Anastrozole

Anastrozole 1mg Tablets

Anastrozole is a generic medicine approved by the FDA for the treatment of breast cancer in postmenopausal women. It is a prescription medication and also comes under the brand name Arimidex. It belongs to a class of drugs called aromatase inhibitors, which work by reducing estrogen levels, a hormone that can promote the growth of breast cancer cells. Anastrozole is effective for early-stage, hormone-receptor-positive breast cancer and for advanced or metastatic cases. It is taken as a 1mg tablet daily and may continue until the tumor stops responding. Not suitable for women who haven’t gone through menopause, it is also not recommended for patients with estrogen receptor-negative breast cancer or those who have not responded to tamoxifen therapy. Follow the guidelines given by your doctor strictly. 

Product Overview

Anastrozole is an effective medication used in the treatment of breast cancer among postmenopausal women. It is categorized as an aromatase inhibitor, which functions by blocking the aromatase enzyme responsible for converting androgens into estrogen. Since many breast cancer tumors grow in response to estrogen, reducing its production is crucial in controlling disease progression. This medication is particularly useful for treating hormone receptor-positive breast cancers in their early stages, as well as for managing advanced or metastatic breast cancers. The standard dosage involves taking a 1 mg tablet once daily, which should be continued until there is no further response from the tumor or according to the physician’s guidance.

Anastrozole is not appropriate for premenopausal women and is generally ineffective in patients with estrogen receptor-negative breast cancers. Additionally, it should not be used by those who have not seen results from prior tamoxifen treatment, a similar hormone therapy. Key points regarding its administration include taking the tablet whole, with or without food, and at a consistent time each day to maintain stable drug levels in the body. While generally well-tolerated, Anastrozole can cause side effects such as bone weakness, hot flashes, joint pain, and elevated cholesterol levels. Due to its potential to decrease bone density, monitoring bone health is essential during treatment.

For patients with liver issues, Anastrozole usually does not require dose adjustments for mild to moderate liver impairment. However, its effects have not been studied in cases of severe liver impairment, so extra caution is advised. Patients taking Anastrozole should avoid using any estrogen-containing products as they can counteract the effects of the medication. Additionally, interaction with certain medications, particularly other estrogen blockers like Tamoxifen, should be managed carefully under a doctor’s supervision to prevent reduced efficacy of Anastrozole. This medication offers a significant benefit for postmenopausal women dealing with certain types of breast cancer. Still, it should be used under the close guidance of a healthcare provider, who can tailor the treatment plan based on individual health needs and monitor for adverse effects or interactions.

Uses of Anastrozole

Anastrozole is a medication used to treat breast cancer in women who have gone through menopause. Here are its specific uses:

• Treatment of early breast cancer: It is prescribed for women whose cancer tests positive for hormone receptors or if the hormone receptor status is unknown. It can be used after surgery or along with other treatments.
• Initial treatment for metastatic breast cancer: This is when the cancer has spread beyond the breast. Anastrozole is used for women with hormone receptor-positive breast cancer or when the status of hormone receptors is not known.
• Treatment of advanced breast cancer: It is used when the cancer progresses despite initial positive responses to the cancer drug tamoxifen.

Anastrozole is not effective for women with estrogen receptor-negative breast cancer or for those who did not respond to treatment with Tamoxifen.

[Important Warning: Anastrozole is not suitable for women who have not yet gone through menopause. If you become pregnant while taking this medicine, you should stop using it immediately.]

How to Use Anastrozole?

Dosage

It comes in the form of a tablet that you take orally and has a strength:

• Anastrozole 1mg tablets

Recommended Dosage of Anastrozole

Breast Cancer Treatment with Medication

• Adjuvant Treatment (To Prevent Cancer Return)

1. 1. • It’s for postmenopausal women who have a type of early breast cancer that responds to hormones.
      • How to take it: 1 mg pill once a day for 5 years.

• First-line Treatment (Initial Treatment)

1. 1. • It’s for postmenopausal women with advanced breast cancer that is either responsive to hormones, or it’s unknown if hormones affect it.
      • How to take it: 1 mg pill once a day. Continue taking it until the tumor stops responding to the treatment.

• Second-line Treatment (After Other Treatment Fails)

1. • It’s for postmenopausal women whose breast cancer has gotten worse after treatment with another medication called Tamoxifen.
   • How to take it: 1 mg pill once a day. Keep taking it until the tumor stops responding.
   • Important Note: This medication usually doesn’t work if the previous treatment with Tamoxifen doesn’t work or if the cancer doesn’t respond to hormone therapy.

Dosage Adjustments for Liver Problems

• Mild to Moderate Liver Issues: No change in the amount of medication needed.
• Severe Liver Issues: The effect of the medication has not been studied in severe cases.
• The dosage generally stays consistent unless there are significant health changes related to liver function.

[Note: These recommendations may vary from person to person. Discuss them with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

• Not all possible dosages and forms are listed here. Your specific dosage, the form of the medication, and how often you take it will depend on:
  • your response to the initial dose
  • your age
  • the severity of your condition
  • the condition being treated
  • Any other medical conditions you have
• You should follow your doctor’s or healthcare provider’s instructions when taking Anastrozole.
• Take this medication by mouth, with or without food, once a day as your doctor directs.
• Try to take your dose at the same time each day to maintain a consistent level of the medication in your body.
• Do not increase your dose. Take it more often or use it for a longer time than prescribed. Doing so won’t improve your condition faster and may increase your risk of severe side effects.
• Do not crush, split, or chew the tablets. Swallow them whole. If you have difficulty swallowing pills, discuss alternatives with your doctor or pharmacist.
• When you receive Anastrozole from the pharmacy, check the expiration date added by the pharmacist on the bottle label. This date is typically one year from when the medication was dispensed. Make sure to use the medication within this timeframe.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Anastrozole Work?

Anastrozole is part of a group of medications known as aromatase inhibitors. These drugs work by blocking the production of estrogen, which is a critical factor in the growth of some breast cancers. A class of drugs is a category of medications that operate in a similar manner, often with identical chemical structures, and are used to treat similar conditions. Before menopause, most of the estrogen in your body is produced by your ovaries, with only a small amount made by the aromatase enzyme. However, after menopause, your ovaries stop producing estrogen, and the aromatase enzyme becomes the primary source of your body’s estrogen.

In postmenopausal women, an enzyme called aromatase converts hormones known as androgens into estrogen. Many types of breast cancer cells grow in the presence of estrogen. Anastrozole works by inhibiting the aromatase enzyme, effectively reducing the amount of estrogen in your body. This reduction helps prevent estrogen from stimulating the growth and spread of breast cancer. Anastrozole begins to work shortly after you start taking it, although its effects are not immediately noticeable. Throughout your treatment, your doctor may conduct various tests to monitor the effectiveness of the drug.

Important Safety Information

Side Effects

Common side effects of Anastrozole may include the following:

• Weakness
• Anxiety
• Swelling of your legs, ankles, or feet
• Bone, joint, and muscle pain or stiffness
• Hot flashes
• High blood pressure
• Skin rash
• Trouble sleeping
• Nausea or vomiting
• Headache
• Sore throat or cough
• Swelling in your lymph nodes
• Shortness of breath
• Depression
• Nervousness
• Back pain
• Bone fractures

Serious side effects of Anastrozole may include:

• Higher cholesterol levels
• Osteoporosis (bone weakness or thinning) signs can consist of: 
  • Pain in your hips, neck, or back
• Liver problems signs can include:
  • A constant feeling of not being well
  • Pain on the right upper side of your stomach area
  • Yellowing of the whites of your eyes or your skin
• Skin reaction signs can include:
  • Blisters
  • Open sores (ulcers)
  • Abnormal growth on your skin (lesion)
  • Numbness, pain, tickling, tingling, or coldness in parts of your hand

[Note: This list may not cover all possible side effects. Always consult with your healthcare provider for medical advice about side effects.]

Warnings

• For People with Osteoporosis: Taking Anastrozole may lower estrogen levels in your body, which can weaken or thin your bones. This might make your osteoporosis worse and increase your risk of fractures. Your doctor will monitor your bone mineral density before and during your treatment with Anastrozole.
• For People with High Cholesterol: Anastrozole can raise your cholesterol levels, potentially increasing your risk of severe heart problems. Your doctor will check your cholesterol levels regularly while you are taking this medication.
• For People with Heart Disease: If you have a history of artery blockage in your heart, Anastrozole might reduce blood flow to your heart. It’s important to discuss the risks and benefits of using this medication for your breast cancer treatment with your doctor.
• For People with Liver Problems: Anastrozole may cause inflammation in your liver, which can aggravate existing liver issues. Your doctor will likely test your liver function before starting and during your treatment with this medication.
• For People Prone to Allergies: Anastrozole can trigger a severe allergic reaction. Signs of this may include swelling of your tongue or throat, hives, and difficulty breathing. If you experience these symptoms, immediately call 911 or visit the nearest emergency room. Do not take this medication again if you have previously had an allergic reaction to it, as taking it again could be life-threatening.
• Do not share this medication with others, even if they have the same medical condition as you. Anastrozole could harm them.

Boxed Warning

• Heart Disease Warning: If you have early breast cancer and a history of heart artery blockage, Anastrozole may reduce blood flow to your heart. Contact your doctor immediately if you experience symptoms such as:
  • Swelling in your feet and legs
  • Shortness of breath
  • Worsening chest pain
• Low Bone Density Risk: Anastrozole can reduce bone density in your lower spine and hips. Your doctor will check your bone mineral density during your treatment with this drug.
• Cholesterol Warning: It may increase your cholesterol levels, which could heighten your risk of heart disease.
• Embryo-Fetal Toxicity Warning: This medicine can harm a developing fetus and may result in pregnancy loss. If you are capable of becoming pregnant, you must use effective birth control while taking Anastrozole and for at least three weeks after your last dose.

Precautions

• For Pregnant Women: Anastrozole is not explicitly banned during pregnancy, but there are important guidelines for its use. The package insert advises those who can become pregnant to use effective contraception while on anastrozole therapy and for at least 3 weeks after the last dose. You should have a negative pregnancy test before starting Anastrozole. Inform your doctor if you are pregnant or planning to become pregnant. If you become pregnant while taking Anastrozole, stop taking the drug immediately and contact your doctor.
• For Women Who Are Breastfeeding: It is unknown if Anastrozole passes into human breast milk or if it impacts breast milk production. However, the drug could harm a nursing child if present in breast milk. You should not breastfeed while taking this drug and for at least 2 weeks after your last dose. If you are breastfeeding, discuss with your doctor before taking Anastrozole. They can suggest safe and appropriate feeding options for your child. Together, you and your doctor will need to decide whether to continue taking Anastrozole or to stop breastfeeding.
• For Women Taking Birth Control: Anastrozole could harm a fetus if taken during pregnancy. If you are sexually active and you or your partner can become pregnant, discuss your birth control needs with your doctor while using Anastrozole. If you are a woman who is able to become pregnant, you should use effective birth control while taking this drug and continue using birth control for at least 3 weeks after your last dose of Anastrozole.
• For Children: The safety and effectiveness of Anastrozole have not been established in individuals younger than 18 years of age.

Contraindications

• Anastrozole should not be used by individuals who have a known allergy to the drug, as it can cause severe allergic reactions.
• Use of Anastrozole is contraindicated in women who are or may become pregnant due to the risk it poses to the fetus, potentially causing fetal harm or pregnancy loss.

Missed Dose

• If you miss a dose of Anastrozole, take it as soon as you remember. However, if it’s nearly time for your next dose, just skip the missed dose. 
• Do not take two doses at once to make up for the missed one, as this could increase your risk of experiencing side effects from Anastrozole.
• To ensure you do not miss a dose, consider using a medication reminder. This could be an alarm or timer on your phone, a reminder app, or even a kitchen timer.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

Taking too much Anastrozole might lead to an increase in the usual side effects associated with the drug. In clinical studies, some participants were given a daily dose of 10 mg of Anastrozole, which is higher than the recommended dosage. Despite this, they did not experience more severe or additional side effects compared to those taking a lower dose.

If you accidentally take two Anastrozole tablets instead of one, it is unlikely to cause serious problems. However, you should always follow your doctor’s recommended dosage and not exceed it. The exact dosage of Anastrozole that could lead to a life-threatening overdose is not known.

If you believe you have taken too much Anastrozole, contact your doctor immediately. You can also reach out to the American Association of Poison Control Centers for guidance. If you experience severe symptoms, call 911 or go to the nearest emergency room right away.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Storage

• Anastrozole tablets should be stored in a tightly sealed container at room temperature, between 68°F and 77°F (20°C and 25°C). 
• Avoid storing the medication in places where it might get damp or wet, such as bathrooms.
• If you no longer need Anastrozole and have leftover medication, it is important to dispose of it properly. 
• Safe disposal helps prevent accidental ingestion by children and pets and also reduces environmental harm.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Anastrozole Interactions

Anastrozole can interact with various other medications, and these interactions can have different effects. For example, some interactions may interfere with how well Anastrozole or other drugs work. Other interactions might increase the side effects or make them more severe. It’s important to discuss all your current medications with your healthcare provider to avoid potential interactions.

Interactions with Other Medications

Below are examples of medications that can interact with Anastrozole. Please note that these lists are not exhaustive, and other drugs may also interact with Anastrozole. Before starting Anastrozole, it is crucial to discuss all medications you are currently taking with your doctor and pharmacist. This includes all prescription and over-the-counter medications, as well as any vitamins, herbs, and supplements you are using. Sharing this information is vital to avoid potential drug interactions. If you have any concerns or questions about drug interactions that may affect you, be sure to ask your doctor or pharmacist for more information.

• Tamoxifen: It is also a hormone therapy used to treat breast cancer. However, taking it together can reduce the effectiveness of Anastrozole. This occurs because Tamoxifen can lower the amount of Anastrozole in your body, making it less effective. Due to this interaction, you should not take these two medications at the same time. However, it is acceptable to start Anastrozole after completing your course of Tamoxifen if this sequence is recommended by your doctor.
• Drugs Containing Estrogen: Taking Anastrozole with medications that contain estrogen could reduce its effectiveness. Therefore, you should avoid using estrogen-containing drugs while on Anastrozole. Examples of such drugs include:
  • Hormone replacement therapy (HRT)
  • Birth control medications, including patches, pills, and vaginal rings
  • Vaginal estrogen products, like creams and tablets

If you have questions about using estrogen-containing medications with Anastrozole, it’s important to discuss them with your doctor.

Interactions with Herbs and Supplements

While there are no specific reports of herbs or supplements interacting with Anastrozole, it’s important to consult your doctor or pharmacist before using any such products while on this medication. For instance, supplements like red clover or wild yam, often used to alleviate menopausal symptoms like hot flashes might reduce the effectiveness of Anastrozole. This potential interaction occurs because these supplements contain phytoestrogens, substances similar to estrogen found in certain plants. The impact of phytoestrogens on breast cancer treatment is not fully understood, so it’s crucial to discuss any herbal or supplemental use with your doctor before starting them with Anastrozole.

Interactions with Foods

There are no known foods that interact with Anastrozole. However, it is always a good idea to discuss with your doctor if there are any specific foods you should avoid while undergoing treatment with Anastrozole.

Interactions with Alcohol

While alcohol does not directly interact with Anastrozole, it may exacerbate some of the drug’s side effects, such as headaches, dizziness, nausea, and tiredness. Furthermore, consuming large amounts of alcohol during treatment can increase your risk of developing osteoporosis, characterized by weak and thin bones. Therefore, it is advisable to limit or avoid heavy alcohol consumption while taking Anastrozole.

Additionally, alcohol consumption is linked to an increased risk of developing breast cancer. However, it is currently unclear if drinking alcohol after being diagnosed with breast cancer can worsen the condition or increase the likelihood of recurrence post-treatment. If you consume alcohol and are concerned about its effects on your breast cancer or its treatment, it’s important to speak with your doctor. They can provide guidance on how much alcohol is safe for you to drink during your treatment.

[Note: This isn’t a complete list, and there could be other drugs that interact with Anastrozole. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Anastrozole Alternatives

• Fareston (toremifene)
• Abraxane (paclitaxel)
• Evista (raloxifene)
• Adriamycin (doxorubicin)
• Arimidex (anastrozole)
• Taxotere (docetaxel)
• Kisqali (ribociclib)
• Afinitor (everolimus)
• Faslodex (fulvestrant)
• Piqray (alpelisib)
• Femara (letrozole)
• Soltamox (tamoxifen)
• Ellence (epirubicin)
• Aromasin (exemestane)
• Ibrance (palbociclib)
• Verzenio (abemaciclib)
• Tamoxifen
• Xeloda (capecitabine)
• Cyclophosphamide

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

Frequently Asked Questions

Why does Anastrozole cause weight gain?

Anastrozole, like other aromatase inhibitors, may contribute to weight gain because it counteracts the effects of estrogen. Estrogen plays a role in regulating metabolism and fat distribution in the body. When estrogen levels decrease due to drugs like Anastrozole, it can affect the activity of an enzyme called lipoprotein lipase (LPL). LPL is responsible for pulling fat out of the bloodstream and depositing it into cells, where it can be stored as fuel. With reduced estrogen levels, the activity of LPL may increase, leading to greater fat storage and potential weight gain.

Is Anastrozole a form of chemotherapy?

No, Anastrozole is not a form of chemotherapy. It is classified as a hormone therapy. Unlike chemotherapy, which directly targets and kills cancer cells, Anastrozole works by inhibiting the growth of cancer cells.

What happens when you stop taking Anastrozole after 5 years?

When you stop taking Anastrozole after a 5-year course of treatment, there’s evidence to suggest that it continues to reduce the risk of breast cancer recurrence for many years afterwards. However, it’s important to adhere to the recommended treatment duration, as not doing so may elevate the risk of breast cancer recurrence. While some individuals may have concerns about discontinuing treatment, it’s essential to follow your doctor’s guidance regarding the duration of Anastrozole therapy to optimize its effectiveness in reducing the risk of breast cancer recurrence.

Is Anastrozole a high-risk medication?

Anastrozole is considered a medication with potential risks, particularly regarding osteoporosis. It can cause or exacerbate osteoporosis by decreasing bone density, which can increase the risk of fractures. It’s essential to discuss these risks with your doctor to understand the implications of taking this medication and to explore strategies for minimizing these risks.

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