In postmenopausal women: adjuvant treatment of estrogen-receptor positive early breast cancer after 2–3 years of tamoxifen therapy to complete a total of 5 years of hormonal therapy; advanced breast cancer with disease progression after tamoxifen therapy.
Give after a meal. 25mg once daily. Concomitant potent CYP3A4 inducer (eg, rifampicin, phenytoin): 50mg once daily. Advanced disease: continue until tumor progression is evident.
Pregnancy (Cat.X). Premenopausal women.
Hepatic or renal insufficiency. Perform routine assessment of Vit. D levels prior to initiation; supplement if deficient. Nursing mothers.
May be antagonized by estrogens (avoid), CYP3A4 inducers. Avoid concomitant bisphosphonates, Vit. D supplements, calcium.
Hot flashes, fatigue, arthralgia, headache, insomnia, increased sweating, nausea, increased appetite; reductions in bone mineral density.