Episode #29: letrozole (Femara) | Podcast Show Notes
letrozole (LET roe zole)
Below will be links for the full Podcast and the Drug Card for letrozole along with a brief summary of various points on letrozole.Â
QUESTIONS:
- Which of the following are a concern for patients on letrozole? Select all that apply.
- A). A decrease in BMD after 2 years.
- B). Medication adherence
- C). Cholesterol
- D). Pregnancy
- E). A, B, and D only.
- Describe the mechanism of action for letrozole?
- In early breast cancer treatment, how long is the duration of therapy and following up what drug?
- Can Femara be used to treat ovarian cancer or is it limited to breast cancer?
SUMMARY:
Letrozole is an aromatase inhibitor that acts as an antineoplastic agent. The brand name for letrozole is Femara. The main indication is for hormone receptor positive breast cancer in women after menopause. If treating early breast cancer letrozole is used after a 5 year course of tamoxifen. If treating advanced breast cancer letrozole follows antiestrogen therapy. There are many off label uses of letrozole such as the many variations of breast cancer along with treating infertility due to polycystic ovary syndrome (PCOS) through ovulation stimulation. Dosing is straight forward at 2.5 mg po qd with for 5 years (in early breast cancer treatment) or 2.5-7.5 mg po qd for 5 days starting on day 3, 4, or 5 following menses or progestin induced bleed. A patient consideration of note is a decrease in bone mineral density (BMD) has been seen 2 years after usage in patients using letrozole compared to patients not on letrozole. The most common side effects seen are hot flashes, headache, hypercholesterolemia, and weight gain. Common monitoring parameters are BMD, pregnancy, cholesterol, and adherence.
ANSWERS:Â Â
- A, B, C, and D are all correct. E is not correct because it does not include cholesterol.
- Letrozole decreases the amount of estrogen in the body. It is a competitive non-steroidal aromatase enzyme inhibitor.Â
- In early breast cancer treatment the duration of therapy is for 5 years and follows up 5 years of tamoxifen.
- Femara can be used to treat platinum and taxane resistant ovarian cancers and not limited to breast cancer treatment. It is also used in treating infertility in women with PCOS.
PDF of Drug Card: letrozole
