Femara: Advanced Hormone Therapy for Breast Cancer Treatment
| Product dosage: 2.5mg | |||
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Synonyms | |||
Femara (letrozole) is a potent, non-steroidal aromatase inhibitor indicated for the adjuvant treatment of postmenopausal women with hormone receptor-positive early breast cancer. It is also approved for the extended adjuvant treatment of early breast cancer following five years of tamoxifen therapy, as well as for the first-line treatment of advanced or metastatic breast cancer in postmenopausal women. By significantly reducing estrogen levels, Femara targets the hormonal drivers of certain breast cancers, offering a targeted therapeutic approach with a well-established efficacy and safety profile.
Features
- Active ingredient: Letrozole 2.5 mg
- Mechanism: Non-steroidal aromatase inhibitor
- Administration: Oral tablet, once daily
- Bioavailability: Rapid and nearly complete
- Half-life: Approximately 2 days
- Metabolism: Hepatic, via CYP3A4 and CYP2A6
- Excretion: Primarily renal
- FDA-approved for multiple indications in breast cancer therapy
Benefits
- Significantly reduces the risk of cancer recurrence in hormone-sensitive early breast cancer
- Improves disease-free survival and overall survival in adjuvant settings
- Effective first-line treatment for advanced or metastatic hormone receptor-positive breast cancer
- Generally well-tolerated with a manageable side effect profile
- Convenient once-daily oral dosing supports treatment adherence
- Does not require concomitant corticosteroid administration
Common use
Femara is primarily used in the management of hormone receptor-positive breast cancer in postmenopausal women. Its applications include adjuvant treatment following surgery, extended adjuvant therapy after initial tamoxifen treatment, and first-line treatment for locally advanced or metastatic disease. It may also be used off-label for ovulation induction in certain fertility treatments under specialist supervision.
Dosage and direction
The recommended dosage is one 2.5 mg tablet taken orally once daily, with or without food. Treatment duration varies based on indication:
- Adjuvant treatment: Typically continued for 5 years
- Extended adjuvant treatment: Up to 5 years following initial tamoxifen therapy
- Advanced/metastatic cancer: Continued until disease progression or unacceptable toxicity Patients should take Femara at approximately the same time each day to maintain consistent drug levels.
Precautions
- Regular monitoring of bone mineral density is recommended due to increased risk of osteoporosis
- Periodic assessment of lipid profiles is advised
- Use with caution in patients with pre-existing liver impairment
- Not recommended for premenopausal women; pregnancy must be excluded before initiation
- Patients should report any unusual vaginal bleeding promptly
- Caution advised when administering to patients with severe renal impairment
Contraindications
- Pregnancy or potential for pregnancy
- Premenopausal women without ovarian suppression
- Known hypersensitivity to letrozole or any excipients
- Concomitant use with estrogen-containing therapies
- Severe hepatic impairment
- Patients with genetic problems of galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption
Possible side effects
Common adverse reactions (≥10%):
- Hot flashes (33%)
- Arthralgia (21%)
- Fatigue (16%)
- Increased cholesterol (15%)
- Headache (13%)
- Nausea (12%)
Less common but serious side effects:
- Osteoporosis and increased fracture risk
- Cardiovascular events including myocardial ischemia
- Thromboembolic events
- Elevated transaminases
- Depression and anxiety
Drug interaction
- Tamoxifen: Concurrent use may reduce letrozole concentrations
- CYP3A4 inducers (e.g., rifampicin): May decrease letrozole efficacy
- CYP2A6 inhibitors: Potential increase in letrozole exposure
- Estrogen-containing therapies: Contraindicated due to opposing mechanisms
- Warfarin: Monitoring of INR recommended due to potential interaction
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one.
Overdose
No specific antidote exists for letrozole overdose. Reported symptoms may include drowsiness, agitation, and vomiting. Management should involve supportive care and symptomatic treatment. Dialysis is unlikely to be effective due to high protein binding. In case of suspected overdose, contact a poison control center immediately.
Storage
Store at room temperature (20-25°C or 68-77°F) in the original container. Protect from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Treatment decisions should be made in consultation with a qualified healthcare professional. Individual response to therapy may vary, and patients should follow their physician’s specific instructions regarding Femara use.
Reviews
Clinical studies demonstrate Femara’s efficacy in breast cancer treatment. The BIG 1-98 trial showed significant improvement in disease-free survival compared to tamoxifen. The MA-17 trial established its benefit in extended adjuvant therapy. Most patients tolerate treatment well, though management of musculoskeletal symptoms and bone health requires ongoing attention. Many oncologists consider Femara a cornerstone of hormonal therapy for appropriate postmenopausal patients with hormone receptor-positive breast cancer.