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Description
This medication is used to treat certain types of breast cancer (such as hormone-receptor-positive breast cancer) in women after menopause. Letrozole is also used to help prevent the cancer from returning. Some breast cancers are made to grow faster by a natural hormone called estrogen. Letrozole decreases the amount of estrogen the body makes and helps to slow or reverse the growth of these breast cancers.
Tamoxifen is also used to treat hormonally-responsive breast cancer, but it does so by interfering with the estrogen receptor. However, letrozole is effective only in post-menopausal women, in whom estrogen is produced predominantly in peripheral tissues (i.e. in adipose tissue, like that of the breast) and a number of sites in the brain. In pre-menopausal women, the main source of estrogen is from the ovaries not the peripheral tissues, and letrozole is ineffective.
In the BIG 1–98 Study, of post-menopausal women with hormonally-responsive breast cancer, letrozole reduced the recurrence of cancer, but did not change survival rate, compared to tamoxifen.


Use Cases of Letrozole Tablets
Women with PCOS
This fertility medication is more useful than clomiphene, and it stimulates the ovaries in women with polycystic ovary syndrome.
People who are resistant to clomiphene
Sometimes, even with an increasing clomiphene dosage, the fertility drug cannot stimulate the ovaries. In such cases, letrozole can be useful.
Infertility treatment (pre-cancer treatment)
in women with breast cancer, taking medications that stimulate the ovaries and increase the level of estrogen causes the tumor to grow faster. In this case, letrozole increases the estrogen level in the body and stimulates the ovaries.
Treatment of endometriosis
Sometimes this fertility drug is used to treat endometriosis. It is used in people whose purpose is not to stimulate the ovaries, but to reduce pelvic pain.
How to Take Letrozole
Before starting treatment for infertility with letrozole, read the medicine leaflet inside the package carefully. This leaflet will help you get comprehensive information about the medication. By reading it, you can also learn about the possible side effects of letrozole for fertility. Also, if you have any questions regarding its use, consult your gynecologist.
The dose and amount of letrozole vary from person to person. Use the medicine exactly as prescribed by your doctor. Regular and continuous use of this medicine plays a significant role in improving the treatment process.
If you forget to take a dose of letrozole, take the missed dose immediately. In case it is less than 3 hours before the next dose, you must omit the missed dose. In this case, do not take the missed dose and take the next dose as usual.
Even if you feel better, do not stop taking medicine without consulting with your doctor and completing the course of treatment.
Some people may ask about foods to avoid while taking letrozole for fertility. However, you should know that there is no food abstinence while taking this medicine. In addition, letrozole can be taken with or without food.
What Special Precautions Should I Follow?
· Before taking letrozole,
· Tell your doctor and pharmacist if you are allergic to letrozole, any other medications, or any of the ingredients in letrozole tablets. Ask your pharmacist for a list of the ingredients.
· Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: medications that contain estrogen such as hormone replacement therapy (HRT) and hormonal contraceptives (birth control pills, patches, rings, and injections); raloxifene (Evista); and tamoxifen (Nolvadex).
· Tell your doctor if you have high cholesterol, osteoporosis (condition in which the bones are fragile and break easily), or liver disease.
· You should know that letrozole should only be taken by women who have experienced menopause and cannot become pregnant. However, if you are pregnant or breast-feeding, you should tell your doctor before you begin taking this medication. Letrozole may harm the fetus.
· You should know that letrozole may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
Side effects
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When treating any condition, finding effective treatments involves weighing the benefits and potential side effects of medications. For example, letrozole (Femara), a hormonal therapy typically used for breast cancer, can lead to side effects ranging from an annoying metallic taste to serious health conditions.
Letrozole works by lowering your body's level of estrogen, an important sex hormone. Reducing estrogen levels can result in a variety of potential side effects, including the dozen discussed below.
1. Metallic Taste
Rarely, using letrozole may result in changes in your sense of taste, including a persistent metallic taste in your mouth, medically known as dysgeusia. Letrozole can also cause dry mouth, which can contribute to changes in how you experience flavors, including a tang that tastes like you have metal in your mouth.
2. Symptoms of Menopause
Because it blocks estrogen production, letrozole can cause symptoms similar to those associated with menopause, such as hot flashes, vaginal dryness, and mood changes.
In clinical study findings published in the Journal of Clinical Oncology, around one-third of women taking letrozole reported experiencing hot flashes. Several MyBCTeam members have also described this side effect in comments like these:
"My body feels like an oven warming up."
"I'm not having hot flashes … I'm having nuclear meltdowns!"
3. Sexual Side Effects
Some of the menopauselike side effects of letrozole can cause vaginal problems such as dryness, bleeding, or increased discharge. Several MyBCTeam members have mentioned experiencing related sexual side effects. One member discussed vaginal dryness: "I use Replens consistently, and it still feels like razor blades and like the walls are so close that I can feel the sting even when I sit. Terrible at 60 to think this will be the way I have to live my life - with painful sex."
Another member expressed a desire to regain their quality of life: "I don't want to be limited - I want my life back."
In response, a member emphasized the importance of advocating for yourself: "Remember, your happiness and pleasure matter!"
4. Aches and Pains
One of the most common side effects of taking letrozole is back pain, as well as pain in bones, joints, and muscles throughout the body. In the clinical study mentioned above, almost half of the participants who received letrozole reported experiencing joint pain.
Although this side effect may linger as long as you take letrozole, some MyBCTeam members noticed improvement in their symptoms over time. "For the first six months, I had some pretty significant leg and hip pain, especially if I sat too long," said one member. "After six months, the pain started getting better, and now I hardly have any pain!"
5. Sleep Problems
Another potential side effect of letrozole is trouble sleeping. If you have difficulty sleeping most nights, you may have insomnia. One MyBCTeam member shared their experience: "I don't sleep more than four to five hours a night."
Letrozole could lead to tiredness that makes the lack of sleep feel even worse. "The fatigue sets in around 2 to 3 p.m.," the same member said. "I rest but can't take a nap; I just can't fall asleep!"
6. Thinning of Bones
As with menopause, a lack of estrogen caused by letrozole can affect the amount of calcium stored in your bones, leading to bone thinning. In the early stages, this loss in bone density is known as osteopenia, which can progress to osteoporosis (brittle bones). Nearly 11 percent of women taking letrozole develop osteoporosis, according to the Journal of Clinical Oncology study. Thinning bones can increase your risk of fractures, so your doctor will closely monitor your bone density while you're on letrozole.
7. Dry Skin and Hair Loss
You may notice changes in your skin and hair while on letrozole. Alopecia (hair thinning and loss) affected about 6 percent of women taking letrozole in the clinical study. This side effect can be upsetting, especially if you've recently regrown your hair after finishing chemotherapy. "I can handle the aches and pains, but the extreme hair loss is the most frustrating side effect for me," a MyBCTeam member said.
In addition, letrozole may cause dry skin, leading to irritation, itchiness, or swelling. One member reflected on switching from anastrozole (Arimidex) to letrozole: "I have noticed significant aging effects like hair loss, dry skin, loss of muscle tone, very dry vaginal fluid, dry eyes, more wrinkles, and more fatigue."
8. Digestive Tract Issues
Letrozole can upset your stomach, causing nausea, stomach pain, diarrhea, or constipation. "I've had hard and painful bowel movements," wrote a MyBCTeam member who developed constipation as a side effect. "I tried everything and still only had one every two days. I finally started eating fresh fruit and found that cantaloupe works well for me."
9. Anxiety and Depression
Letrozole can affect your mental health, making you feel anxious or depressed. One MyBCTeam member described feeling sad all the time while taking letrozole: "When I took Femara, all I did was cry. When I slept, my eyes would fill with tears."
Another member asked, "Has anyone felt a mood drop taking letrozole? I have been taking it since January, and I just don't feel like doing anything."
10. Flu-Like Symptoms
Fu-like symptoms can indicate that you have an infection and should seek medical help, but letrozole can cause similar side effects, including:
Chills
Fever
Sore throat
Cough
Extreme weakness
In the clinical study, about 5 percent of participants taking letrozole developed a cough. "I've been having a dry, hacking cough, and I read that it could be a side effect," one MyBCTeam member said. "It wakes me up at night and can happen anytime- I can't stop it - I've tried drinking something, cough drops, etc. It isn't like a cold, so I don't know what this is."
11. Weight and Appetite Changes
If you've noticed that your weight fluctuates while taking letrozole, the changes might be related to an increased appetite that leads to weight gain. "I crave doughnuts and pastry like I'm pregnant," a MyBCTeam member commented.
On the other hand, letrozole could also cause a loss of appetite and weight. One member seemed to experience both types of weight-related side effects: "I gained weight with letrozole and then lost it kind of suddenly. It was weird."
12. More Serious Side Effects
It's important to be aware of some rare but serious side effects of letrozole. Notify your health care provider immediately to get medical advice if you experience any of the following:
Signs of a blood clot, like swelling or pain along a vein
Urinary tract infection symptoms, such as more frequent or painful urination or bloody urine
Yellowing of the skin or eyes, which may indicate liver problems
Signs of an allergic reaction, such as an itchy, widespread rash or swelling of the lips, mouth, or throat that makes breathing difficult
Stroke symptoms, including sudden weakness or numbness, difficulty speaking, loss of coordination, or facial drooping on one side
Symptoms of a heart attack, such as chest pain or pressure, sudden nausea or vomiting, or pain in the arms, back, neck, jaw, or stomach
Call for emergency care if you think you're having a stroke or heart attack.
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