Femara Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Femara Tablet, known generically as letrozole, is an aromatase inhibitor used to treat certain types of breast cancer in women who have gone through menopause. It works by lowering estrogen levels to slow or stop the growth of hormone-sensitive cancer cells. Femara is taken by mouth, usually once daily, and is also used off-label to treat infertility caused by ovulation problems.

What is Femara Tablet

Femara is a brand-name tablet used to treat certain types of breast cancer in women who have gone through menopause. It contains the active ingredient letrozole and belongs to a group of medicines called aromatase inhibitors.

Femara Tablet uses

• Treating breast cancer in postmenopausal women
• First-line treatment of hormone receptor positive or hormone receptor unknown locally advanced or metastatic breast cancer
• Treatment of advanced breast cancer after other anti-estrogen therapy has failed
• Extended adjuvant treatment of early breast cancer after 5 years of tamoxifen therapy
• Adjuvant treatment of estrogen receptor positive invasive early breast cancer
• Neoadjuvant treatment in certain postmenopausal women before surgery
• Off-label use to treat infertility caused by ovulation problems

Benefits of Femara Tablet

• Helps treat certain hormone receptor-positive breast cancers in postmenopausal women.
• Works by lowering estrogen levels, which can slow or stop the growth of estrogen-dependent cancer cells.
• May help reduce the risk of breast cancer recurrence after initial treatment.
• Can be used as extended adjuvant therapy after other hormonal treatments such as tamoxifen.
• Is also commonly used off-label to induce ovulation in some women with infertility, especially those with polycystic ovary syndrome (PCOS).

How Femara Tablet works

Femara works by blocking an enzyme called aromatase, which the body uses to make estrogen after menopause. By stopping this enzyme from working normally, Femara lowers estrogen levels, which stops estrogen from encouraging hormone-sensitive breast cancer cells to grow.

Femara Tablet dosage

Femara is usually taken once per day, or once every other day, depending on your doctor's instructions. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. You may take this medicine with or without food. Femara tablets should be swallowed whole and should not be crushed, split, or chewed. Try to take your dose at the same time each day.

If you miss a dose, take it as soon as you remember unless it is almost time for your next dose. In that case, skip the missed dose. Do not take extra medicine to make up for a missed dose. While using Femara, you may need frequent medical tests, and your bone mineral density may also need to be checked.

Available forms and strengths

• Tablet

Side effects of Femara Tablet

Common

• Hot flashes, warmth or redness in the face or chest
• Headache, dizziness, weakness
• Bone pain, muscle or joint pain
• Swelling, weight gain
• Increased sweating
• Increased cholesterol in the blood
• Fatigue
• Nausea
• Vaginal bleeding or spotting
• Changes in mood
• Aching or pain in joints and muscles
• Menopausal symptoms such as hot flushes and night sweats
• Low mood and depression
• Difficulty sleeping
• Diarrhea and constipation
• Loss of appetite, indigestion and heartburn
• Carpal tunnel syndrome (pain, tingling, and numbness in the arm, hand, or fingers)
• Changes to hair or facial hair
• Skin changes such as rash or dryness

Serious

• Reduced bone mineral density (weakened bones) and osteoporosis
• Increased cholesterol level
• High blood pressure
• Severe allergic reaction with hives, difficulty breathing, or swelling of the face, lips, tongue, or throat
• Fast heart rate (palpitations) and chest pain
• Blood clots such as deep vein thrombosis or pulmonary embolism
• Arterial thrombosis and pulmonary embolism
• Hepatitis and toxic epidermal necrolysis (rare)

Warnings and precautions

• This medicine can lower bone density over time, which can lead to weaker bones and a higher risk of fractures. Your doctor may check your bone strength before and during treatment.
• This medicine can raise cholesterol levels, so your doctor may want to monitor your cholesterol while you take it.
• Tell your doctor if you have liver disease, especially cirrhosis, high cholesterol, or osteoporosis before starting this medicine.
• Do not take this medicine if you have not completely gone through menopause or if you are pregnant, since it is only meant for women who cannot become pregnant.
• Do not take this medicine together with tamoxifen or any product containing estrogen, since this can make it less effective.
• Do not take Femara if you are pregnant, as it can harm an unborn baby or cause birth defects. Use effective birth control if you have not gone through menopause, and continue using it for at least 3 weeks after your last dose.
• Do not breastfeed while taking Femara, and continue to avoid breastfeeding for at least 3 weeks after your last dose.
• Caution is needed for patients with reduced kidney function, especially if creatinine clearance is very low.
• People with liver problems, especially cirrhosis, may be exposed to about twice as much of the drug, so a lower dose may be recommended, such as taking it every other day instead of daily.
• Alcohol is not known to interact directly with Femara, but drinking a lot of alcohol can raise the risk of weak bones (osteoporosis), which this medicine can already cause. Alcohol may also worsen side effects like headache, dizziness, nausea, or tiredness.
• This medicine may cause tiredness, dizziness, or drowsiness, so be careful when driving or using machinery until you know how it affects you.

Storage

• Store at 20–25°C (68–77°F) at controlled room temperature.
• Keep tablets in their original, tightly closed container until use.
• Protect from excessive heat, moisture, and direct sunlight.
• Avoid storing in bathrooms or other hot and humid areas.
• Keep out of reach and sight of children and pets.

When to see a doctor

• Get emergency medical help if you notice signs of a serious allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
• Seek emergency help right away if you notice signs of a blood clot, such as pain, redness, or swelling in an arm or leg, sudden shortness of breath, chest pain or tightness, or an unexplained cough or coughing up blood.
• If you think you may have taken too much of this medicine, contact your doctor or a poison control service right away, or go to the nearest emergency room if symptoms are severe.
• Tell your treatment team if vaginal bleeding continues for more than a few days.

Alternatives

• Fulvestrant (Faslodex)
• Tamoxifen
• Exemestane (Aromasin)
• Anastrozole (Arimidex)