Class: Hormonal therapy
Generic Name: Letrozole (LET-ruh-zole)
Trade Name: Femara®
How is Femara used? Femara is FDA approved for the treatment of early and advanced breast cancer in postmenopausal women with hormone-receptor positive, or hormone-receptor unknown disease. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Femara is classified as an anti-aromatase agent. Femara produces its anti-cancer effects by inhibiting the production of the female hormone estrogen in the body. A significant portion of breast cancers, referred to as estrogen- or hormone-positive, are stimulated to grow by estrogen, which circulates in the blood stream and binds to cancer cells. By inhibiting estrogen production, the growth stimulus of the cancer cell is removed, ultimately causing cancer cells to die.
How is Femara given (administered)? Femara is given orally in the form of a tablet. Patients should try to take letrozole around the same time each day.
How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with letrozole. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy. In addition, patients may undergo a bone density test prior to or during treatment with letrozole.
What are the common (occur in 30% or more of patients) side effects of treatment with Femara?
There are no documented side effects that occur in 30% or more of patients treated with Femara.
What are the less common (occur in 10% to 29% of patients) side effects of treatment with Femara?
• Hot flashes
• Bone pain
• Joint pain
• Muscle pain
• Back pain
• Difficulty breathing
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
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• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• Eat small meals frequently to help alleviate nausea.
• Patients who experience hot flashes may wish to wear light clothing, stay in a cool environment, and place cool cloths on their body or head to relieve their symptoms.
Are there any special precautions patients should be aware of before starting treatment?
• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• If an oral dose is missed, do not double up on doses. Patients should contact their physician in this event.
• Keep tablets out of reach of children and return to the pharmacy for safe disposal if treatment is terminated.
• Patients should use caution when driving or completing tasks that require mental alertness until effects of the drug are known
When should patients notify their physician?
• Persistent, severe pain
• Chest pain, pressure or palpitations
• Swollen extremities
• Numbness, weakness or loss of strength
• Severe headache
• Difficulty speaking
• Difficulty breathing
• Unusual bleeding or bruising
• Vaginal bleeding
• Skin rash or itching
• Severe nausea
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.
Important Limitations of Use
The information provided above on the drug you have selected is provided for your information only and is not a substitute for consultation with an appropriate medical doctor. We are providing this information solely as a courtesy and, as such, it is in no way a recommendation as to the safety, efficacy or appropriateness of any particular drug, regimen, dosing schedule for any particular cancer, condition or patient nor is it in any way to be considered medical advice. Patients should discuss the appropriateness of a particular drug or chemotherapy regimen with their physician.
As with any printed reference, the use of particular drugs, regimens and drug dosages may become out-of-date over time, since new information may have been published and become generally accepted after the latest update to this printed information. Please keep in mind that health care professionals are fully responsible for practicing within current standards, avoiding use of outdated regimens, employing good clinical judgment in selecting drugs and/or regimens, in calculating doses for individual patients, and verifying all dosage calculations.
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The prescribing physician is solely responsible for making all decisions relating to appropriate patient care including, but not limited to, drugs, regimens, dose, schedule, and any supportive care.