Starting Letrozole: A Practical First-Month Guide

Starting letrozole after a breast cancer diagnosis can feel like a big step, even though the treatment itself is one small tablet a day. Letrozole is used in women after the menopause, and the first few weeks are when most people settle into a routine, notice any early side effects and have their baseline checks. This guide covers what to expect and how to make the first month go smoothly. If you are still weighing up options with your oncologist, our comparison of anastrozole vs letrozole explains how the two aromatase inhibitors differ.

Week one: setting up a routine

The licensed dose is 2.5 mg once a day, with or without food. Choosing a fixed time, such as with breakfast or when you brush your teeth at night, makes missed doses much less likely.

A few simple habits help:

• Use a weekly pill organiser or a phone alarm.
• Keep a short diary of how you feel each day. It makes conversations with your oncologist or breast care nurse far more useful.
• If you miss a dose, take it when you remember, unless your next dose is nearly due. Never take two at once.

Baseline checks

Because letrozole lowers oestrogen, it can gradually reduce bone density. Many people have a bone density scan (often called a DEXA scan) around the start of treatment. Your team may also check cholesterol and vitamin D levels. Ask your GP or oncologist whether these have been arranged, and whether calcium or vitamin D supplements are advised for you.

Weeks two to four: early side effects

Not everyone notices side effects, and they often ease with time. The most common in the early weeks are:

• Hot flushes and night sweats. Layered clothing, a fan by the bed and cutting back on alcohol and caffeine can help.
• Joint and muscle stiffness, especially first thing in the morning. Gentle daily movement, such as walking or swimming, often makes a real difference.
• Tiredness. Pacing your day and keeping regular sleep times helps.
• Headaches or dizziness. Take care when driving until you know how the tablets affect you.
• Vaginal dryness, for which your GP or nurse can suggest suitable products.

Contact your care team promptly if you have severe joint pain, chest pain, sudden breathlessness, swelling in one leg or changes in your vision.

Looking after your bones and heart

Weight-bearing exercise, such as brisk walking, helps protect bone strength. A balanced diet with enough calcium, stopping smoking and keeping alcohol moderate all support bone and heart health over the years of treatment ahead.

Other medicines and supplements

Tell your chemist and GP that you are taking letrozole before starting anything new. Products containing oestrogen, including some HRT and certain herbal remedies, may work against it.

Planning your supply

Letrozole is usually taken for five years or more, so a steady supply matters. Reorder when you have around two weeks of tablets left. A valid prescription is required for every order of a prescription medicine. If you choose to buy generic letrozole online, check the strength is 2.5 mg and keep to the same product where possible so the tablet looks familiar. When you buy medicines online, allow for delivery time to the UK and Europe. You can see the options in our oncology range.

The emotional side of starting treatment

The first month can bring worry as well as physical changes. Many people find it helpful to talk with their breast care nurse, a counsellor or a local support group. Friends and family often want to help but are unsure how, so telling them what would be useful can make a difference. You do not have to manage this alone.

Want to go further? You can see Letzol-Sure 2.5 (letrozole 2.5 mg).

This is general information, not medical advice. Speak to your doctor or pharmacist before starting any medicine.