Femara

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Related to Femara: tamoxifen

letrozole

Femara

Pharmacologic class: Aromatase inhibitor

Therapeutic class: Antineoplastic

Pregnancy risk category D

Action

Inhibits aromatase, an enzyme that promotes conversion of estrogen precursors to estrogen. This inhibition reduces circulating estrogen levels and stops progression of breast cancer.

Availability

Tablets: 2.5 mg

Indications and dosages

➣ Metastatic or advanced breast cancer in postmenopausal women; early breast cancer in postmenopausal women who have received 5 years of antiestrogen therapy

Adults: 2.5 mg P.O. daily

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:

• severe hepatic impairment

• pregnant or breastfeeding patients

• children (safety not established).

Administration

• Give with or without meals.

Adverse reactions

CNS: anxiety, depression, dizziness, drowsiness, fatigue, headache, vertigo, asthenia

CV: chest pain, hypertension

EENT: blurred vision

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, anorexia

Metabolic: hypercalcemia

Musculoskeletal: musculoskeletal or joint pain, fractures

Respiratory: cough, dyspnea, pleural effusion

Skin: alopecia, pruritus, rash, diaphoresis

Other: hot flashes, edema, weight gain, angioedema, anaphylactic reactions

Interactions

Drug-diagnostic tests. Cholesterol, gamma-glutamyltransferase: increased levels

Patient monitoring

• Check vital signs and assess cardiovascular and respiratory status.

• Monitor renal and hepatic function, electrolyte levels, and lipid panels.

• Assess for adverse CNS effects, including depression. Institute safety measures as needed to prevent injury.

Patient teaching

• Tell patient she can take with or without food.

• Instruct patient to weigh herself regularly and report significant changes.

• Advise patient and family to watch for signs and symptoms of depression.

• Tell patient to minimize GI upset by eating small, frequent servings of healthy food and drinking plenty of fluids.

• Caution patient to avoid driving and other hazardous activities until she knows how drug affects concentration and alertness.

• Inform patient that treatment is long term. Urge her to keep follow-up appointments with prescriber.

• Tell patient to inform prescriber if she is pregnant or breastfeeding.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.

letrozole

(let-roe-zole) ,

Femara

(trade name)

Classification

Therapeutic: antineoplastics
Pharmacologic: aromatase inhibitors

Pregnancy Category: X

Indications

First-line or second-line treatment of postmenopausal women with hormone receptor positive or hormone receptor unknown advanced breast cancer.Adjuvant treatment of postmenopausal women with hormone receptor positive early breast cancer.Extended adjuvant treatment of postmenopausal early breast cancer already treated with 5 yr of tamoxifen.

Action

Inhibits the enzyme aromatase, which is partially responsible for conversion of precursors to estrogen.

Therapeutic effects

Lowers levels of circulating estrogen, which may halt progression of estrogen-sensitive breast cancer.

Decreased risk of recurrence/metastatic disease.

Pharmacokinetics

Absorption: Rapidly and completely absorbed.

Distribution: Unknown.

Metabolism and Excretion: Mostly metabolized by the liver.

Half-life: 2 days.

Time/action profile (effect on lowering of serum estradiol levels)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	2–3 days	unknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity;Premenopausal women; Obstetric: Potential for fetal harm.

Use Cautiously in: Severe hepatic impairment; Lactation / Pediatric: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

anxiety
depression
dizziness
drowsiness
fatigue
headache
vertigo
weakness

Respiratory

coughing
dyspnea
pleural effusion

Cardiovascular

chest pain
edema
hypertension
cerebrovascular events
thromboembolic events

Gastrointestinal

nausea (most frequent)
abdominal pain
anorexia
constipation
diarrhea
dyspepsia
vomiting

Dermatologic

alopecia
hot flashes
↑ sweating
pruritus
rash

Fluid and Electrolyte

hypercalcemia

Metabolic

hypercholesterolemia
weight gain

Musculoskeletal

musculoskeletal pain (most frequent)
arthralgia
↓ bone density
fractures

Interactions

Drug-Drug interaction

None significant.

Route/Dosage

Oral (Adults) 2.5 mg daily.

Hepatic Impairment

Oral (Adults) Severe hepatic impairment—2.5 mg every other day.

Availability (generic available)

Tablets: 2.5 mg

Nursing implications

Nursing assessment

Assess patient for pain and other side effects periodically throughout therapy.
Lab Test Considerations: May cause elevated AST, ALT, alkaline phosphatase, bilirubin, GGT and cholesterol levels.

Potential Nursing Diagnoses

Acute pain (Side Effects)

Implementation

Do not confuse Femara (letrozole) with Femhrt (ethinyl estradiol/norethindrone).
Oral: May be taken without regard to food.

Patient/Family Teaching

Instruct patient to take medication as directed.
May cause dizziness and fatigue. Caution patient to avoid driving and other activities requiring awareness until response to medication is known.
Inform patient of potential for adverse reactions and advise her to notify health care professional if side effects are problematic.
Caution women who are perimenopausal or who recently became menopausal to use adequate contraception during therapy; letrozole may cause fetal harm.

Evaluation/Desired Outcomes

Slowing of disease progression in women with advanced breast cancer.
Decreased risk of recurrence/metastatic disease.

Femara

(fə-mär′ə)

A trademark for the drug letrozole.

Femara

A brand name for LETROZOLE.

Mentioned in ?

References in periodicals archive ?

The packaging of the Kisqali Femara Co-Pack allows patients the convenience of obtaining a full 28-day cycle of the two medicines in one package with one prescription and one co-pay.

Novartis gains Rydapt approval for AML: BioMarin's Brineura wins FDA approval for Batten disease

Novartis produces Clozarilm Voltaren, Tegretol, Diovan, Glivec, Neoral, Femara, Ritalin and Lamisil.

Forbes Global 2000: Biggest Drug Companies of 2014; Pfizer Tops List

Trade Generic Dosage Strengths names names form Enliven Imatinib Capsule 100mg/ Capsule Letrozole Letrozole Tablet 2.5mg/ Tablet Femara Letrozole Tablet 2.5mg/ Tablet Trade Pack Price Company names size (MRP) names Enliven 28's/ 2800.00 Orion Box Letrozole 5's/ 200 Renata Box Femara 30's/ 7577.00 Novartis Box Beacon Pharmaceuticals going to produce some products that are as follows:

To determine and examine the prospect and feasibility study of anti-cancer drugs for local production in Bangladesh

The month I turned thirty-eight I gave it one last try--a crazy aggressive cycle, as I came to think of it--the anti-estrogen drug Femara and a whole lot of Follistim to stimulate egg production, and it still didn't work, just the palest baby pink of possible positives on the home pregnancy test.

The donor egg essay

Table 1: Metabolism and Transport Effects (10-13) Arimidex Aromasin Femara Tamoxifen CYP1A2 weakly inhibits CYP2A6 minor substrate minor weakly substrate inhibits weakly inhibits CYP3A4 weakly major substrate minor major substrate inhibits weakly induces substrate weakly inhibits CYP2B6 minor substrate weakly inhibits CYP2C8 weakly weakly inhibits inhibits CYP2C9 weakly major substrate inhibits weakly inhibits CYP2C19 weakly inhibits CYP2D6 major substrate CYP2E1 minor substrate + minor substrate ++ major substrate [down arrow] weakly inhibits [down arrow] [down arrow] strongly induces [up arrow] weakly inhibits CYP2D6 Polymorphisms

Naturopathic co-management of patients receiving adjuvant endocrine therapy for breast cancer

In their report Massachusetts General Hospital (MGH) Cancer Center investigators describe finding that the HOXB13/IL17BR ratio can indicate which women are at risk for cancer recurrence after tamoxifen and which are most likely to benefit from continuing treatment with the aromatase inhibitor letrozole (Femara).

Biomarker predicts recurrence of breast cancer after treatment

An experimental drug known as PD 0332991, when given in combination with Femara (letrazole), has been shown to extend "progression-free survival" by as much as 26 months compared to less than eight months among women given Femara alone.

Two different drug treatments may extend survival in advanced breast cancer patients

Aromatase inhibitors (Arimidex, Aromasin, or Femara) have fewer side effects and more benefits than tamoxifen.

A simple, inexpensive solution for pain from breast cancer treatment

After my chemotherapy ended, I could choose to take five years of an oral hormonal drug called Tamoxifen, or I could suppress my ovaries by taking a drug called Lupron or Zoladex and take five years of an Aromatase Inhibitor such as Letrozole (brand name Femara), Exemestane (Aromasin), or Anastrozole (Arimidex), or I could take five years of Tamoxifen and follow it up with another five years of an Aromatase Inhibitor.

Going it alone: after a diagnosis of breast cancer at 39, this mother of two was devastated to learn that doctors expected her to make all key treatment decisions

Six months of vitamin D at 30,000 IU per week proved safe and was associated with "less worsening" of musculoskeletal events and fewer overall adverse quality of life events in women starting adjuvant letrozole (Femara) for hormone receptor--positive breast cancer, Dr.

Vitamin D eases Arthralgia from AI therapy

Father-of-two Hafiz Noorullah, 45, of Pateley Crescent, Fartown, was asked to keep more than two million Contam, Lopresor and Femara pills in his warehouse in Meltham.

pounds 1m stolen pills man gets four years jail; Pharmacist 'indifferent to health hazard'

Last week, a wholesalers who supply the breast cancer drug Femara told a chemist they had ordered 2000 packets but were delivered 166, which were gone in half an hour.

PILL CRISIS WILL KILL; Chemists' stark warning as drug shortages reach crisis point

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