Your doctor will take this into account during your treatment with Letrozole. If any of these conditions apply to you, do not take this medicine and talk to your doctor. If you have any questions about how Letrozole works or why this medicine has been prescribed for you, ask your doctor. The allowance for VAT currently paid alongside product reimbursement for products supplied in accordance with SSPs, will stop being paid from 1 June 2023. More information on the dispensing of unlicensed medicines is available in this section of our site.

  • It is notable, for example, that a clinical trial investigating the use of St. John’s Wort to relieve hot flashes in breast cancer patients has been stopped due to “concerns about interaction between St. John’s Wort and tamoxifen”24.
  • Enteric coated prednisolone tablets are NOT included on the formulary.
  • These women’s ovaries have stopped producing oestrogen, but some of the hormone is still made in several other tissues by an enzyme called aromatase.
  • We are still working with the DHSC to agree concessionary prices for other drugs reported to be unavailable at the stated November 2023 Drug Tariff price.
  • In vitro, letrozole inhibits the cytochrome P450 isoenzymes 2A6 and, moderately, 2C19, but the clinical relevance is unknown.

Side effects with frequency unknown (the frequency cannot be determined based on the available data). If you have taken too much Letrozole, or if someone else accidentally takes your tablets, contact a doctor or hospital for advice immediately. Continue taking Letrozole every day for as long as your doctor tells you. If you have any questions about how long to keep taking Letrozole, talk to your doctor. Always take this medicine exactly as your doctor or pharmacist has told you. The contractormust use their professional skill and judgement to decide, alongside medical experts, whether it’s reasonable and appropriate to substitute the patient’s prescribed order for the active SSP.

Products for Gastrointestinal Health: Laxatives – Product Availability

Our network of clinics offers an exceptional standard of treatments across all areas of fertility. Whether you require a day-case procedure or a hospital stay for surgery, you can be confident you’re in the best possible hands. Talking about changes to your body, sex and intimacy can be difficult, but it’s important to tell your treatment team, breast care nurse or GP if you’re experiencing any of these issues. You can also call our free helpline to talk through your worries and concerns – please see below. If you’re worried or want more information about sex and chemotherapy, talk to your specialist or breast care nurse.

  • A price concession can be requested for any drugs listed in Part VIIIA, Part VIIIB and Part VIIID of the Drug Tariff.
  • If there’s a chance that you will lose your hair, your treatment team will talk to you before treatment starts about what might happen.
  • Approximately 50% of patients crossed over to the opposite treatment arm and crossover was virtually completed by 36 months.
  • Doublestar® pre-filled pen provides a dose of units in one injection in steps of 2 units.
  • In the adjuvant setting a sequential treatment schedule (letrozole 2 years followed by tamoxifen 3 years) could also be considered (see sections 4.4 and 5.1).

And it doesn’t stop there – studies have shown that green tea interacts together with tamoxifen, boosting its effectiveness 42,43. The mechanism leading to the beneficial interaction is thought to involve flavonoids (substances with a chemical structure called “phenolic”) such as EGCG (Epigallocatechin gallate) present in green tea. First choice Gonadorelin analogue for treatment of metastatic prostate cancer. Use in accordance with guideline BHTCG 789FM Gonadorelin analogues for use in prostate cancer. The aromatase enzyme is involved in producing the female sex hormone, oestrogen, in women who have gone through the menopause.


Our product range includes a wide range of ‘Prescription Only Medicines’ and Consumer Healthcare ‘P’ (Pharmacy only) and ‘GSL’ (General Sales listing) products. Our Consumer Healthcare range has been recently been updated to provide strong branding and ‘on the shelf’ Clomid retail presence to encourage customer brand loyalty and increase consumer sales. In people with the most common type of lactase deficiency (primary) the development of symptoms depends on how much lactose they need to ingest before the available lactase is saturated.

  • Clinicians and researchers do not yet know which should be the first-line medication.
  • In some cases, there is a need for negotiation between Community Pharmacy England and DHSC on an individual product’s circumstances; this can take time.
  • Vaginal dryness is a common, often distressing symptom in women who have had treatment for breast cancer.
  • The median time to crossover was 17 months (Femara to tamoxifen) and 13 months (tamoxifen to Femara).
  • This presents the woman with a hormone inbalance which, among other symptoms, can cause irregular menstrual cycles and difficulties in conceiving.

A. Price concessions, once granted, apply for the whole ‘dispensing month’. For example a price concession announced on August 30th applies to the entirety of your August ‘prescription bundle’. We are mindful of the need to finalise price concessions as early as possible in the month so that contractors have certainty over what they will be reimbursed. However, there is a fine balance between agreeing to a price too early in the month versus holding out to secure a better price later in the month particularly in a market where prices are increasing. Your treatment team or GP may be able to refer you to a dermatologist (doctor who specialises in skin problems) who has a specialist interest in managing hair loss.

Drugs that work in different ways to block the effect of oestrogen on cancer cells. • Extended adjuvant treatment of hormone-dependent invasive breast cancer in postmenopausal women who have received prior standard adjuvant tamoxifen therapy for 5 years. Antidepressive agents are often prescribed to women with breast cancer, not only to target depression but also for anxiety and hot flushes 48. However many antidepressants inhibit CYP2D6 to various extents, which can interfere with the conversion of tamoxifen to endoxifen 49, 50,51 (see diagram). Lab research has shown that black cohosh can inhibit the two core enzymes that convert tamoxifen to endoxifen, meaning it may reduce the function of tamoxifen.

In this analysis, the five-year incidence of endometrial cancer was higher in the tamoxifen group (0.3%) compared with the aromatase inhibitor group (0.2%), but still rare overall. In this study, primarily funded by Cancer Research UK, the researchers combined all the available evidence to answer this question, since data from individual trials had been inconclusive. They combined data from four large-scale randomised controlled trials, which involved a total of over 7,000 women with early stage breast cancer, from countries across the world. Restricted – prescribing by Consultant Oncologists, with androgen deprivation therapy for treating high-risk hormone-relapsed non-metastatic prostate cancer in accordance with NICE TA 740.

Insufficient data are available in cases of renal insufficiency with creatinine clearance lower than 10 ml/min (see sections 4.4 and 5.2). If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet.

Aromatase inhibitors, drugs which block oestrogen production, are even more effective than tamoxifen in postmenopausal women, reducing this risk by a further 30%. Most breast cancers are sensitive to oestrogen, and their growth is stimulated by this hormone. By lowering the levels of oestrogen in the body, letrozole starves the breast cancer cells and stops them from growing or spreading. Letrozole is only effective in treating breast cancers that are sensitive to oestrogen (these are sometimes called oestrogen receptor positive cancers). One controlled double-blind trial was conducted comparing Femara (letrozole) 2.5 mg to tamoxifen 20 mg as first-line therapy in postmenopausal women with advanced breast cancer. In 907 women, letrozole was superior to tamoxifen in time to progression (primary endpoint) and in overall objective response, time to treatment failure and clinical benefit.