Letrozole

Letrozole Brand Name– Femara

What is Letrozole

Letrozole is a nonsteroidal oral aromatase inhibitor. It is used in postmenopausal women for the adjuvant treatment of early breast cancer, for extended adjuvant therapy after 5 years of tamoxifen, and for the treatment of advanced breast cancer.

It is also used off-label for the treatment of infertility, idiopathic short stature in boys, and delayed puberty in boys.

Unlike aminoglutethimide, an early aromatase inhibitor, letrozole does not inhibit adrenal steroid synthesis; therefore, glucocorticoid or mineralocorticoid replacement therapy is not necessary.

The use of letrozole is contraindicated in pregnancy. Decreases in bone mineral density and increases in total cholesterol may occur; monitoring is recommended

Indications

1. breast cancer
2. delayed puberty
3. endometriosis
4. infertility

For the treatment of breast cancer

for adjuvant treatment of postmenopausal women with hormone receptor-positive early breast cancer

Side Effects

1. abdominal pain
2. alopecia
3. anaphylactoid reactions
4. angina
5. angioedema
6. anorexia
7. anorexia
8. anxiety
9. appetite stimulation
10. arthralgia
11. arthralgia
12. asthenia
13. asthenia
14. back pain
15. back pain
16. blurred vision
17. bone fractures
18. bone pain
19. bone pain
20. carpal tunnel syndrome
21. cataracts
22. cataracts
23. chest pain (unspecified)
24. constipation
25. constipation
26. cough
27. depression
28. depression
29. diarrhea
30. diarrhea
31. dizziness
32. dizziness
33. drowsiness
34. dysesthesia
35. dysgeusia
36. dyspepsia
37. dyspnea
38. dyspnea
39. edema
40. edema
41. elevated hepatic enzymes
42. endometrial hyperplasia
43. erythema
44. erythema multiforme
45. fatigue
46. fatigue
47. fever
48. flushing
49. flushing
50. headache
51. headache
52. heart failure
53. hepatitis
54. hot flashes
55. hot flashes
56. hyperbilirubinemia
57. hypercalcemia
58. hypercholesterolemia
59. hypercholesterolemia
60. hyperhidrosis
61. hyperhidrosis
62. hypertension
63. hypertension
64. increased urinary frequency
65. infection
66. infection
67. influenza
68. insomnia
69. insomnia
70. irritability
71. jaundice
72. lethargy
73. lethargy
74. leukopenia
75. lymphopenia
76. maculopapular rash
77. malaise
78. malaise
79. memory impairment
80. musculoskeletal pain
81. musculoskeletal pain
82. myalgia
83. myalgia
84. myocardial infarction
85. nausea
86. nausea
87. new primary malignancy
88. night sweats
89. ocular irritation
90. osteopenia
91. osteopenia
92. osteoporosis
93. osteoporosis
94. palpitations
95. paresis
96. paresthesias
97. peripheral edema
98. phlebitis
99. pleural effusion
100. polydipsia
101. pruritus
102. psoriaform rash
103. pulmonary embolism
104. rash
105. renal failure (unspecified)
106. sinus tachycardia
107. spontaneous fetal abortion
108. stomatitis
109. stroke
110. teratogenesis
111. thrombocytopenia
112. thromboembolism
113. thrombosis
114. toxic epidermal necrolysis
115. urticaria
116. vaginal bleeding
117. vaginal bleeding
118. vaginal discharge
119. vaginal irritation
120. vaginal irritation
121. vertigo
122. vesicular rash
123. vomiting
124. vomiting
125. weakness
126. weight gain
127. weight gain
128. weight loss
129. weight loss
130. xerosis
131. xerostomia

Monitoring Parameters

• pregnancy testing
• serum cholesterol

Contraindications

• biliary cirrhosis
• breast-feeding
• children
• contraception requirements
• hepatic disease
• hypercholesterolemia
• infertility
• osteoporosis
• pregnancy
• pregnancy testing
• reproductive risk

Interactions

• Estrogens
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Tamoxifen