Anastrozole, sold under the brand name Arimidex among others, is a medication used in addition to other treatments for breast cancer. Specifically it is used for hormone receptor-positive breast cancer. It has also been used to prevent breast cancer in those at high risk. It is taken by mouth.Common side effects of anastrozole include hot flashes, altered mood, joint pain, and nausea. Severe side effects include an increased risk of heart disease and osteoporosis. Use during pregnancy may harm the baby. Anastrozole is in the aromatase-inhibiting family of medications. It works by blocking the production of estrogens in the body, and hence has antiestrogenic effects.Anastrozole was patented in 1987 and was approved for medical use in 1995. It is on the World Health Organizations List of Essential Medicines. Anastrozole is available as a generic medication. In 2019, it was the 176th most commonly prescribed medication in the United States, with more than 3 million prescriptions. Medical uses
Breast cancer
Anastrozole is used in the treatment and prevention of breast cancer in women. The Arimidex, Tamoxifen, Alone or in Combination (ATAC) trial was of localized breast cancer and women received either anastrozole, the selective estrogen receptor modulator tamoxifen, or both for five years, followed by five years of follow-up. After more than 5 years the group that received anastrozole had better results than the tamoxifen group. The trial suggested that anastrozole is the preferred medical therapy for postmenopausal women with localized estrogen receptor-positive breast cancer.
However, maximal suppression of estradiol levels occurs within 3 or 4 days of therapy.Active efflux of anastrozole by P-glycoprotein at the blood–brain barrier has been found to limit the central nervous system penetration of anastrozole in rodents, whereas this was not the case with letrozole and vorozole. As such, anastrozole may have peripheral selectivity in humans, although this has yet to be confirmed. In any case, estradiol is synthesized peripherally and readily crosses the blood–brain barrier, so anastrozole would still expected to reduce estradiol levels in the central nervous system to a certain degree. The plasma protein binding of anastrozole is 40%.The metabolism of anastrozole is by N-dealkylation, hydroxylation, and glucuronidation. Inhibition of aromatase is due to anastrozole itself rather than to metabolites, with the major circulating metabolite being inactive. The elimination half-life of anastrozole is 40 to 50 hours (1.7 to 2.1 days). This allows for convenient once-daily administration. The medication is eliminated predominantly by metabolism in the liver (83 to 85%) but also by residual excretion by the kidneys unchanged (11%). Anastrozole is excreted primarily in urine but also to a lesser extent in feces. Chemistry
Anastrozole is a nonsteroidal benzyltriazole. It is also known as α,α,α,α-tetramethyl-5-(1H-1,2,4-triazol-1-ylmethyl)-m-benzenediacetonitrile. Anastrozole is structurally related to letrozole, fadrozole, and vorozole, with all being classified as azoles. History
Anastrozole was patented by Imperial Chemical Industries (ICI) in 1987 and was approved for medical use, specifically the treatment of breast cancer, in 1995. Society and culture
Generic names
Anastrozole is the generic name of the drug and its INN, USAN, BAN, and JAN.