Instructions for Use:

1. Take Femara tablets exactly as prescribed.
   
   
2. Swallow the tablet whole, with a glass of water.
   
   
3. You can take it with or without food.
   
   
4. Try to take it at the same time each day to maintain steady levels in your body.
   
   

Missed Dose:

• If you forget a dose, take it as soon as you remember.
  
  
• If it’s almost time for your next dose, skip the missed dose—do not double the next one.
  
  

Do not stop taking Femara unless your doctor tells you to. Stopping early may reduce its effectiveness.

Femara is a type of medicine called an aromatase inhibitor. In postmenopausal women, most estrogen is made by a process that involves the aromatase enzyme. This enzyme helps convert androgens (male hormones) into estrogen.

Femara blocks the aromatase enzyme, which reduces the amount of estrogen in the body. Since some breast cancers need estrogen to grow, lowering estrogen can slow or stop the growth of these cancer cells.

This is especially helpful in women whose breast cancer is hormone-sensitive (also called estrogen receptor-positive or ER+ cancer).

Like all medications, Femara can cause side effects. Some are mild and go away, while others may need medical attention.

Common Side Effects:

• Hot flashes
  
  
• Fatigue or tiredness
  
  
• Joint or muscle pain
  
  
• Sweating
  
  
• Nausea
  
  
• Weight gain
  
  
• Dizziness
  
  
• Hair thinning
  
  

Serious Side Effects:

• Bone thinning (osteoporosis) – Femara can reduce bone strength over time, increasing the risk of fractures.
  
  
• High cholesterol
  
  
• Depression or mood changes
  
  
• Liver problems – Symptoms may include yellowing of the skin or eyes.
  
  
• Blood clots (rare)
  
  

When to See a Doctor:

• Severe bone pain
  
  
• Chest pain or trouble breathing
  
  
• Vision problems
  
  
• Signs of liver issues (dark urine, yellow skin)
  
  
• Swelling in the arms or legs
  
  

If any symptoms feel severe or unusual, contact your doctor right away.

Femara is a strong medicine, and certain people should not use it or need extra care when using it.

Do NOT use Femara if:

• You are pregnant or breastfeeding
  
  
• You are allergic to letrozole or any ingredients in Femara
  
  
• You are still having menstrual periods (Femara is for postmenopausal women only)
  
  

Use with Caution:

• If you have a history of osteoporosis or low bone density
  
  
• If you have high cholesterol
  
  
• If you have liver disease
  
  

Before starting Femara, tell your doctor:

• If you have any medical conditions
  
  
• What medicines you are taking
  
  
• If you have had bone fractures, depression, or heart problems
  
  

Regular blood tests and bone scans may be needed to monitor your health during treatment.

Femara can interact with some other medicines, which may change how it works or increase side effects.

Common interactions include:

• Estrogen-containing medicines (like hormone replacement therapy or birth control) – These can make Femara less effective.
  
  
• Tamoxifen – Should not be used at the same time as Femara.
  
  
• Certain antidepressants, such as fluoxetine or paroxetine – May reduce the effects of Femara.
  
  
• Other cancer drugs – Must be used carefully and only under a doctor’s supervision.
  
  

Always tell your doctor or pharmacist about all the medicines, supplements, and herbs you are taking.

Standard Dosage:

• 2.5 mg once daily by mouth
  
  

How Long to Take It:

• Often prescribed for 5 years after breast cancer surgery
  
  
• Some women may be told to take it for up to 10 years
  
  
• For advanced or metastatic breast cancer, treatment may continue as long as it works
  
  

Special Considerations:

• Bone health: Since Femara can weaken bones, your doctor may suggest calcium, vitamin D, or even bone-strengthening medications.
  
  
• Blood tests: Regular checks for cholesterol, liver function, and bone density are important.
  
  

Never adjust your dose or stop treatment without your doctor’s guidance.

Femara is a prescription-only medicine, which means it can only be given by a doctor.

Before prescribing Femara, your doctor will:

• Confirm that you are postmenopausal
  
  
• Check if your breast cancer is hormone-receptor positive
  
  
• Review your medical history
  
  
• Discuss possible side effects and the length of treatment
  
  
• Set up a plan for follow-up tests and monitoring
  
  

You will likely have regular appointments to check how well the medicine is working and watch for any side effects.

• What is Femara used for?
  It is prescribed to treat hormone receptor–positive (HR+) breast cancer in:

  • Postmenopausal women after surgery (adjuvant therapy)

  • Advanced or metastatic breast cancer

  • Extended adjuvant therapy after 5 years of tamoxifen
    It may also be used off-label to stimulate ovulation in infertility treatments.

• What is the active ingredient?
  Letrozole, an aromatase inhibitor.

• How does Femara work?
  It blocks the aromatase enzyme, which converts androgens into estrogen — lowering estrogen levels and slowing the growth of hormone-dependent breast cancer cells.

• Is Femara chemotherapy?
  No — it is hormone (endocrine) therapy, not traditional chemotherapy.

• How is Femara taken?
  Orally, as a tablet (2.5 mg), once daily, with or without food.

• How long is Femara treatment continued?
  Typically for 5 years, though duration may vary based on cancer type, stage, and prior treatments.

• What are the common side effects?
  Hot flashes, joint pain, fatigue, headache, sweating, and mild bone or muscle pain.

• Are there serious side effects?
  Yes, though less common:

  • Bone thinning (osteoporosis) or fractures

  • High cholesterol

  • Heart disease risk increase

  • Severe allergic reactions (rare)

• Does Femara cause weight gain?
  Some patients experience mild weight gain or fluid retention, though others may lose weight due to appetite loss or fatigue.

• Can Femara cause bone loss?
  Yes, long-term use can cause osteopenia or osteoporosis — doctors may monitor bone density and recommend calcium/vitamin D supplements.

• Does Femara cause hair thinning?
  Yes, mild hair thinning may occur, but complete hair loss is rare.

• Is Femara used for infertility?
  Yes — off-label, Femara is used to induce ovulation in women with conditions like PCOS who do not respond to clomiphene (Clomid).

• Can premenopausal women take Femara?
  Generally no, unless used for fertility purposes under strict medical supervision.

• Can I take Femara during pregnancy?
  No — it is contraindicated in pregnancy, as it can cause severe birth defects. Effective birth control is required during and after treatment.

• Can I take Femara while breastfeeding?
  No — it’s not recommended, as the drug may pass into breast milk.

• Does Femara interact with other medications?
  It has few major interactions, but inform your doctor if you take hormone therapies, estrogen-containing products, or supplements that affect liver enzymes (CYP3A4, CYP2A6).

• What lifestyle changes help while taking Femara?

  • Maintain a balanced diet with calcium and vitamin D

  • Engage in weight-bearing exercise

  • Avoid smoking and excessive alcohol use

• Can I drink alcohol while taking Femara?
  Moderate alcohol is not contraindicated, but excess drinking may worsen side effects like fatigue or dizziness.

• Is Femara safe for long-term use?
  Yes, but requires regular monitoring of bone density, cholesterol, and liver function.

• Is there a generic available?
  Yes — letrozole is available as a generic version of Femara.

• Where can I get Femara?
  Available by prescription at pharmacies and oncology clinics.