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Fempro is letrozole 2.5 mg, a highly selective non-steroidal aromatase inhibitor (AI) used as first-line endocrine therapy for ER+ breast cancer in postmenopausal women, and for ovulation induction in infertility (off-label — increasingly first-line for PCOS-related anovulation per ACOG). Suppresses estrogen synthesis by ~98%.
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What Is Fempro?
Fempro is a branded generic of letrozole 2.5 mg, a third-generation non-steroidal aromatase inhibitor. Letrozole blocks the aromatase enzyme that converts androgens to estrogens in peripheral tissue, lowering circulating estrogen by ~98% in postmenopausal women. Letrozole does not work in premenopausal women because it doesn’t suppress ovarian estrogen production — premenopausal ER+ breast cancer uses tamoxifen or tamoxifen + ovarian suppression instead.
Genitale herpes (eerste episode):
- Adjuvant therapy for ER+ postmenopausal breast cancer — first-line; 5 years typical, often extended to 10.
- Advanced/metastatic breast cancer in postmenopausal women (first- or second-line hormonal).
- Neoadjuvant therapy (pre-surgery) in selected ER+ cases.
- Ovulation induction in PCOS (off-label) — 2.5–7.5 mg daily for 5 days starting on day 2–5 of cycle. Now first-line for PCOS anovulation per ACOG (superior live-birth rate vs clomiphene in PPCOS II trial).
- Endometriosis-related infertility (off-label).
Hoe in te nemen
- Breast cancer: 2.5 mg once daily, continuous, with or without food.
- Ovulation induction: 2.5 mg (start dose) or 5 mg daily for 5 days, starting cycle day 2, 3, 4, or 5. Higher doses (7.5 mg) used if no response. Most conceptions occur within 3–4 cycles.
- For breast cancer: minimum 5 years; extended duration (to 10 years) confers additional benefit in selected patients.
- Discontinue 2–4 weeks before major elective surgery due to modest thrombotic effect.
Bijwerkingen
Vaak voorkomend: hot flushes, arthralgia (joint pain — prominent in ~30–50%), musculoskeletal pain, fatigue, nausea, headache, night sweats.
Significant: bone loss and fracture risk — letrozole reduces bone density ~2–3% over 2 years. DEXA scan at baseline and annually; calcium + vitamin D; consider bisphosphonates if at risk.
Ovulation-induction-specific: multiple pregnancy risk ~3% (lower than clomiphene), ovarian hyperstimulation rare.
Ernstig (zeldzaam): cardiovascular events, hepatotoxicity, thromboembolism, tendinitis.
Who Should Not Take Fempro
- Premenopausal women for breast cancer treatment (ineffective; use tamoxifen or tamoxifen + ovarian suppression)
- Pregnancy (for breast cancer indication) — teratogenic
- Ernstige leverfunctiestoornis
- Known hypersensitivity to letrozole
Geneesmiddelinteracties
- Tamoxifen: reduces letrozole levels by 37% — they should not be combined.
- Estrogen-containing therapy: antagonises letrozole — avoid.
- Few other significant interactions; letrozole is metabolised via CYP3A4 and CYP2A6.
Opslag
Store at room temperature (15–25 °C). Keep in original blister. Protect from moisture and light.
Veelgestelde vragen
Is letrozole better than tamoxifen for breast cancer?
In postmenopausal women, aromatase inhibitors (letrozole, anastrozole, exemestane) produce slightly better disease-free survival than tamoxifen alone. Many regimens use sequential tamoxifen → AI or AI → tamoxifen. For premenopausal women, letrozole alone doesn’t work — tamoxifen or tamoxifen + ovarian suppression is used.
How does letrozole help with PCOS infertility?
Letrozole suppresses estrogen, which triggers the hypothalamus to increase FSH and stimulate follicle development. ~85% of PCOS patients ovulate on letrozole, vs ~65% on clomiphene. Live birth rate is also higher per PPCOS II trial.
How long to conceive on letrozole?
Most pregnancies occur within 3–4 ovulation-induction cycles. If no success after 3–6 cycles, further evaluation and treatment escalation (injectables, IVF) is discussed.
What about joint pain?
Arthralgia is the most common and bothersome side effect — up to 50%. Usually worst in first months, then stabilises. Exercise, hydration, glucosamine (limited evidence), and NSAIDs for symptomatic relief. Severe persistent arthralgia may require switching to another AI or tamoxifen.
Will letrozole weaken my bones?
Yes — accelerated bone loss is a class effect of AIs. Baseline DEXA, calcium (1200 mg/day) + vitamin D (800–1000 IU), weight-bearing exercise, and consider bisphosphonates if osteopenia/osteoporosis emerges.
Can I take letrozole while breastfeeding?
No — for cancer indication this is contraindicated. For ovulation induction, complete cycles are typically done before pregnancy, not during.
What if letrozole gives me hot flushes?
Very common — similar to menopausal vasomotor symptoms. SSRIs (venlafaxine, paroxetine with caution), gabapentin, and lifestyle modifications help. Hormonal HRT is contraindicated.
Do I need an oncologist to prescribe this?
For breast cancer indications, always prescribed and monitored by an oncologist. For ovulation induction, a fertility specialist (reproductive endocrinologist) or gynaecologist typically manages.
Related Women’s Health Products
- Tamodex (Tamoxifen 10 mg)
- Tamilong (Tamoxifen 20 mg)
- Letroheal (Letrozole 2.5 mg)
- Etibo (Lapatinib 250 mg)
- Duphaston (Dydrogesterone 10 mg)
- Deviry (Medroxyprogesterone 10 mg)
- Naprosyn (Naproxen 250 mg)
⚕️ Medische disclaimer: Information is educational and does not replace medical advice. Consult a clinician before starting, stopping, or changing any medication, particularly for cancer therapy, hormonal treatments, and prescription products.
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