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Key takeaways
Anastrozole is used to treat hormone receptor-positive breast cancer in postmenopausal women, working by lowering estrogen levels, but may not be suitable for everyone due to side effects like bone loss.
Alternatives to anastrozole include other aromatase inhibitors, SERMs, CDK 4/6 inhibitors, mTOR kinase inhibitors, and PI3K inhibitors, each with potentially different side effect profiles and uses.
Common alternatives to anastrozole include Femara (letrozole), Aromasin (exemestane), Faslodex (fulvestrant), tamoxifen, and Kisqali (ribociclib), which vary in administration methods and specific uses.
Natural alternatives are generally not recommended in place of medical treatment for breast cancer, but supportive therapies like acupuncture and mindfulness activities may help manage treatment side effects and improve quality of life.
Anastrozole (brand name Arimidex) is a medication used to treat breast cancer in women after menopause. Specifically, anastrozole treats hormone receptor-positive breast cancer. Anastrozole is an oral tablet taken by mouth once daily. Women with hormone receptor-positive breast cancer often respond to endocrine therapy (also called hormone therapy), such as anastrozole, which can reduce tumor burden and symptoms with generally fewer side effects and toxicities than chemotherapy. As an endocrine therapy, anastrozole works as a type of nonsteroidal aromatase inhibitor that lowers estrogen levels in the body by blocking aromatase, an enzyme that converts other hormones into estrogen (estradiol and estrone). Hormone receptor-positive breast cancer cells need estrogen and/or progesterone to grow. The goal of treatment with anastrozole is to decrease tumor mass or delay progression.
RELATED: What is anastrozole?
While an effective treatment option for some people, anastrozole may not be the best and safest option for all women treating breast cancer. Anastrozole and other aromatase inhibitors can cause bone loss. Combination therapy will often be used to help treat the cancer through different mechanisms and require more than one medication. While endocrine therapy, like anastrozole, is recommended for women starting treatment, this therapy may not be effective for some women. Chemotherapy can be used in women with disease not responding to endocrine therapy, more invasive breast cancers, or those who have extensive symptomatic visceral involvement.
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What can I take in place of anastrozole?
There are other options available to treat hormone receptor-positive breast cancer that do not improve with anastrozole. These alternative medications include other types of aromatase inhibitors, selective estrogen receptor modulators (SERMs), cyclin-dependent kinase (CDK) 4/6 inhibitors, mTOR kinase inhibitors, and phosphatidylinositol 3-kinase (PI3K) inhibitors. Among the available aromatase inhibitors, clinical trials have shown that the clinical activity, side effects, and toxicity of these are almost identical, and the choice of any one of them is appropriate. Overall, these alternatives may be more suitable for certain individuals due to their different uses, side effect profiles, and dosages.
RELATED: Anastrozole side effects and how to avoid them
Compare anastrozole alternatives |
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|---|---|---|---|
| Drug name | Uses | Dosage | Savings options |
| Arimidex (anastrozole) |
|
Take 1 mg by mouth once daily | Arimidex coupons |
| Afinitor (everolimus) |
|
Take 10 mg by mouth once daily | Afinitor coupons |
| Aromasin (exemestane) |
|
Take 25 mg by mouth once daily | Aromasin coupons |
| Evista (raloxifene) |
|
Take 60 mg by mouth once daily | Evista coupons
|
| Fareston (toremifene) |
|
Take 60 mg by mouth once daily | Fareston coupons |
| Faslodex (fulvestrant) |
|
Administer 500 mg intramuscularly (IM) on Days 1, 15, and 29, and then once per month | Faslodex coupons |
| Femara (letrozole) |
|
Take 2.5 mg by mouth once daily | Femara coupons |
| Ibrance (palbociclib) |
|
Take 125 mg by mouth once daily on days 1-21 of a 28-day cycle | Ibrance coupons |
| Kisqali (ribociclib) |
|
Take 600 mg by mouth every morning on days 1-21 of a 28-day cycle | Kisqali coupons |
| Piqray (alpelisib) |
|
Take 300 mg by mouth daily | Piqray coupons |
| Tamoxifen |
|
Take 20 to 40 mg by mouth daily | Tamoxifen coupons |
| Verzenio (abemaciclib) |
|
Take 150 mg by mouth twice daily | Verzenio coupons |
Other alternatives to anastrozole
The following are other alternatives for people seeking treatment options for hormone receptor-positive breast cancer:
- Chemotherapy
- Antibody Drug Conjugates
Top 5 anastrozole alternatives
The following are some of the most common alternatives to anastrozole.
1. Femara (letrozole)
Femara is the brand name of the medication letrozole and is another type of aromatase inhibitor. Like anastrozole, letrozole is nonsteroidal and used to treat hormone receptor-positive breast cancer in postmenopausal women. Letrozole is also an oral tablet that is taken by mouth once daily. Letrozole has similar side effects as anastrozole such as skin blushing or flushing, nausea, sweating, hot flashes, increased cholesterol levels, increased blood pressure, and weight gain. Letrozole has shown similar efficacy as anastrozole. For some women who aren’t able to tolerate anastrozole, letrozole may be a suitable option.
RELATED: Letrozole side effects and how to avoid them
2. Aromasin (exemestane)
Aromasin is the brand name of the medication exemestane and is another type of aromatase inhibitor. Unlike anastrozole and letrozole, exemestane is a steroidal aromatase inhibitor and may produce androgenic effects (masculinization effects), but the clinical relevance of this has yet to be determined. This alternative is also an oral tablet that is taken by mouth once daily. Exemestane has similar side effects as anastrozole and has shown similar efficacy. Exemestane may be a suitable option for women who are unable to tolerate anastrozole.
RELATED: Arimidex vs. Aromasin: Differences, similarities, and which one is better for you
3. Faslodex (fulvestrant)
Faslodex is the brand name of the medication fulvestrant and is an estrogen receptor antagonist. Fulvestrant works to lower the amount of estrogen which can slow down or stop the growth of the tumor. This medication is given as an injection into the muscle (typically in the buttocks) once a month. Fulvestrant has similar side effects as anastrozole. As an injection, some side effects include pain at the injection site, joint pain, muscle pain, and bone pain. Faslodex may be a suitable alternative for women who are unable to tolerate an aromatase inhibitor or who need combination therapy.
4. Tamoxifen
Tamoxifen is a generic medication that is a selective estrogen receptor modulator (SERM). Tamoxifen is used to treat hormone-receptor positive early, locally advanced, and metastatic breast cancers. This medication can be used to treat breast cancer in both women and men. Tamoxifen blocks estrogen from attaching to receptors in the body which can slow or stop the growth of the tumor. Tamoxifen is taken as an oral tablet by mouth one or two times a day. Common side effects include hot flashes, nausea, skin flushing, fluid retention, and mood changes.
RELATED: Tamoxifen alternatives: What can I take instead of tamoxifen?
5. Kisqali (ribociclib)
Kisqali is the brand name of the medication ribociclib and is a targeted treatment option. Kisqali works as a cyclin-dependent kinase inhibitor and can reduce tumor growth. This medication is used for the treatment of hormone-receptor positive, HER2-negative advanced or metastatic breast cancer in postmenopausal females or in adult males (in combination with an aromatase inhibitor with endocrine-based therapy or fulvestrant following disease progression). Kisqali is available as an oral tablet that is taken by mouth once daily in the morning for 21 days, followed by 7 days off, and repeated every 28 days. Side effects include skin rash, hair loss, nausea, vomiting, decreased appetite, and infection.
Natural alternatives to anastrozole
In general, healthcare providers do not recommend replacing anastrozole and other breast cancer prescription drugs with natural therapies. Natural alternatives have not been proven to help treat breast cancer. It’s important for people taking prescription therapies to know that certain supplements or herbal treatments may lead to an increased risk of drug interactions or adverse effects if used without the guidance of a healthcare provider. Cancer treatments can be overwhelmingly expensive. If cost is a reason for seeking natural alternatives, a SingleCare discount card may help alleviate some financial stress.
Some natural remedies may be helpful to support the body and mind while treating breast cancer. Healthcare providers may recommend natural therapies in addition to standard breast cancer treatments. These therapies may include acupuncture, massage, meditation, and different mindful hobbies.
Acupuncture involves insertion of very fine needles into the skin at various points on the body. The acupuncture needles stimulate nerves under the skin and in muscle tissue causing the body to produce natural chemicals, such as endorphins. Along with possible improvements in mood and anxiety, acupuncture may help with some side effects of chemotherapy, such as nausea and sickness, when given alongside anti-nausea medications.
Activities and hobbies that involve deep concentration and focus can improve mindfulness and help people cope with the stress of cancer treatment. Examples include crafting, knitting, painting, or cooking. The calming effect that comes with mindful activities can be similar to practicing meditation.
How to switch to a anastrozole alternative
1. Discuss all health conditions with a healthcare provider
Before switching from anastrozole to an alternative, it’s important the prescribing oncologist has reviewed all health conditions. Alternatives may have serious side effects or precautions that need to be avoided. It’s best to seek medical advice prior to changing medication therapy.
2. Do not suddenly stop taking anastrozole
Before stopping anastrozole, make a care plan with the prescribing oncologist to avoid cancer progression. Once a plan has been made, anastrozole can be safely discontinued and replaced with the new breast cancer treatment if appropriate.
3. Keep up with oncology clinic appointments
It’s important to schedule and maintain regular appointments with the oncology team. These appointments are crucial for discussing treatment side effects, monitoring cancer progression, and ensuring patients of the support from their healthcare team.