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Here is important safety information regarding the use of letrozole (Femara). It is crucial to review these details carefully and discuss any concerns with your healthcare provider.

• Bone Health: Prolonged use of letrozole (Femara), especially for individuals aged 65 and older, can reduce bone mineral density (BMD), increasing the likelihood of fractures. This risk is elevated if there are pre-existing factors that contribute to osteoporosis. Your healthcare provider may recommend regular bone scans and preventative medications such as zoledronic acid (Zometa) or denosumab (Xgeva) to mitigate bone loss.

• Cholesterol Levels: Elevated cholesterol is a common side effect of letrozole (Femara), potentially leading to a higher risk of cardiovascular events such as heart attacks and strokes. Your oncology team will monitor your cholesterol levels and suggest lifestyle modifications, including diet and exercise. If necessary, medications to lower cholesterol may be prescribed.

• Liver Function: Since the liver metabolizes letrozole (Femara), any liver impairment can increase the risk of adverse effects due to elevated drug levels. Individuals with liver problems should inform their oncologist, as a dose adjustment might be required.

• Drowsiness: Letrozole (Femara) may cause drowsiness, impairing concentration and reaction time. This effect can be heightened if combined with other sedative medications. It is advisable to assess how the medication affects you before engaging in activities that demand alertness, such as driving. Consult your healthcare provider if excessive drowsiness occurs.

• Pregnancy Risk: Although pregnancy is unlikely post-menopause, letrozole (Femara) can harm an unborn baby. If there is a possibility of pregnancy, effective contraception should be used while taking the medication and for at least three weeks after the final dose. Notify your oncology care team if you suspect pregnancy.

Always consult your healthcare provider for personalized advice and before making any changes to your medication regimen.

Common side effects:

• Hot flashes
• Hair loss
• Bone or muscle pain
• Tiredness
• Unusual sweating
• Nausea
• Diarrhea
• Dizziness
• Trouble sleeping

Less common but important to monitor:

• Bone fractures
• Night sweats
• Weight gain

Serious side effects:

• Blood clots
• Shortness of breath
• Chest or jaw pain
• Sudden dizziness or fainting
• Pain or swelling in the groin or calf
• Trouble speaking
• Severe headaches
• Allergic reaction with rash, itching, or swelling
• Severe dizziness
• Trouble breathing

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Ceritinib
• Cilostazol
• Clarithromycin
• Tegafur

Interactions with low risk that usually do not require a change in therapy:

• Ethinyl Estradiol
• Conjugated estrogens
• Anastrozole
• Tamoxifen
• Tibolone