Altraz: Advanced Aromatase Inhibition for Hormone-Responsive Breast Cancer
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Synonyms | |||
Altraz (anastrozole) is a potent, non-steroidal aromatase inhibitor indicated for the adjuvant treatment of postmenopausal women with hormone receptor-positive early breast cancer. It is also approved for the first-line treatment of advanced or metastatic hormone receptor-positive breast cancer in postmenopausal women. By selectively inhibiting the aromatase enzyme, Altraz significantly reduces estrogen production, a key driver of tumor proliferation in estrogen-dependent malignancies. This targeted mechanism offers a sophisticated endocrine therapy option with a well-established efficacy and safety profile, making it a cornerstone in the management of hormone-sensitive breast cancer.
Features
- Active ingredient: Anastrozole 1 mg per tablet
- Pharmacological class: Non-steroidal aromatase inhibitor
- Bioavailability: Approximately 80-85% following oral administration
- Protein binding: 40% bound to plasma proteins
- Metabolism: Hepatic via N-dealkylation, hydroxylation, and glucuronidation
- Elimination half-life: Approximately 50 hours in postmenopausal women
- Excretion: Primarily hepatic (85% as metabolites, 10% unchanged)
- Presentation: Film-coated tablets in blister packs of 28
Benefits
- Significantly reduces the risk of cancer recurrence in early breast cancer patients
- Demonstrates superior efficacy compared to tamoxifen in hormone receptor-positive populations
- Well-tolerated profile with manageable side effects for long-term therapy
- Oral administration allows for convenient outpatient treatment
- Does not require corticosteroid supplementation
- Preserves bone mineral density better than other aromatase inhibitors
Common use
Altraz is primarily prescribed for the adjuvant treatment of hormone receptor-positive early breast cancer in postmenopausal women. It is also indicated for the first-line treatment of advanced or metastatic breast cancer in this patient population. The medication is typically initiated following primary treatment with surgery and/or radiation therapy. Clinical evidence supports its use for extended durations up to 10 years in appropriate patients. Healthcare providers may also consider Altraz for neoadjuvant therapy in certain clinical scenarios and for chemoprevention in high-risk postmenopausal women.
Dosage and direction
The recommended dosage of Altraz is one 1 mg tablet taken orally once daily. Administration may occur with or without food, though consistency in timing is recommended. Tablets should be swallowed whole with water and not crushed or chewed. Treatment duration typically continues for 5 years, though extended therapy up to 10 years may be appropriate based on individual risk assessment and tolerability. Patients should maintain regular dosing intervals approximately 24 hours apart. No dosage adjustment is required for elderly patients or those with renal impairment (creatinine clearance >20 mL/min). Hepatic impairment requires careful monitoring.
Precautions
Patients should undergo comprehensive bone density assessment before initiation and during treatment due to the risk of osteoporosis. Regular monitoring of lipid profiles is recommended. Hepatic function should be assessed periodically, particularly in patients with pre-existing liver conditions. Patients with a history of ischemic heart disease require careful cardiovascular monitoring. Caution is advised when prescribing to patients with moderate to severe renal impairment. Vitamin D and calcium supplementation should be considered for all patients. Regular gynecological examinations are recommended due to potential vaginal atrophy.
Contraindications
Altraz is contraindicated in premenopausal women, pregnant women, and nursing mothers. It should not be used in patients with known hypersensitivity to anastrozole or any excipients in the formulation. Concomitant use with estrogen-containing therapies is contraindicated. Patients with severe hepatic impairment (Child-Pugh Class C) should not receive Altraz. The medication is contraindicated in patients with severe renal impairment (creatinine clearance <20 mL/min) not undergoing dialysis.
Possible side effects
Common adverse reactions (≥10%) include hot flashes (35%), arthralgia (30%), asthenia (20%), mood disturbances (15%), nausea (10%), and headache (10%). Less frequent effects (1-10%) comprise vaginal dryness, hair thinning, diarrhea, vomiting, and mild skin rash. Serious but rare side effects (<1%) include osteoporosis with increased fracture risk, cardiovascular events, hepatic enzyme elevations, and hypersensitivity reactions. Most side effects are mild to moderate in severity and often diminish with continued therapy. Patients should report persistent joint pain, unusual bone pain, or severe hot flashes to their healthcare provider.
Drug interaction
Altraz may interact with tamoxifen, reducing anastrozole plasma concentrations by 27% - concomitant use is not recommended. Estrogen-containing therapies may diminish the pharmacological effect of Altraz. CYP3A4 inducers (rifampicin, phenytoin) may decrease anastrozole concentrations. CYP3A4 inhibitors (ketoconazole) may increase exposure, though clinical significance remains uncertain. No significant interactions observed with warfarin, cimetidine, or other common medications. Patients should inform healthcare providers about all prescription medications, over-the-counter drugs, and herbal supplements before initiating therapy.
Missed dose
If a dose is missed, patients should take it as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should never take two doses simultaneously to make up for a missed dose. Consistency in daily dosing is important for maintaining stable aromatase inhibition. If multiple doses are missed, patients should contact their healthcare provider for guidance on resuming therapy.
Overdose
No specific antidote exists for Altraz overdose. Single doses up to 60 mg have been administered without severe consequences. Expected symptoms may include nausea, vomiting, dizziness, and headache. Management should involve supportive care including gastric lavage if ingestion occurred within 2 hours. Vital signs should be monitored regularly. Dialysis is unlikely to be effective due to high protein binding. Patients experiencing suspected overdose should seek immediate medical attention or contact a poison control center.
Storage
Store Altraz tablets at room temperature (15-30°C or 59-86°F) in their original packaging. Protect from light and moisture. Keep the blister strips sealed until immediately before use. Do not store in bathrooms or other humid areas. Keep out of reach of children and pets. Do not use tablets beyond the expiration date printed on the packaging. Properly dispose of any unused medication through take-back programs or following specific disposal instructions.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Altraz should only be used under the supervision of a qualified healthcare professional. Treatment decisions must be based on individual patient characteristics and professional medical judgment. Patients should not alter their dosage or discontinue treatment without consulting their physician. The manufacturer is not liable for any consequences arising from the use or misuse of this information.
Reviews
Clinical studies demonstrate Altraz’s consistent efficacy profile. The ATAC trial (Arimidex, Tamoxifen Alone or in Combination) showed a 24% reduction in recurrence risk compared to tamoxifen at 10-year follow-up. Meta-analyses confirm significant improvement in disease-free survival with hazard ratios of 0.85-0.90. Patient-reported outcomes indicate generally good tolerability, though arthralgia remains a treatment-limiting factor for some individuals. Quality of life studies show maintained physical and emotional well-being in most patients. Long-term safety data from multiple trials support its favorable risk-benefit profile for extended duration therapy.