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Here is the revised safety and warning information for the medication letrozole (Femara). Please review the following points carefully and consult with your healthcare provider if you have any questions or concerns:

• Bone Health Concerns: Individuals aged 65 and older who take letrozole (Femara) for extended periods (2 years or more) may experience reduced bone mineral density (BMD), increasing the risk of fractures. This risk is heightened if you are on other medications that also lower BMD or have conditions like osteoporosis. Your healthcare provider will likely recommend a bone density scan before starting treatment and periodically during treatment. Medications to prevent bone loss, such as zoledronic acid (Zometa) or denosumab (Xgeva), may also be advised.

• Cholesterol Levels: A common side effect of letrozole (Femara) is elevated cholesterol levels in the blood, which can increase the risk of heart attacks and strokes. Your healthcare team will assist you in planning a nutritious diet and regular exercise routine to mitigate this risk. Cholesterol levels will be monitored before and during treatment, and medications may be prescribed if levels rise significantly.

• Liver Function: The liver metabolizes letrozole (Femara), and any liver dysfunction can lead to higher drug levels in your body, increasing the risk of side effects. Inform your healthcare provider if you have any existing liver issues, as this may require a dosage adjustment.

• Drowsiness Risk: Letrozole (Femara) can cause drowsiness, potentially impairing your ability to think, react, and concentrate. This risk is greater if you are also taking other sedatives. Assess how this medication affects you before driving or engaging in activities requiring full attention. Contact your healthcare provider if excessive drowsiness occurs.

• Pregnancy Warning: Letrozole (Femara) can harm an unborn baby. If you suspect you might be pregnant, inform your healthcare team immediately. If there is any possibility you can become pregnant, use effective contraception during treatment and for at least three weeks after the final dose.

Please ensure you adhere to these precautions and consult your healthcare provider for any personalized advice or modifications to your treatment plan.

When taking this medication, you may experience some common side effects, which are generally mild. These include hot flashes, hair loss, bone or muscle pain, tiredness, unusual sweating, nausea, diarrhea, dizziness, and trouble sleeping. If any of these side effects persist or become bothersome, it's advisable to consult your healthcare provider.

In some instances, more serious side effects can occur. Be vigilant for symptoms such as persistent nausea or vomiting, bone fractures, or swelling and pain in the joints, muscles, or tendons. Mental or mood changes like depression or anxiety, swelling of the arms or legs, blurred vision, unusual tiredness, dark urine, or yellowing of the eyes or skin also warrant immediate medical attention.

Rarely, this medication may lead to severe complications like blood clots, which could result in a heart attack or stroke. Seek urgent medical help if you notice symptoms such as shortness of breath, chest or jaw pain, sudden dizziness or fainting, swelling or warmth in the legs, trouble speaking, weakness on one side of the body, sudden vision changes, or severe headaches.

Although a serious allergic reaction to this medication is rare, watch out for signs like rash, itching, swelling (particularly of the face, tongue, throat, or neck), severe dizziness, and trouble breathing. If any unusual side effects occur, it's important to contact your healthcare provider for advice.