Indications: Breast cancer:

— First-line treatment of locally-advanced or metastatic breast cancer (hormone receptor-positive or unknown) in postmenopausal women.

— Adjuvant treatment of early hormone receptor-positive breast cancer in postmenopausal women.

———— Treatment of advanced breast cancer in postmenopausal women with disease progression following tamoxifen therapy.

Contra-indications: not for premenopausal women.

Hepatic impairment: avoid in moderate to severe impairment.

Renal impairment: avoid if creatinine clearance less than 20 ml/minute

Pregnancy: avoid

Breast-feeding: avoid.

Side Effects: hot flushes, vaginal dryness, vaginal bleeding, hair thinning, anorexia, nausea, vomiting, diarrhoea, headache, arthralgia, arthritis, bone fractures, bone pain, rash (including Stevens-Johnson syndrome), cutaneous vasculitis; asthenia and drowsiness—may initially affect ability to drive or operate machinery; slight increases in total cholesterol levels reported; very rarely allergic reactions including angioedema and anaphylaxis.

Dose: 1 mg daily