Patient Medication Information: uses, side effects, how to take - Zinda-Letrozole
ABOUT THIS MEDICATION
What Zinda-LETROZOLE is used for:
- The adjuvant treatment of postmenopausal women with hormone receptor-positive early breast cancer;
- The extended adjuvant treatment of hormone receptor positive invasive early breast cancer in postmenopausal women who have received approximately 5 years of prior standard adjuvant tamoxifen therapy;
- The first-line therapy in postmenopausal women with advanced breast cancer; and
- The hormonal treatment of advanced metastatic breast cancer after relapse or disease progression in women with natural or artificially-induced postmenopausal endocrine status, who have previously been treated with antiestrogens.
What does Zinda-LETROZOLE do:
Estrogen is a normally occurring female sex hormone that stimulates normal breast tissue and the growth of some types of breast cancer. Zinda-LETROZOLE is an aromatase inhibitor which acts by binding to aromatase, a substance needed to make estrogen. As a result, the production of estrogen and the growth of breast cancer are reduced.
What is adjuvant therapy:
Adjuvant therapy in breast cancer refers to treatment following breast surgery (the primary or initial treatment) in order to reduce the risk of recurrence. The purpose of adjuvant therapy with Zinda-LETROZOLE is to treat hormone receptor-positive early breast cancer, after surgery, in postmenopausal women to reduce the risk of recurrence.
What is extended adjuvant therapy:
The purpose of extended adjuvant therapy with Zinda-LETROZOLE is to treat hormone receptor-positive early breast cancer in postmenopausal women who have received approximately 5 years of prior standard adjuvant tamoxifen therapy in order to prevent recurrence. Treating breast cancer with Zinda-LETROZOLE beyond the standard 5 years of hormone therapy is called "extended adjuvant therapy".
When it should not be used:
Zinda-LETROZOLE should not be used in children and adolescents under 18 years of age.
Zinda-LETROZOLE should not be used in hormone-receptor negative disease.
Do not take Zinda-LETROZOLE if you:
- have ever had an unusual or allergic reaction to letrozole or any other ingredient in Zinda-LETROZOLE;
- still have menstrual periods;
are pregnant or breast-feeding, as Zinda-LETROZOLE may harm your baby.
What the medicinal ingredient is:
Letrozole
What the nonmedicinal ingredients are:
Zinda-LETROZOLE also contains the following non-medicinal ingredients needed to make the tablets: lactose monohydrate, magnesium stearate, microcrystalline cellulose and pregelatinized starch, as well as the following coating ingredients; iron oxide yellow, macrogol/polyethylene glycol 3350, polyvinyl alcohol, talc and titanium dioxide.
What dosage forms it comes in:
Zinda-LETROZOLE (letrozole) 2.5 mg Tablets
Zinda-LETROZOLE is supplied as film-coated tablets. The film-coated tablets are round, slightly biconvex with bevelled edges, tan to dark yellow tablets, debossed with “INT” on one side and plain on the other side.
Zinda-LETROZOLE is supplied in blister packs containing 15 tablets and bottles containing 30 and 100 tablets.
WARNINGS AND PRECAUTIONS
Serious Warnings and Precautions
Zinda-LETROZOLE should be used under the supervision of a doctor experienced in the use of anti-cancer drugs.
Zinda-LETROZOLE reduces blood estrogen levels which may cause a reduction in bone mineral density and a potential increase in bone loss (osteoporosis) and/or bone fractures.
The use of aromatase inhibitors, including Zinda-LETROZOLE , may increase the risk of cardiovascular events compared to tamoxifen, such as heart attacks and stroke. Women at risk of heart disease should be carefully monitored by their doctor.
You should not use Zinda-LETROZOLE if you may become pregnant, are pregnant and/or breastfeeding. There is a potential risk of harm to you and the fetus, including risk of fetal malformations. If you have the potential to become pregnant (this includes women who are perimenopausal or who recently became postmenopausal), you should discuss with your doctor about the need for effective contraception.
If there is exposure to Zinda-LETROZOLE during pregnancy, you should contact your doctor immediately to discuss the potential of harm to your fetus and potential risk for loss of the pregnancy.
Zinda-LETROZOLE should not be used in children and adolescents under 18 years of age.
BEFORE you take Zinda-LETROZOLE:
Tell your doctor if you:
- have a serious kidney or serious liver disease;
- are taking hormone replacement therapy;
- are taking other medication to treat your cancer;
- have a personal or family history of osteoporosis or have ever been diagnosed with low bone density or have a recent history of fractures (in order for your doctor to assess your bone health on a regular basis);
- have a personal or family history of high blood cholesterol or lipid levels. Zinda-LETROZOLE may increase lipid levels;
- have or have had cardiovascular or heart disease including any of the following: heart attack, stroke or uncontrolled blood pressure. Zinda-LETROZOLE may increase the risk of cardiovascular or heart diseases;
- have an intolerance to milk sugar (lactose);
- have pain in bones, or joints or muscles.
Driving a vehicle or using machinery:
Zinda-LETROZOLE tablets are unlikely to affect your ability to drive a car or to use machinery. However, some patients may occasionally feel tired, dizzy, sleepy or experience visual disorders. If this happens, you should not drive or operate any tools or machinery until you feel normal again.
INTERACTIONS WITH THIS MEDICATION
Please tell your doctor or pharmacist if you are taking or have recently taken any other prescription or over-the-counter medicines, vitamins or natural health products during your treatment with Zinda-LETROZOLE. This includes in particular:
- Tamoxifen.
- Other anti-estrogens or estrogen-containing therapies.
These substances may diminish the action of Zinda-LETROZOLE.
PROPER USE OF THIS MEDICATION
Usual dose:
The usual dosage is one tablet of Zinda-LETROZOLE to be taken once daily. The tablet should be swallowed whole with a small glass of water. You can take Zinda-LETROZOLE with or without food. It is best to take Zinda-LETROZOLE at about the same time every day.
Overdose:
| If overdosage is known or suspected, contact your doctor or the nearest poison control centre for advice immediately. Show the pack of tablets. Medical treatment may be necessary. |
Missed Dose:
If you forget to take a dose of Zinda-LETROZOLE, don't worry, take the missed dose as soon as you remember. However, if it is almost time for the next dose (e.g. within 2 or 3 hours), skip the missed dose and go back to your regular dosage schedule. Do not take a double dose to make up for the one that you missed.
SIDE EFFECTS AND WHAT TO DO ABOUT THEM
As with all medicines, patients taking Zinda-LETROZOLE may experience side effects. Most side effects that have been observed were mild to moderate and will generally disappear after a few days to a few weeks of treatment. Check with your doctor if the unwanted effects do not go away during treatment or become bothersome.
Some side effects, such as hot flushes, hair loss or vaginal bleeding may be due to the lack of estrogen in your body.
Very common side effects (they affect more than 10 in every
100 patients)
- increased level of cholesterol (hypercholesterolemia)
- hot flushes
- increased sweating
- night sweats
- fatigue (including weakness and malaise (generally
- feeling unwell))
- pain in bones and joints (arthralgia).
Common side effects (they affect between 1 to 10 in every 100 patients)
- headache
- rash
- dizziness
- gastrointestinal disorders (such as, nausea, vomiting, indigestion, constipation, diarrhea)
- increase in or loss of appetite
- increased blood sugar (hyperglycaemia)
- urinary incontinence
- pain in muscles
- bone loss (osteoporosis)
- bone fractures
- depression
- weight increase
- anxiety
- insomnia
- hair loss
- vaginal bleeding
- dry skin
- raised blood pressure (hypertension)
- abdominal pain.
Uncommon side effects (they affect between 1 to 10 in every 1000 patients)
- nervous disorders (such as nervousness, irritability, drowsiness)
- pain or burning sensation in the hands or wrists (carpal tunnel syndrome)
- reduced sense of touch (dysaesthesia)
- eye irritation
- palpitations, rapid heart rate
- itchy rash (urticaria), rapid swelling of face, lips, tongue, throat (angioedema)
- severe allergic reaction (anaphylactic reaction)
- vaginal disorders (such as discharge or dryness)
- joint stiffness (arthritis)
- breast pain
- fever
- thirst, taste disorder, dry mouth
- dryness of mucous membranes
- weight decrease
- urinary tract infection, increased frequency of urination
- cough
- abnormal liver function test results (blood test disorders).
Side effects with frequency not known
- trigger finger, a condition in which your finger or thumb catches in a bent position.
If any of these affects you severely, tell your doctor.
If you notice any other side effects not listed in this leaflet, please tell your doctor or pharmacist.
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY HAPPEN AND WHAT TO DO ABOUT THEM | ||||||
|---|---|---|---|---|---|---|
| Symptom / effect | Talk with your doctor or pharmacist | Stop taking drug and call your doctor or pharmacist and seek emergency medical attention | ||||
| Only if severe | In all cases | |||||
| Common | ||||||
| -Pain in the muscles, bones and joints; | X | |||||
| -Joint stiffness; | X | |||||
| -Persistent sad mood (i.e. depression). | X | |||||
| Uncommon | ||||||
| -Tightness or feeling of heaviness in the chest or pain radiating from your chest to | X | X | ||||
| SERIOUS SIDE EFFECTS, HOW OFTEN THEY HAPPEN AND WHAT TO DO ABOUT THEM |
|---|
| Symptom / effect | Talk with your doctor or pharmacist | Stop taking drug and call your doctor or pharmacist and seek emergency medical attention |
|---|
| Only if severe | In all cases | ||
|---|---|---|---|
| your arms or shoulders, neck, teeth or jaw, abdomen or back (signs of angina pectoris or heart attack); | |||
| -Numbness or weakness in arm or leg or any part of the body, loss of coordination, vision changes, sudden headache, nausea, loss of coordination, difficulty in speaking or breathing (signs of brain disease e.g. stroke); | X | X | |
| -Swelling and redness along a vein which is extremely tender and possibly painful when touched (signs of inflammation of a vein due to a blood clot, e.g. thrombophlebitis); | X | X | |
| -Difficulty in breathing, chest pain, fainting, rapid heart rate, bluish skin discoloration (signs of blood clot formation in the lung such as pulmonary embolism); | X | X | |
| -Swelling of arms, hands, feet, ankles or other parts of the body (signs of oedema); | X | X | |
| -Swelling mainly of the face and throat (signs of allergic reaction); | X | X | |
| -Severe fever, chills or mouth ulcers due to infections (signs of low level of white blood cells); | X | X | |
| -Blurred vision (sign of cataract); | X | X | |
| -Yellow skin and eyes, nausea, loss of appetite, dark-coloured urine (signs of hepatitis); | X | X | |
| -Rash, red skin, blistering of the lips, eyes or mouth, skin peeling, fever (signs of skin disorder). | X | X | |
This is not a complete list of side effects. For any unexpected effects while taking Zinda-LETROZOLE, contact your doctor or pharmacist.
HOW TO STORE IT
Store your tablets in a dry place at room temperature 15 to 30 C.
Avoid places where the temperature may rise above 30 C.
Protect from moisture. Keep container tightly closed.
Keep this medicine out of the reach and sight of children and pets.
Expiry Date:
Do not take Zinda-LETROZOLE after the expiry date which is stated on the carton or bottle after EXP. The expiry date refers to the last day of the month. Remember to take any unused medication back to your pharmacist.
REPORTING SUSPECTED SIDE EFFECTS
You can report any suspected adverse reactions associated with the use of health products to the Canada Vigilance Program by one of the following 3 ways:
Postage paid labels, Canada Vigilance Reporting Form and the adverse reactions reporting guidelines are available on the MedEffectTM Canada Website at www.healthcanada.gc.ca/medeffect. NOTE: Should you require information related to the management of side effects, contact your health professional. The Canada Vigilance Program does not provide medical advice. |
MORE INFORMATION
This document plus the full product monograph, prepared for health professionals can be found by contacting the distributor, Zinda Pharma Limited, at:
8250 Decarie Suite 110 Montreal, QC H4P 2P5