Names and pronunciation
(an-a-stroh′zole) Arimidex
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Drug reference
(an-a-stroh′zole) Arimidex
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Func. class.: Antineoplastic
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Chem. class.: Aromatase inhibitor
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ACTION: Highly selective nonsteroidal aromatase inhibitor that lowers serum estradiol concentrations; many breast cancers have strong estrogen receptors
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USES: Advanced breast carcinoma in estrogen receptor–positive patients (post- menopausal); patients with advanced dis- ease taking tamoxifen, adjunct therapy
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Unlabeled uses: Breast cancer risk reduction (postmenopausal women)
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CONTRAINDICATIONS: Preg- nancy, breastfeeding, hypersensitivity Precautions: Children, geriatric patients, premenopausal women, osteo- porosis, hepatic/cardiac disease
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SIDE EFFECTS CNS: Hot flashes, headache, lighthead edness, depression, dizziness, confusion, insomnia, anxiety, fatigue, mood changes CV: Chest pain, hypertension, thrombo- phlebitis, edema, angina GI: Nausea, vomiting, altered taste lead- ing to anorexia, diarrhea, constipation, abdominal pain, dry mouth GU: Vaginal bleeding, vaginal dryness, pelvic pain INTEG: Rash, Stevens-Johnson syndrome, anaphylaxis, angioedema MISC: Hypercholesterolemia MS: Bone pain, myalgia, back pain, arthralgia, fractures RESP: Cough, sinusitis, dyspnea EENT: Pharyngitis
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INTERACTIONS • Do not use with oral contraceptives, es- trogen, tamoxifen, androstenedione, DHEA, may decrease the action of anastrozole Drug/Lab Test Increase: AST, ALT, cholesterol
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DOSAGE AND ROUTES • Adult: PO 1 mg/day, max 5 yr, may also combine with tamoxifen for up to 10 yr Breast cancer risk reduction (post- menopausal women) (unlabeled) Adult: PO 1 mg/day × 5 yr
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Available forms: Tablets 1 mg
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Administer: • Use cytotoxic handling procedures • Give without regard to meals at same time of day • Store in light-resistant container at room temperature
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Assess: • Bone mineral density, cholesterol, lipid panel, periodically • Serious skin reactions: Stevens- Johnson syndrome • Pregnancy: Identify that patient is not pregnant before starting
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Evaluate: • Therapeutic response: decreased tu- mor size, spread of malignancy
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To report any complaints, side effects to prescriber • That vaginal bleeding, pruritus, hot flashes are reversible after discontinuing treatment • To report continued vaginal bleeding immediately • That tumor flare—increase in size of tumor, increased bone pain—may occur and will subside rapidly; may take anal- gesics for pain • Pregnancy/breastfeeding: to tell prescriber if pregnancy is planned or suspected; do not use in pregnancy and for 3 wk after last dose or breastfeeding during or for 15 days after product is stopped • To take adequate calcium and vitamin D due to risk for bone loss/fractures • That follow-up exams will be needed See lymphocyte immune globulin
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PHARMACOKINETICS Peak 4-7 hr; half-life 50 hr; metabolized in liver 85%, excreted in feces, urine, terminal half-life 50 hr
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• Adult: PO 1 mg/day, max 5 yr, may also combine with tamoxifen for up to 10 yr Breast cancer risk reduction (post- menopausal women) (unlabeled) Adult: PO 1 mg/day × 5 yr
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