Femara (letrozole)
What is Femara ?
Femara is a drug used to treat breast cancer in post-menopausal women
(women who have gone through the menopause/change of life). It is a type of hormone
treatment known as an aromatase inhibitor.
How does it work?
The female hormone oestrogen is involved in the stimulation of
some breast cancers. This means that in these types of tumours oestrogen encourages
the cancer cells to grow. When a woman has been through the menopause, oestrogen is
produced in body tissues such as fatty tissue and the tumour itself. This happens because
other hormones (androgens) are converted into oestrogen by an enzyme known as aromatase. Femara works by stopping the conversion of androgens into oestrogen and so reducing the amount of oestrogen circulating around the body.
When is Femara prescribed?
Femara can be prescribed for post menopausal women with primary breast cancer (cancer
which started in the breast and has not spread to other parts of the body). Femara prescribed in this way is also called adjuvant therapy. Femara may be prescribed as a further
treatment after five years of Tamoxifen. This is known as extended adjuvant therapy. In
this case Femara treatment should begin within three months of completing
Tamoxifen therapy.
Femara will only be prescribed if your breast cancer is thought to rely on oestrogen to grow (oestrogen receptorpositive tumours). Femara may be prescribed if
your breast cancer comes back or progresses while you are taking tamoxifen or other
hormone treatments. In some situations it may be prescribed for primary breast
cancer to reduce the size of the tumour before surgery. This is called neo-adjuvant treatment.
How is Femara taken ?
Femara comes as a tablet(2.5mg) that you take once a day. It is best to take it at the
same time every day. If you miss a dose you don't need to take an extra dose the next day as
the level of drug in your body will remain high from the previous day. It is important not to stop taking Femara without talking to your specialist first. If the drug causes Nausea, or
stomach upset, it may be taken with food and/or at bedtime.
How long will I have to take Femara ?
This will vary from person to person. Your specialist will discuss with you how long you
need to carry on taking Femara. You will usually continue to take the drug for as long as
your breast cancer remains under control. If your breast cancer does progress while
you are taking Femara, there are other treatments that may be effective.
What are the side effects of Femara ?
Everyone reacts differently to drugs and some people may experience more side effects
than others. Usually Femara causes only a few side effects that can be kept under control.
It is rare for someone to stop taking Femara because of the side effects. The known side effects of Femara are listed below. It is important to remember that you may not get any of these.
More common side effects
These include symptoms such as aching or pain in the muscles and joints, loss of appetite or
nausea. These symptoms tend to be mild and temporary. If your symptoms don't improve
talk to your specialist, as there are other ways of controlling side effects.You may have menopausal symptoms such as hot flushes, night sweats and vaginal dryness. You can do practical things to help yourself such as wearing cotton clothing and reducing your intake of caffeine and alcohol. Some people find complementary therapies helpful.
For further information see our factsheet on Understanding and Managing Menopausal Symptoms. and our booklet on Complementary Therapies .
You may also suffer from nausea or vomiting which can be helped by taking your tablet
with food.
Less common side effects
These include side effects such as tiredness, headaches and shortness of breath. They are
usually temporary, but you should tell your specialist if you experience any of these.
Some women notice that their hair becomes thinner while taking Femara, although it is not usually noticeable to other people. Aromatase inhibitors may cause osteoporosis (bone
weakening) when administered for a prolonged period.As a result of this your specialist
may wish to check your bone density (strength and thickness) with a scan before taking
Femara and during the treatment. To maintain bone health you can increase your intake of c alcium and vitamin D. You may also be prescribed a calcium and vitamin D supplement. Stopping smoking and regular weight bearing exercise will also help to keep bones strong.
Other less common side effects include perspiration, constipation and feeling in a
low mood. Weight gain may also occur in some women.
Can I take Femara with my other Drugs ?
It is not advisable to take other drugs containing oestrogen, such as hormone
replacement therapy (HRT), while you are taking Femara. There do not seem to be any
other drugs that interfere with Femara and other medicines are not affected if you are
taking Femara.
Further Support
If you have any concerns about taking Femara you can talk to your specialist or breast care nurse. You might find it easier to share your feelings with someone who has had a similar
experience to you. Reach to Recovery is a programme set up to help and support women who have
recently had a breast cancer diagnosis. The programme works on the principle of
personal contact between the patient and a Reach to Recovery volunteer – a woman who has had treatment for breast cancer. Carefully selected and fully trained volunteers are available to provide advice and reassurance at a time when a woman is most in need of both.
For more information on individual support or support groups in your area, call the
National Cancer Helpline Freefone on 1800 200 700 .
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