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Tamoxifen vs letrozole side effects

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    Tamoxifen vs letrozole side effects


    Trigeek wrote: Hey gals I finished my Dose Dense 4 X ac and 4 X taxol .. I have a meeting with my oncologist today and he I believe is planning to put me on tamoxifen. I am 45 and was premenaupausal ( well I am now in the deep trenches of chemaupause with insomnia and night flashes galore !! )I have been hearing that some gals have been put on Femara instead of tamox.. Any studies regarding comparing the efficacy of them compared to teach other ? Aylin Mar 20, 2008 PM Liz M wrote: You need to ensure you are postmenopausal before starting on an aromatase inhibitor (Femara/Arimidex/Aromasin). With that said Femara has been shown to be slightly more effective at preventing recurrence than Tamoxifen in ALL studies, including those in which Femara was given as first hormone therapy right after surgery. I was 49 at diagnosis and premenopausal and chemo put me in chemopause. My oncologist wanted me to go on Tamoxifen for 2 to 3 years and then switch to Arimidex or Femara. I chose to remove my ovaries and create a menopausal state in order to take an aromatase inhibitor. can i buy cytotec at cvs Many postmenopausal women take hormonal therapy medicine – either an aromatase inhibitor or tamoxifen – after breast cancer surgery and other treatments for hormone-receptor-positive, early-stage breast cancer. Hormonal therapy medicine can reduce the risk of the cancer coming back (recurrence). A new analysis of results from the BIG 1-98 trial found that the aromatase inhibitor Femara (chemical name: letrozole) improved both disease-free survival (living without the cancer growing) and overall survival (living whether or not the cancer grew) compared to tamoxifen in postmenopausal women diagnosed with estrogen-receptor-positive, HER2-negative breast cancer. The benefits of Femara over tamoxifen were most notable in treating lobular breast cancer compared to ductal breast cancer. Femara was also better at treating luminal B breast cancers with a high level of the protein Ki-67, which helps breast cancer cells grow. The study, "Relative effectiveness of letrozole compared with tamoxifen for patients with lobular carcinoma in the BIG 1-98 trial," was presented at the 2012 San Antonio Breast Cancer Symposium. Lobular breast cancer is breast cancer that begins in the milk-producing lobules, which empty out into the milk ducts that carry milk to the nipple.

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    If the side effects from letrozole are intolerable, benefits are maintained by switching to tamoxifen rather that stopping hormonal therapy altogether." Posted December 2, 2011 If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. best website to buy nolvadex This treatment won't get rid of the cancer but can stop it growing or shrink. taking tamoxifen for 5 years and then letrozole for a further 5 years. By the way, i am not aware there are several brands of temoxifen. i have my chemo treatment in Bristish Columbia, tamoxifen is.

    After a median of 8 years of follow-up from a large randomized trial, women with estrogen receptor positive breast cancer who received 5 years of treatment with the aromatase inhibitor letrozole were less likely to have their cancer recur or to die during follow-up than women who had 5 years of treatment with tamoxifen. In addition, 5 years of sequential treatment—either 2 years of letrozole followed by 3 years of tamoxifen or 2 years of tamoxifen followed by 3 years of letrozole—was not better than 5 years of letrozole alone at preventing recurrence or death. These results, from the BIG 1-98 trial, were published online October 20, 2011 in Lancet Oncology. Researchers from 27 countries enrolled 8,010 postmenopausal women with invasive breast cancer that could be removed surgically in the trial. After surgery, the women were randomly assigned to one of four groups: 5 years of letrozole (letrozole monotherapy), 5 years of tamoxifen (tamoxifen monotherapy), or one of the two sequential treatment groups. Novartis, the maker of letrozole, provided funding for the trial, along with NCI and the International Breast Cancer Study Group. In 2005, preliminary results from the trial showed that letrozole alone was better than tamoxifen at preventing early recurrences, and when given the option to cross over, 619 of the 2,459 women in the tamoxifen-only arm chose to cross over to receive letrozole. "Taking hormonal drugs for up to 15 years reduces the risk of breast cancers coming back," BBC News reports. A new study looked at 1,918 postmenopausal women with what is known as oestrogen receptor-positive (or ER ) breast cancers – where cancer growth is stimulated by the hormone oestrogen. A class of drugs known as aromatase inhibitors are often used in such cases, as they are able to reduce the production of oestrogen. The women had previously responded well to a five-year course of hormone treatments. They were randomised into two groups: either they took an aromatase inhibitor called letrozole for another five years, or they were given a dummy treatment (placebo). Disease-free survival after five years was 95% in the treatment group and 91% in the placebo group. Extended aromatase inhibitor treatment cut the risk of recurrent or new breast cancer development by about a third.

    Tamoxifen vs letrozole side effects

    Letrozole versus tamoxifen in the treatment of advanced breast., About hormone therapy for breast cancer Cancer Research UK

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  5. Femara letrozole is a non-steroidal aromatase inhibitor lowers estrogen production used to treat breast cancer in postmenopausal women. Femara is often given to women who have been taking tamoxifen Nolvadex, Soltamox for 5 years. Femara is available in generic form.

    • Arimidex vs. Femara for Breast Cancer Differences & Side Effects
    • Side effects of Tamoxifen compared to Letrozole - Breast Cancer.
    • Femara vs Tamoxifen Comparison -

    Compare Letrozole vs. Tamoxifen, which is better for uses like Breast Cancer, Water Retention and Ovulation Induction. Compare head-to-head ratings, side effects, warnings, dosages, interactions and patient reviews. Patients rated Letrozole 2.9/5 over Tamoxifen 2.6/5 in overall satisfaction. metformin cost Hi. i had been on Tamoxifen for 8 years and will switch to Letrozole as one of my seconday breast cancer BC spreaded to sternum treatments. to me, tamoxifen side effects is nothing. only hair thinning and slow growth need hair cut once every 9 months. Femara vs. Tamoxifen for Breast Cancer. Femara, Tamoxifen Show Equal Survival Rates in Breast Cancer Study. The new study shows that the drugs' side effects were in line with known risks; no.

     
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    Elderly patients are more likely to have decreased renal function; contraindicated in patients with renal impairment, carefully monitor renal function in the elderly and use with caution as age increases Not for use in patients 80 years unless normal renal function established Initial and maintenance dosing of metformin should be conservative in patients with advanced age due to the potential for decreased renal function in this population Controlled clinical studies of metformin did not include sufficient numbers of elderly patients to determine whether they respond differently from younger patients Asthenia Diarrhea Flatulence Weakness Myalgia Upper respiratory tract infection Hypoglycemia GI complaints Lactic acidosis (rare) Low serum vitamin B-12 Nausea/vomiting Chest discomfort Chills Dizziness Abdominal distention Constipation Heartburn Dyspepsia 5 mmol/L), decreased blood p H, electrolyte disturbances with an increased anion gap, and an increased lactate/pyruvate ratio; when metformin is implicated as the cause of lactic acidosis, metformin plasma concentrations 5 mcg/m L are generally found Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (eg, carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, and hepatic impairment; if metformin-associated lactic acidosis is suspected, immediately discontinue Patients with CHF requiring pharmacologic management, in particular those with unstable or acute CHF who are at risk for hypoperfusion and hypoxemia, are at an increased risk for lactic acidosis; the risk for lactic acidosis increases with the degree of renal dysfunction and the patient’s age Do not start in patients aged 80 years or older unless Cr Cl demonstrates that renal function is not reduced, because these patients are more susceptible to developing lactic acidosis; metformin should be promptly withheld in the presence of any condition associated with hypoxemia, dehydration, or sepsis Should generally be avoided in patients with clinical or laboratory evidence of hepatic disease; patients should be cautioned against excessive alcohol intake, either acute or chronic, during metformin therapy because alcohol potentiates the effects of metformin on lactate metabolism Discontinue metformin at the time of or before an iodinated contrast imaging procedure in patients with an e GFR between 30-60 m L/minute/1.73 m²; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinate contrast The onset of lactic acidosis often is subtle and accompanied by nonspecific symptoms (eg, malaise, myalgias, respiratory distress, increasing somnolence, nonspecific abdominal distress); with marked acidosis, hypothermia, hypotension, and resistant bradyarrhythmias may occur; patients should be instructed regarding recognition of these symptoms and told to notify their physician immediately if the symptoms occur; metformin should be withdrawn until the situation is clarified; serum electrolytes, ketones, blood glucose, and, if indicated, blood p H, lactate levels, and even blood metformin levels may be useful Once a patient is stabilized on any dose level of metformin, GI symptoms, which are common during initiation of therapy, are unlikely to be drug related; later occurrences of GI symptoms could be due to lactic acidosis or other serious disease Lactic acidosis should be suspected in any diabetic patient with metabolic acidosis who is lacking evidence of ketoacidosis (ketonuria and ketonemia); lactic acidosis is a medical emergency that must be treated in a hospital setting; in a patient with lactic acidosis who is taking metformin, the drug should be discontinued immediately and general supportive care measures promptly instituted; metformin is highly dialyzable (clearance up to 170 m L/min under good hemodynamic conditions); prompt hemodialysis is recommended to correct the acidosis and to remove the accumulated metformin; such management often results in prompt reversal of symptoms and recovery Increased risk of severe hypoglycemia especially in elderly, debilitated or malnourished, adrenal or pituitary insufficiency, dehydration, heavy alcohol use, hypoxic states, hepatic/renal impairment, stress due to infection, fever, trauma, or surgery Concomitant administration of insulin and insulin secretagogues (e.g., sulfonylurea) may increase risk of hypoglycemia; therefore, a lower dose of insulin or insulin secretagogue may be required to minimize risk of hypoglycemia when used in combination with metformin Withholding of food and fluids during surgical or other procedures may increase risk for volume depletion, hypotension, and renal impairment; therapy should be temporarily discontinued while patients have restricted food and fluid intake Rare lactic acidosis may occur due to metformin accumulation; fatal in approximately 50% of cases; risk increases with age, degree of renal dysfunction, and with unstable or acute CHF; if metformin-associated lactic acidosis suspected, general supportive measures should be instituted promptly in a hospital setting, along with immediate discontinuation of therapy; in patients with a diagnosis or strong suspicion of lactic acidosis, prompt hemodialysis is recommended to correct acidosis and remove accumulated metformin (metformin hydrochloride is dialyzable, with a clearance of up to170 m L/minute under good hemodynamic conditions); hemodialysis has often resulted in reversal of symptoms and recovery Possible increased risk of CV mortality May cause ovulation in anovulatory and premenopausal PCOS patients May be necessary to discontinue therapy with metformin and administer insulin if patient is exposed to stress (fever, trauma, infection), or experiences diabetic ketoacidosis Several of the postmarketing cases of metformin-associated lactic acidosis occurred in setting of acute congestive heart failure (particularly when accompanied by hypoperfusion and hypoxemia); cardiovascular collapse (shock) acute myocardial infarction, sepsis, and other conditions associated with hypoxemia have been associated with lactic acidosis and may also cause prerenal azotemia; discontinue therapy when such events occur May impair vitamin B12 or calcium intake/absorption; monitor B12 serum concentrations periodically with long-term therapy Not indicated for use in patients with type 1 diabetes mellitus that are insulin dependent due to lack of efficacy Withhold in patients with dehydration and/or prerenal azotemia Conclusive evidence of macrovascular risk reduction with metformin not established Limited data with in pregnant women are not sufficient to determine drug-associated risk for major birth defects or miscarriage; published studies with metformin use during pregnancy have not reported a clear association with metformin and major birth defect or miscarriage risk; poorly-controlled diabetes mellitus in pregnancy increases maternal risk for diabetic ketoacidosis, pre-eclampsia, spontaneous abortions, preterm delivery, stillbirth and delivery complications; poorly controlled diabetes mellitus increases the fetal risk for major birth defects, stillbirth, and macrosomia related morbidity Limited published studies report that metformin is present in human milk; however, there is insufficient information to determine effects of metformin on breastfed infant and no available information on effects of metformin on milk production; therefore, developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from the underlying maternal condition The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Metformin, heart failure, and lactic acidosis is metformin absolutely. buy estrace online Metformin Use in Patients with Contraindications or Precautions Metformin - UpToDate
     
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