anastrozole: clinical use

Prescribing considerations

• Confirm postmenopausal status biochemically if uncertain.
• For primary prevention, undertake an individual benefit–risk assessment and arrange appropriate breast surveillance.
• Assess cardiovascular risk, particularly for primary prevention, and review new or worsening hypertension or hypercholesterolaemia.
• Use caution in severe renal impairment and moderate or severe hepatic impairment.
• Persistent vaginal bleeding requires further evaluation.

Contraindications and cautions

• Pregnancy
• Breastfeeding
• Hypersensitivity to anastrozole or any product excipient
• The selected product should not be used in patients with galactose intolerance, total lactase deficiency or glucose-galactose malabsorption.

Monitoring

• Assess bone mineral density at baseline and periodically in people with osteoporosis, osteopenia or relevant risk factors.
• Review fracture risk and institute bone-protective management when appropriate.
• Monitor cholesterol and cardiovascular risk factors.
• Monitor clinically for musculoskeletal toxicity, including tendon symptoms, and hepatic adverse effects.

Clinical pharmacology

Anastrozole is a highly selective non-steroidal aromatase inhibitor. Oral absorption is rapid; food slightly slows absorption without materially reducing its extent. Protein binding is about 40%, and elimination is mainly through metabolism, with a plasma half-life of approximately 40–50 hours.

Formulation and product differences

• The selected product is a white, round, biconvex film-coated tablet marked “1” on one side and “H” on the other.
• It contains lactose monohydrate and is essentially sodium-free.
• Core excipients are lactose monohydrate, sodium starch glycolate, povidone and magnesium stearate; the coating contains hypromellose, titanium dioxide and macrogol 400.

Tablet

Route: Oral

Strengths: 1 mg