Apo-Anastrozole Special Precautions

Anastrozole tablet is not recommended for use in children as safety and efficacy have not been established in these patients.
The menopause should be defined biochemically in any patient where there is doubt about menopausal status.
There are no data to support the safe use of anastrozole tablet in patients with moderate or severe hepatic impairment, or patients with severe impairment of renal function (creatinine clearance less than 20 ml/min).
Women with osteoporosis or at risk of osteoporosis should have their bone mineral density formally assessed by bone densitometry e.g. DEXA scanning at the commencement of treatment and at regular intervals thereafter. Treatment or prophylaxis for osteoporosis should be initiated as appropriate and carefully monitored.
There are no data available for the use of anastrozole with LHRH analogues. This combination should not be used outside clinical trials.
As anastrozole tablet lowers circulating oestrogen levels it may cause a reduction in bone mineral density with a possible consequent increased risk of fractures. The use of bisphosphonates may stop further bone mineral loss caused by anastrozole tablet in postmenopausal women and could be considered.
Effects on ability to drive and use machines: Anastrozole is unlikely to impair the ability of patients to drive and operate machinery. However, asthenia and somnolence have been reported with the use of anastrozole and caution should be observed when driving or operating machinery while such symptoms persist.