the side effects may improve your quality of life, but you will need to discuss their costs and side effects with your physician.
3) You may consider the other Aromatase Inhibitor, Aromasin (exemestane). Pfizer has a financial assistance program as well - http://www.pfizerhelpfulanswers.com/pages/misc/Default.aspx
4) Another alternative is Tamoxifen. Studies have shown that Aromatase Inhibitors are more effective in postmenopausal women with ER+ breast cancers, but if side effects are severe, Tamoxifen is an option to consider.

Here are a couple of articles comparing tamoxifen to aromatase inhibitors:
http://www.medscape.com/viewarticle/447550_2
http://www.sciencedaily.com/releases/2008/12/081211161737.htm Here are some options to consider:

1) Getting financial support for Femara. You may be eligible for financial support to help purchase Femara. One program specifically is the Femara Cares Program at http://femara.com. You may want to ask the community about other financial support programs.
2) Stay on Arimedex and treat the side effects. The medications to treat the side effects may improve your quality of life, but you will need to discuss their costs and side effects with your physician.
3) You may consider the other Aromatase Inhibitor, Aromasin (exemestane). Pfizer has a financial assistance program as well - http://www.pfizerhelpfulanswers.com/pages/misc/Default.aspx
4) Another alternative is Tamoxifen. Studies have shown that Aromatase Inhibitors are more effective in postmenopausal women with ER+ breast cancers, but if side effects are severe, Tamoxifen is an option to consider.

Here are a couple of articles comparing tamoxifen to aromatase inhibitors:
http://www.medscape.com/viewarticle/447550_2
http://www.sciencedaily.com/releases/2008/12/081211161737.htm

First of all, your physician should test to make sure that you are post-menopausal.

Aromatase inhibitors are the most common hormonal treatment for post-menopausal women. The three most prescribed are:
- Arimidex (chemical name: anastrozole)
- Femara (chemical name: letrozole)
- Aromasin (chemical name: exemestane)

Alternative treatments are:
- tamoxifen
- Faslodex (fulvestrant)
- Fareston (toremifene)
- Megace (megestrol)
- Halotestin (fluoxymesterone)

A combination of the above therapies might be considered in some cases.

If the side effects are too severe, you might consider changing treatments.

Sometimes though, the cancer changes and the hormonal treatment is ineffective or might even fuel the cancer. In these cases, the treatments should stop and potentially another hormonal therapy can be tried. First of all, your physician should test to make sure that you are post-menopausal.

Aromatase inhibitors are the most common hormonal treatment for post-menopausal women. The three most prescribed are:
- Arimidex (chemical name: anastrozole)
- Femara (chemical name: letrozole)
- Aromasin (chemical name: exemestane)

Alternative treatments are:
- tamoxifen
- Faslodex (fulvestrant)
- Fareston (toremifene)
- Megace (megestrol)
- Halotestin (fluoxymesterone)

A combination of the above therapies might be considered in some cases.

If the side effects are too severe, you might consider changing treatments.

Sometimes though, the cancer changes and the hormonal treatment is ineffective or might even fuel the cancer. In these cases, the treatments should stop and potentially another hormonal therapy can be tried.