Letrozole
Brand Names: Femara
Methodology & AI Transparency ⓘ
Letrozole Key Takeaways
Translated by Sarah Jenkins (AI RN Plain-English Translator) at a 7th-grade reading level
- 1 What it does: Letrozole tablet is an aromatase inhibitor indicated for: Adjuvant treatment of postmenopausal women with hormone receptor positive early breast cancer ( 1.1 ) Extended adjuvant treatment of postmenopausal women with early breast cancer who have received prior standard adjuvant tamoxifen therapy ( 1.2 ) First and second-line treatment of postmenopausal women with hormone receptor positive or unknown advanced breast cancer ( 1.3 ) 1.1 Adjuvant Treatment of Early Breast Cancer Letrozole tablets are indicated for the adjuvant treatment of postmenopausal women with hormone receptor positive early breast cancer.
- 2 Real-world patient consensus: Zero-PHI community consensus: 84% favorable across 22 logged regimens (Femara).
- 3 Typical cash cost range: 30-day cash pricing ranges from $7.48 on Cost Plus Drugs to $34.50 walk-in retail (NADAC $0.1408/unit).
- 4 Top reported side effects / signs: Leading openFDA/SPL adverse events for Letrozole: headache (8.9%), dizziness (8.2%), fatigue (8%).
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Letrozole Mechanism, CYP450 Pathways & DailyMed Monograph
Letrozole tablet is an aromatase inhibitor indicated for: Adjuvant treatment of postmenopausal women with hormone receptor positive early breast cancer ( 1.1 ) Extended adjuvant treatment of postmenopausal women with early breast cancer who have received prior standard adjuvant tamoxifen therapy ( 1.2 ) First and second-line treatment of postmenopausal women with hormone receptor positive or unknown advanced breast cancer ( 1.3 ) 1.1 Adjuvant Treatment of Early Breast Cancer Letrozole tablets are indicated for the adjuvant treatment of postmenopausal women with hormone receptor positive early breast cancer.
12.1 Mechanism of Action The growth of some cancers of the breast is stimulated or maintained by estrogens. Treatment of breast cancer thought to be hormonally responsive (i.e., estrogen and/or progesterone receptor positive or receptor unknown) has included a variety of efforts to decrease estrogen levels (ovariectomy, adrenalectomy, hypophysectomy) or inhibit estrogen effects (antiestrogens and progestational agents). These interventions lead to decreased tumor mass or delayed progression of tumor growth in some women.
Pharmacokinetic profiling of Letrozole demonstrates an elimination half-life of Mean elimination half-life of 7 to 15 hours across adult Letrozole dosing with Oral fraction absorbed ranges from 69% to 81% (Letrozole 2.5) systemic bioavailability; clearance proceeds via dual hepatorenal clearance pathway combining glucuronidation and urinary filtration of letrozole, reaching clinical onset within oral tmax achieved within 2 to 4 hours following letrozole ingestion.
Titration schedules for Letrozole (2.5 mg/1 Tablet, Film Coated → 2.5 mg/1 Tablet → 2.5mg Tablet) require excluding pregnancy: letrozole can cause fetal harm .; pregnancy: letrozole can cause fetal harm .; known hypersensitivity to the active substance, or to any of the excipients .; real-world patient logs highlight headache (8.9% of reports), dizziness (8.2% of reports), fatigue (8% of reports) alongside a 84.00% Worth-It consensus.
Reconcile eGFR-adjusted medications before escalating Letrozole in polypharmacy regimens.
Alcohol or high-fat meal timing can shift absorption rate and orthostatic tolerance during Letrozole dosing.
Standard Adult Titration & Dosages
Absolute & Relative Contraindications
- Pregnancy: Letrozole can cause fetal harm .
- Pregnancy: Letrozole can cause fetal harm .
- Known hypersensitivity to the active substance, or to any of the excipients .
Logged Side-Effect Incidence (22 Reports)
Letrozole Real-World Side Effects: openFDA FAERS vs. Patient Micro-Logs
Peer-Reviewed Human Clinical Trials & Meta-Analyses (Letrozole)
| Study & Plain-English Finding | Sample (N) | Rigor | Primary Source |
|---|---|---|---|
| New Insights on Effect of palbociclib plus letrozole on patient-reported health-related quality: What a 444-Participant Study Found This extended follow-up analysis of PROs in PALOMA-2 shows continued QoL maintenance for patients with ER+/HER2- mBC receiving long-term palbociclib plus letrozole treatment. ESMO open • 2025-04-15 • Phase III Randomized Trial | N = 444 | 93/100 | PMID 40107156 ↗ |
| New Insights on Prognostic relation of body mass index on extended aromatase inhibition treatment: What a 3,606-Participant Study Found We observed that the prognostic relation of BMI changes according to the type of adjuvant ET and mode of administration of extended AI. European journal of cancer (Oxford, England : 1990) • 2025-06-03 • Phase III Randomized Trial | N = 3,606 | 90/100 | PMID 40286474 ↗ |
| Can This Approach Help? Inside the Latest Research on Letrozole to prevent breast cancer in postmenopausal women with BRCA1/2 mutations Due to the underpowered nature of the trial and the observed trend, it cannot be ruled out that using AI to prevent invasive breast cancer could be effective for BRCA1/2 carriers overall, or for specific subgroups within a... European journal of cancer (Oxford, England : 1990) • 2025-12-09 • Phase III Randomized Trial | Multi-cohort | 88/100 | PMID 41240533 ↗ |
| Can This Approach Help? Inside the Latest Research on Letrozole co-treatment during ovarian stimulation with gonadotrophins for IVF: a The remaining authors have no competing interests. Human reproduction (Oxford, England) • 2022-01-28 • Randomized Controlled Trial | N = 67 | 88/100 | PMID 34792133 ↗ |
| Can This Approach Help? Inside the Latest Research on Ovulation induction with clomiphene citrate or letrozole following laparoscopy in Further research could focus on prolonging cycles of ovulation induction or choosing alternative ovarian stimulation protocols. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology • 2022-02-15 • Randomized Controlled Trial | Multi-cohort | 82/100 | PMID 34020578 ↗ |
Letrozole Public Price Transparency Ledger
| Dispensing Channel / Benchmark | Verification Source | Reference Cost | Details |
|---|---|---|---|
| Pharmacy Acquisition Cost (CMS NADAC) | CMS Medicaid NADAC Weekly National Survey | $0.1408/unit (~$4.22/30u) | Wholesale baseline |
| Mark Cuban Cost Plus Drugs (Mail-Order Generic) | Public Wholesale Price List (NADAC + 15% + pharmacy fee) | $7.48 / mo | Formulary listing ↗ |
| Average U.S. Walk-In Retail Cash Price | Chain Pharmacy Uninsured Cash Index | $34.50 / mo | Before coupon/insurance |
| Patient-Logged Out-of-Pocket Average | 22 Anonymous DotMD Community Micro-Logs | $8.60 / mo | View logs ↓ |
Letrozole Federal Verification & Benchmark Summary
| Metric | Verified Benchmark | Source |
|---|---|---|
| Letrozole RxNorm Concept ID | 200064 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $0.1408 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $34.50 / mo | U.S. Uninsured Retail Cash Index |
| Public Mail-Order Wholesale Benchmark | $7.48 / mo (Cost Plus Drugs) | Mark Cuban Cost Plus Public API |
| Real-World Patient Consensus | 84.00% Worth It (22 anonymous logs) | DotMD Zero-PHI Patient Ledger |
Letrozole Patient Community, Cohort Filters & Dosage Logs
Federal clinical ledger for Letrozole integrating DailyMed SPL (2024-06-19), CMS NADAC ($0.1408/unit), and 22 Zero-PHI patient logs.
Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.
Filter Letrozole community threads and patient logs by age, biological sex, dosage, and treatment duration.
Anyone else switch Letrozole (2.5 mg/1 Tablet, Film Coated) from chain retail to cash mail-order?
FDA/PubMed Clinical Context Note: Letrozole (RxNorm 200064) carries a federal CMS Medicaid NADAC pharmacy acquisition cost of $0.1408/unit and a verified Cost Plus Drugs price of $7.48, compared with $34.50 walk-in retail cash averages. All FDA-approved AB-rated generics meet 80%–125% bioequivalence AUC/Cmax criteria.
My neighborhood chain pharmacy quoted $34.50 out-of-pocket while my deductible reset for Letrozole. Moved my prescription to Mark Cuban Cost Plus Drugs and paid $7.48 for a 30-day supply at 2.5 mg/1 Tablet, Film Coated. Has anyone noticed any tablet manufacturer differences or refill shipping delays on 90-day fills?
Made the exact same switch 3 months ago for Letrozole. Asking my doctor to write a 90-day supply dropped the per-month shipping/dispensing overhead even further below $7.48, and lab numbers stayed identical.
Appreciate the transparent benchmark here. Having the CMS NADAC unit cost next to the $7.48 cash option gave me concrete numbers to review with my pharmacist before filling.