#29: letrozole (Femara) | Treating and Preventing Breast Cancer, Ovarian Cancer, and Infertility in PCOS Patients

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.  Go to DrugCardsDaily.com for my episode show notes which will contain a drug summary, quiz, and a link to FREE drug card sheets. SUBSCRIBE on Spotify or Apple Podcasts or search for us on your favorite place to listen to podcasts. I will go over the Top 100-200 Drugs as well as throwing in some recently released drugs that peak my interest. Also, if you’d like to say hello, suggest a drug, or leave any constructive feedback on the show I’d really appreciate it! Leave a voice message at anchor.fm/drugcardsdaily or message us through twitter @drugcardsdaily