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Compare Nolvadex vs. Femara

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Tamoxifen (Nolvadex) and letrozole (Femara) are both used to treat breast cancer, but they work in different ways and have different uses. Tamoxifen blocks estrogen, which can help stop breast cancer cells from growing. It can be used in both premenopausal and postmenopausal women, as well as men. Letrozole, on the other hand lowers the body's production of estrogen and is only used in postmenopausal women. Tamoxifen is taken once daily and can be used for 5 to 10 years, while letrozole is also taken daily but is typically used for shorter durations. Common side effects of tamoxifen include hot flashes, vaginal discharge, and swelling, whereas letrozole can cause menopausal symptoms like hot flashes, night sweats, and joint pain. Additionally, tamoxifen may help prevent bone loss after menopause, but has a risk of causing uterine cancer, blood clots, and cataracts. On the other hand, letrozole can weaken bones and increase cholesterol levels. Both medications are available in generic forms, making them more affordable options.

  • Tamoxifen (Nolvadex)
    Letrozole (Femara)
  • Tamoxifen (Nolvadex)
    Letrozole (Femara)

  • Summary of Nolvadex vs. Femara

    Summary for Selective estrogen receptor modulator (SERM)
    Prescription only

    Tamoxifen (Nolvadex) is a selective estrogen receptor modulator (SERM). It’s used to treat early stage and advanced or metastatic hormone receptor-positive (HR+) breast cancer in males and females. It’s also used to lower the risk for breast cancer in females who have a higher risk for breast cancer. Tamoxifen (Nolvadex) is an oral tablet that's taken by mouth, usually once a day. Common side effects of this medication include hot flashes, vaginal discharge, and swelling in the arms and legs, which might lead to weight gain. Brand name Nolvadex is no longer available.

    Summary for Aromatase inhibitor
    Prescription only

    Letrozole (Femara) is an aromatase inhibitor, a type of hormonal therapy. It’s FDA-approved to treat or prevent breast cancer in females who’ve already gone through menopause. It’s sometimes prescribed off-label by fertility specialists to help females become pregnant. Letrozole (Femara) is taken by mouth, typically once a day for breast cancer. Common side effects include hot flashes and pain in the bones, muscles, and joints.

  • Indications of Nolvadex vs. Femara

    Indications for
    •Metastatic HR+ breast cancer
    •Early-stage HR+ breast cancer after surgery to lower the risk of breast cancer coming back
    •Ductal carcinoma in situ (DCIS) in females after breast surgery and radiation to lower the risk of breast cancer coming back
    •Lowering the risk of breast cancer in females who are considered high risk
    Indications for
    •Breast cancer in females who have already gone through menopause:
    •Preventing breast cancer from coming back (hormone receptor-positive early breast cancer), sometimes after treatment with tamoxifen (Nolvadex)
    •Treatment of advanced or metastatic breast cancer

  • Pros and Cons of Nolvadex vs. Femara

    Pros and Const for Selective estrogen receptor modulator (SERM)
    Pros
    •Usually taken once a day
    •Oral tablet is available as a lower-cost generic
    •Might help prevent bone loss (osteoporosis) after menopause
    Cons
    •Might raise your risk for blood clots, uterine cancer, and cataracts
    •Can’t take while pregnant or breastfeeding
    •Usually taken long term (at least 5 years)
    Pros and Const for Aromatase inhibitor
    Pros
    •Can be used during early and advanced stages of breast cancer
    •Taken by mouth once daily
    •Available as a lower-cost generic
    Cons
    •Only for females who've reached menopause (for treating breast cancer)
    •Can cause menopausal symptoms, such as hot flashes and night sweats
    •Can weaken your bones if taken long-term

  • Common Side Effects of Nolvadex vs. Femara

    Common Side Effects for
    •Hot flashes (up to 80%)
    •Vaginal discharge (up to 55%)
    •Swelling in the arms and legs (up to 32%)
    •Nausea (up to 26%)
    •Irregular or no monthly bleeding (up to 25%)
    •Vaginal bleeding (up to 23%)
    •Weight loss (23%)
    •Skin changes (19%)
    Common Side Effects for
    •High blood cholesterol levels (52%)
    •Hot flashes (34%)
    •Muscle, bone, or joint pain (25%)

    Note: Side effects reported by females who took letrozole (Femara) after surgery for early breast cancer.

  • Warnings of Nolvadex vs. Femara

    Common Side Effects for
    •Blood clots
    •Changes in the uterus and risk of uterine cancer
    •Eye problems
    •Liver problems
    •High calcium levels in the blood
    •Low platelet count (risk of bleeding)
    •Harm to unborn baby
    Common Side Effects for
    •Weakened bones
    •High cholesterol levels
    •Liver problems
    •Risk of drowsiness
    •Harm to unborn baby

  • Prices with our coupons for Nolvadex vs. Femara

    Learn more about Tamoxifen
    Learn more about Letrozole

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