Therapeutic indications of letrozole
Letrozole is a drug indicated for the treatment of breast cancer in postmenopausal women. It is a drug that belongs to the aromatase class of drugs. Letrozole is indicated for treatment in women with hormone receptor positive early breast cancer. It is prescribed for first-line treatment of postmenopausal women with hormone receptor positive. Letrozole may also be indicated for the treatment of advanced breast cancer in postmenopausal women. Patients are advised to make all necessary laboratory studies in order to depict the hormone receptor breast cancer. It is a drug that does not cause addiction. Letrozole is a hormonal therapy due to the fact that it interferes with the hormones receptor positive breast cancer. It is contraindicated in patients with a known hypersensitivity to it or to any of its ingredients. It is also contraindicated in women with premenopausal endocrine evidence. Prior to commencing the therapy with letrozole, consult a doctor and get informed about possible side effects, potential interaction with other drugs and other important information related to the use of letrozole.

How does it work?
When the breast cancer is depicted, it precipitates the hormone oestrogen growth. This type of breast cancer is known as oestrogen-receptor positive breast cancer. The main mechanism of action of letrozole is the attack on the growth of cancer cells. In postmenopausal women, the growth of oestrogen is done through the conversion of androgens, carried by aromatase enzyme. Therefore, letrozole blocks the process of aromatization and reduces the oestrogen cells.

Important information about letrozole
As already mentioned, it is important to make all necessary laboratory studies in order to depict the cancer cells and start the therapy based on clear clinical evidence of oestrogens.

• Letrozole may be indicated in women who had surgery to remove the cancer cells. The therapy after surgery is also known as adjuvant therapy, because it reduces the risk of cancer cells recurrence.
• Letrozole may also be prescribed for women before having the surgery. This therapy is known as neo-adjuvant hormonal therapy, because it allows the patient to have first lumpectomy (removal of the lump) than mastectomy (removal of the breast).
• Generally, the duration of therapy with letrozole is long and may take to several years. However, the length of treatment with this drug depends on many factors, including the particular condition of the patient, either for controlling the cancer or treating the cancer.
• Letrozole may be prescribed in women who already received hormonal therapy, for example tamoxifen.
• As already mentioned, letrozole may be prescribed to treat women with advanced or metastatic breast cancer.

Precautions with letrozole

• It is a drug that may cause drowsiness and light-headedness. It is important to avoid operating any heavy machinery or driving if dizziness is persistent. The patient loses concentration and may harm himself unintentionally.
• Patients on therapy with letrozole are at great risk of osteoporosis. In order to avoid it, it is necessary to assess the bone strength prior to commencement of therapy with it and during the therapy. If there is the need, take bone-strengthening drugs in order to prevent from osteoporosis development.
• If you have an upcoming surgery or are about to receive treatment with other drugs, prevent your doctor about the hormonal therapy with letrozole. Also, get the full information from a physician about the medicines who do not interact with letrozole in order to avoid potential interaction and developing of severe adverse events and prevent your doctor about the medicines you are taking on a daily basis, including prescription and non-prescription ones, vitamins, minerals and natural supplements.
• Avoid drinking grapefruit juice while on therapy with letrozole.

Indications of use and dosage
Letrozole is a drug available for oral administration as tablets. Patients need to follow the treatment exactly as prescribed in order to avoid developing of adverse reactions or decreasing the effect of the drug. The usual recommended dose is one tablet once a day. It is important to take the tablet around the same time each day in order to make a clear schedule and help the patient to not forget about the dose administration. Therefore, it may be taken in the morning or in the evening.

Possible side effects with letrozole
Like most of medicines, letrozole may also cause side effects when administered as prescribed. It is a general fact related to all medicines due to the fact that each patient reacts differently to the same medicine. Some people may not experience any side effects, while others may experience severe side effects. It is very important to assess the efficiency and safety of the drug on a regular basis in order to avoid developing of any side effects. Report to your physician about any adverse reactions you experience while on therapy with this drug. Generally, the side effects patients may experience with letrozole are mild to moderate in severity.
Possible side effects reported by patients on therapy with letrozole are the following:

• Hot flushes, are generally mild and disappear right after passing the initial phase of therapy with it;
• Muscular aches and joint pain;
• Nausea and vomiting;
• Tiredness and headaches;
• Hair thinning;
• Skin rash;
• Vaginal dryness;

If any of the described side effects occur, tell your doctor and take appropriate measures to treat the symptoms. There are available tablets and gels for the treatment of the enumerated adverse events. There have not been reported cases of discontinuation with letrozole due to severe side effects.

Overdosage with letrozole
There have been reported cases of overdosage with letrozole. The symptoms patients may experience after accidental or intentional overdosage with letrozole are gastrointestinal disturbances, such as nausea, vomiting, diarrhea, abdominal pain, constipation and other side effects depending on the quantity of letrozole ingested. Take all appropriate measures in order to treat the symptoms, which include reporting about overdosage immediately and staying under the supervision of physicians for a period of time until the symptoms disappear.

If you missed a dose
If you forgot to take a dose of letrozole, do not worry; take it as soon as you remember. If it is not too late, take the tablet. However, if it is already the time to take the next dose, leave the missed one and continue your usual schedule. The levels of medicine in the blood will not change too much. However, try to not miss more than two doses in a row and do not take greater doses in order to make up for the skipped ones.

Storage
Keep letrozole in a clean and dry place at the room temperature below 30 degrees C. Try to avoid the direct sunlight, heat and moisture. It is recommended to store letrozole out of the sight and reach of children. Keep the tablets in their original packaging and prior to beginning therapy with it look carefully at the expiry date at the bottom of the package. Do not use expired medicine. Contact a pharmacist if you have any questions related to the disposal ways of expired medicines.