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