Among anticancer drugs, the Femara drug stands in a special place. It is designed to combat the insidious disease - breast cancer in women. It is an aromatase enzyme inhibitor. Of course, only a highly specialized specialist should deal with the appointment of the drug, its dosage and monitoring of treatment, but it will be useful for potential patients to familiarize themselves with the medication, find out the features of the Femara tablets. The instructions list all the indications when a medication can be prescribed, gives indicative dosage regimens, and also lists possible side effects and all contraindications.
What is the drug released
The medicine "Femara" is made in the form of tablets, which are coated with a special enteric film coating. The pills are somewhat biconvex, the edges are beveled. Color is dark yellow. They are sold in cardboard packs, where there are three blisters containing 10 tablets each. On one side of the pill are Latin letters CG, and on the other FV.
Healing ingredients
Pills "Femara" consist of several components. However, the main active ingredient is one - letrozole, which in each pill contains 2.5 mg. The following substances are also present in the composition to create the necessary form and activate the active ingredient:
- hypromellose;
- macrogol 8000;
- corn starch;
- microcrystalline cellulose;
- talc;
- silicon dioxide;
- lactose monohydrate;
- sodium carboxymethyl starch;
- magnesium stearate;
- iron oxide dye;
- titanium dioxide.
The active substance letrozole has a pronounced antiestrogenic effect. The action is due to the inhibition of the aromatose enzyme, which is involved in the production of estrogen.
How does it affect the body
Tablets "Femara", instructions to confirm this, block the synthesis of female sex hormones. Moreover, the process goes both in the tumor tissue and in the peripheral. It is known that during menopause in women, estrogens are formed only when exposed to aromatase, which prevents the production of androgens (substances characteristic of the adrenal glands). If you take Letrozole daily in the form of the Femara drug, then there is a 75-95% decrease in the production of estradiol, estrone and estrone sulfate. Moreover, the action aimed at suppressing the synthesis of hormones occurs throughout the course of therapy, which is quite long with tumor processes.
If the dosage of the active substance is increased to 5 mg, then additional administration of glucosteroids and mineralocorticoids is not required. In this case, there are no violations of the synthesis of aotdosterone and there are no malfunctions in the adrenal glands. Also, the accumulation of androgens does not occur, which is often a side effect of the blockade of biosynthesis. During treatment with Femara, instructions and reviews confirm this, there were no violations in the plasma concentration of luteinizing and follicle-stimulating hormones. No changes in lipid profile occur. Also, experts in their medical practice revealed that there is no increase in the frequency of myocardial infarction while taking the drug and the number of strokes. Tablets do not affect the function of the thyroid gland.
Possible effects of therapy
Quite common in the oncological field of "Femara". The medicine does not affect the cardiac and brain activity, as evidenced by extensive experience with the application. However, during treatment, there may be risks of a woman having osteoporosis. But, as laboratory studies have shown, such risks when patients used a placebo also increased, but the percentage was slightly lower. Doctors conclude that the frequency of fractures is approximately comparable in women taking pills, with patients who do not use them, but who are at the same age.
If a remedy is prescribed in the early stages of detecting a tumor in the chest (as adjuvant therapy), then the survival rate of patients who do not even detect symptoms of the disease for five years is significantly increased, and the number of relapses due to cure is reduced.
If the therapy is extended, then the risk of developing a secondary tumor is reduced by more than 40%. Even if lymph nodes were involved, survival without serious symptoms also increased, and mortality decreased by 40%.
Pharmacological properties
Femara tablets dissolve and quickly enter the bloodstream from the gastrointestinal tract. The instructions say that the bioavailability of the drug is close to 100%, the absorption rate only slightly decreases, if combined with food intake.
If you drink pills on an empty stomach, then the maximum concentration of the active component in the blood is detected after an hour. If you combine the intake with food, then the active substance is activated in the bloodstream after two hours.
Letrozole binds to plasma proteins by 60%, but most of all it is found in red blood cells. As soon as therapy lasts at least 2 weeks, in some cases 6 weeks, equilibrium is achieved, provided that 2.5 mg of the active ingredient is consumed daily.
It is worth noting that the cumulative effect is not fixed and letrozole does not linger in the tissues. As a result of synthesis, it is converted into an inactive metabolite. Excretion occurs mainly due to the kidneys. Only a fraction is excreted through the intestines. For the half-life, two days are allocated.
Some nuances
Regardless of the patient’s age, the doctor can prescribe Femaru. The instructions indicate that this indicator does not affect the pharmacokinetics of letrozole. Also, the main indicators do not change if a woman with renal failure is being treated. However, with moderate malfunctions in the work of the kidneys and liver, the total concentration of active substances in the plasma is fixed above the usual by more than 30%. But indicators do not exceed normal limits for relatively healthy people.
If treatment occurs against a background of severe liver diseases, the concentration of the active component in the plasma increases already to 95%, while the half-life also changes in the direction of delay. But usually dosage adjustment is not required, because in daily doses up to 10 mg, Femara is well tolerated. Instructions for use and reviews confirm that there are no further violations in the liver, which would require a change in dosage or discontinuation of the drug.
When tablets are shown
There are several indications for prescribing tablets in the instructions, however, only a specialist should deal with treatment. So, for Femara, the use may be justified in the following cases:
- treatment of breast cancer detected in the early stages, if hormone receptors are detected in the tumor cells during the period of female menopause;
- treatment of all common breast tumors that were detected during natural menopause or created artificially
- breast cancer treatment after antiestrogen therapy;
- ongoing treatment after tamoxifen therapy of tumors at an early stage in the postmenopausal period;
- treatment of hormone-dependent breast tumors in patients in the postmenopausal period.
Do not forget that it is a serious medical product of the intended purpose “Femara”. The instruction prescribing treatment regimens and indicating the dosage is given for general reference only.
To whom the medication is contraindicated
The annotation also lists the conditions of patients during which treatment with this medication is prohibited:
- patient age 18 years;
- hormonal status of the body, characterizing the childbearing function of a woman;
- During pregnancy and breastfeeding;
- sensitivity or allergic reaction to letrozole or other components of the tablet.
Before prescribing therapy with this medication, a specialist must conduct a comprehensive examination and refer the patient to a series of tests. If creatine clearance of less than 10 ml / min is detected, then tablets should be taken only under strict medical supervision.
"Femara": instructions for use
The drug is available in the form of standard pills, which are intended only for oral administration. Moreover, the effectiveness of treatment is practically independent of food intake.
If Femara is prescribed to a woman, the instructions for use give approximate dosage regimens that can be studied. The recommended dosage is 2.5 mg per day, which equals one tablet. It is worth considering that the treatment will be long, and the course of adjuvant therapy can last up to 5 years. It is forbidden to take pills longer.
The specialist must constantly monitor the patient's condition and with a progressing tumor, treatment with this agent is stopped and the tactics changed.
Elderly women and those with a history of impaired liver and / or kidney function may also be prescribed Femara. The instructions contain instructions that the dosage in this case does not change. However, in severe cases, a woman should undergo treatment only under the supervision of a specialist.
Adverse Events
The drug "Femara" side effects gives mild or moderate. Basically, experts associate their occurrence with the suppression of estrogen synthesis. Judging by the reviews of patients, medical experience and data from the instructions, the following negative points are possible during treatment:
- From the digestive system. Most often recorded nausea, vomiting. Women complain of diarrhea syndrome or constipation. Dry mouth and stomatitis can sometimes be a concern.
- From the cardiovascular system. Sometimes patients have tachycardia and an increase in blood pressure. Some complain of palpitations. Quite rarely, but thrombophlebitis of superficial and deep veins may occur.
- From the hemopoietic system. There are cases of a decrease in the number of white blood cells.
- From the central nervous system. Quite often, patients taking pills complain of headache, dizziness, insomnia and depression. May disturb memory impairment. Sometimes perversions of sensitivity, anxiety and irritability are recorded.
- From the musculoskeletal system. Quite often, women experience joint pain, muscle pain and bone fractures occur against the background of progressive osteoporosis.
- From the urinary system. Frequent urination or infection may sometimes bother.
- From the reproductive system. Quite rarely, but vaginal bleeding and pain in the mammary glands can be recorded. Dry vagina or discharge is also characteristic.
Other adverse reactions
Often when taking tablets, patients have dermatological problems. They appear in:
- itchy skin;
- redness;
- rashes;
- dryness
- Quincke's edema (rarely).
Pills cause some reactions that are considered normal, but cause a lot of unpleasant moments. Among them it is worth highlighting:
- hot flashes;
- sweating
- hair loss;
- general malaise;
- asthenia or anorexia;
- increased appetite and weight gain;
- dry mucous membranes;
- peripheral edema;
- fatigue;
- thirst;
- pain in the foci of the tumor process.
For any ailment, it is important to always consult a doctor. Only a specialist can evaluate the ongoing process and, if necessary, prescribe replacement therapy aimed at alleviating the condition.
Overdose cases
Isolated cases of drug overdose were recorded. However, specialized treatment and antidote do not exist, so the doctor prescribes only supportive therapy and aimed at removing the main symptoms. If the concentration of letrozole in the plasma is too high, hemodialysis is recommended.
"Femara" in reproductology
Often used in reproductive medicine "Femara". Stimulating the ovaries and preparing them for the release of a mature egg is the main purpose of the drug in this case. Against the background of taking, undesirable consequences are not detected, which allowed doctors to use the medicine. "Femara" and analogues are now used on an equal basis, but previously only Clamid was recommended by doctors. This is due to the fact that studies were conducted that revealed the effect of letrozole on the future fetus and the occurrence of congenital malformations in it. However, such conclusions were later refuted, which made it possible for the grabbers to continue to use the Femaru.
The course of administration to stimulate the release of a mature egg is only five days. You need to start on the third day of the monthly cycle. The dosage in this case is determined individually, but the usual scheme usually involves one tablet per day.
"Femara" and instructions for the use of analogues
The following medicines can serve as a replacement for the drug:
- Letrozal-Teva;
- "Flown";
- Estrolet;
- "Letroza";
- Letrozole;
- Lestrodex;
- "Letrothera."
All drugs are made on the basis of the active component of letrozole, so the principle of action is identical for them. Instructions for use involves the use of drugs to eliminate the tumor process during menopause. Doctors can also prescribe pills to provoke a mature egg from the follicle. However, an analogue can only be recommended by the attending physician on the basis of analyzes and an increased reaction to the original. It is strictly forbidden to independently replace one medicine with another, even at first glance identical,.
Drug feedback
Femara has reviews from both specialists and patients. Among the drugs that inhibit aromatosis, it is this medicine that shows the greatest activity. Compared with other similar active ingredients, letrozole is more effective in the treatment of breast tumors identified in the early stages. As the reviews of doctors show, the relapse rate is reduced and the time interval between them increases significantly.
Patients claim that Femara is well tolerated and side effects occur quite rarely. If a woman has been treated for at least 5-6 years, then only the following points may be disturbing:
- hot flashes and excessive sweating;
- nausea;
- arthritis;
- fatigue;
- peripheral edema.
Experts know that the risk of osteoporosis is great and understand how to deal with it. Against the background of treatment, patients are simultaneously prescribed bisphosphonates and the proportion of bone fractures is significantly reduced.
However, the issue of using Femara to stimulate the ovaries still raises many discussions. The unequivocal position of doctors is only in the following cases:
- the drug is prohibited during pregnancy;
- it is better to replace the tool with another during the planning period.
Many doctors believe that in order to ovulate a mature egg, it is better to use more targeted drugs that have worked well.
Price of pills
The drug is available for purchase in retail pharmacies. It can also be ordered on online resources. Of course, the price of packaging is not at all budgetary and varies around 7000-8000 rudders. Given that therapy involves the use of pills for several years, treatment is expensive.