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To prevent steroid-induced osteoporosis, the steroid dose and duration should be as low and as short as possible. All patients on long term glucocorticoids (≥3 months) should be encouraged to do weightbearing exercise, avoid smoking and excess alcohol and take fall prevention measures. Daily calcium and vitamin d intake should be sufficient.
Letrozole, sold under the brand name Femara among others, is an aromatase inhibitor medication that is used in the treatment of breast cancer for post-menopausal women. [ 1 ] It was patented in 1986 and approved for medical use in 1996. [ 4 ]
Ovarian stimulation with the aromatase inhibitor letrozole has been proposed for ovulation induction in order to treat unexplained female infertility. In a multi-center study funded by the National Institute of Child Health and Development, ovarian stimulation with letrozole resulted in a significantly lower frequency of multiple gestation (i.e., twins or triplets) but also a lower frequency ...
Letrozole has a 1,2,4 triazole ring which is important for binding with Fe 2+ in the heme moiety of the aromatase enzyme. Also, the cyano benzyl moiety is significant because it partly imitates the steroid backbone of the natural hormone androstenedione.
In pharmacokinetics, a loading dose is an initial higher dose of a drug that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose. [ 1 ] A loading dose is most useful for drugs that are eliminated from the body relatively slowly, i.e. have a long systemic half-life .
In pharmacokinetics, a maintenance dose is the maintenance rate [mg/h] of drug administration equal to the rate of elimination at steady state. This is not to be confused with dose regimen , which is a type of drug therapy in which the dose [mg] of a drug is given at a regular dosing interval on a repetitive basis.
The formula for determining the dose is: [1] If there is a single recommended maintenance dose in the literature, this is preferred. If there are a range of recommended maintenance doses then If the literature recommends generally increasing from initial to maximum dose provided it is tolerated, pick the maximum dose.
Due to the potential complications that can occur as a result of diarrhea in older adults, diacerein is no longer recommended in patients aged 65 years and above. It is also advised that patients start treatment on half the normal dose (i.e. 50 mg daily instead of 100 mg daily), and should stop taking diacerein if diarrhea occurs.
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