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Anastrozole

ARIMIDEX

What it isAromatase inhibitor blocking peripheral estrogen synthesis; hormone receptor-positive breast cancer in postmenopausal women.

Why this oneUnlike steroidal exemestane, it is reversible and nonsteroidal; it lacks tamoxifen's endometrial-cancer and thrombosis liabilities.

What limits itAccelerated bone loss and arthralgia; monitor density. It is ineffective before menopause unless ovarian function is suppressed.

FDA-approved for

FDA label

FDA dosingPopulationStartTargetMax
Breast cancer (adjuvant early-stage, or advanced) in postmenopausal womenPostmenopausal women1 mg QD1 mg QD1 mg QD

Renal No adjustment needed

Hepatic Mild-to-moderate impairment: no change; severe impairment: not studied.

Instructions

Cautions

Adverse reactions

Pregnancy May cause fetal harm based on animal findings and mechanism of action; embryo-fetal toxicities in rats; advise effective contraception.

Lactation No data on presence in human milk; because of tumorigenicity in animal studies, breastfeeding is not recommended.

NO BOXED WARNINGS

Principal riskAccelerated bone loss and arthralgia

Cost, est. cash$10–$1,000/month

Generic entry2010

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4
Overdose danger2 / 4
Weight-gain liability0 / 4
Sedation liability0 / 4
QT / Torsades0 / 4
Direct muscarinic antagonism0 / 4
Embryofetal risk3 / 4

Legacy pregnancy categoryMultiple / indication-, trimester- or formulation-dependent

Defining liabilityThrombotic, metabolic, hepatic, skeletal or reproductive toxicity varies by hormonal target.

Mechanism of action: Anastrozole ballicule

Anastrozole ballicule: receptor binding, kinetics and half-life diagram

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Memory aids: mascots and interaction avatars

Anastrozole ARIMIDEX mascot mnemonic cartoon
“An Astro Arm-o-dex”

Open Anastrozole in the interactive console ↗