Side Effects of Levinox:
The side effects of Levinox will cover a wide breadth and will be very similar to Arimidex. Both weakness and fatigue are two of the most common side effects of Levinox use. However, for the anabolic steroid user this will normally not be an issue. The use of anabolic steroids should prevent such states so as long as estrogen suppression isn’t taken too far. The exception would be its use during a hard bodybuilding contest prep cycle. During a harsh bodybuilding diet, the individual will normally be very weak and fatigue at the end of his diet due to tremendously intense training and very low caloric intake. Beyond possible energy issues, the most common side effects of Levinox use include:
- High Blood Pressure
- Hot Flashes
- Joint Pain
Levinox has also been shown to have the ability to notably decrease bone mineral content, which could increase the risk of osteoporosis. This should, however, not be a big risk for the anabolic steroid as most steroids have the ability to promote bone mineral content to a degree, especially Nandrolone. As with all medications and anything we put into our body, the side effects of Levinox will largely surround possible and not guaranteed. We are all different and respond to varying substances differently. This is something you need to keep in mind, and if the side effects of Levinox prove to be too much to handle, alternative medications should be looked at.
The final side effect of Levinox surrounds cholesterol, specifically a reduction in HDL cholesterol. Alone it does not appear to have a strong, statistical impact, but for the anabolic steroid user this can be a concern. Many anabolic steroids already have the ability to negatively affect cholesterol, and when conjoined with an AI it appears to be greatly exasperated. Studies have shown that therapeutic doses of testosterone have very little negative effect on cholesterol but the same doses can suppress HDL cholesterol by as much as 25% when combined with an AI. When testosterone is administered at a supraphysiological level, a minimal level of HDL suppression is normally expected. When the same dosing level is conjoined with an AI data shows that a 20% or greater suppression of HDL cholesterol is a very real possibility.
Due to the possible adverse effects on cholesterol, especially for the anabolic steroid user, a cholesterol friendly lifestyle becomes imperative. A healthy lifestyle will greatly revolve around your diet. Simple sugars and saturated fats should be limited and omega fatty acids should be a large part of your diet. Daily fish oil supplementation is recommended. Many may also find a cholesterol antioxidant supplement to be useful. Further, implementing plenty of cardiovascular activity into your routine is very important. Some type of daily cardiovascular activity is advised.
Because of the potential cholesterol issues, many anabolic steroid users will need to use SERM’s to combat estrogenic side effects when possible. SERM’s won’t always get the job done, but they can work and will work a lot better than many steroid users believe. If an AI is needed, some have suggested that a daily dose of Nolvadex at 10mg per day with your AI could help protect cholesterol levels due to SERM’s actively promoting healthier cholesterol levels.
- Pregnancy, premenopausal women
Effects of Drug Abuse
- See "What Are Side Effects Associated with Using Levinox?"
- See "What Are Side Effects Associated with Using Levinox?"
- Use caution in liver impairment
- May cause dizziness, sleepiness and fatigue
- May increase total serumcholesterol
- Increased risk of osteoporosis
- Avoid concomitant estrogens
- Used off-label to induce ovulation
- Health Canada and Novartis Canada warned against such use
- Use Levinox during pregnancy only in LIFE-THREATENING emergencies when no safer drug is available. There is positive evidence of human fetal risk
- It is unknown if Levinox is excreted in breast milk (for post-menopausal women). Consult your physician if breastfeeding.
Before taking Levinox, tell your doctor or pharmacist if you are allergic to it; or to anastrozole; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: high blood fats (cholesterol), bone problems (such as osteopenia, osteoporosis), stroke or blood clots, heart disease (such as chest pain, heart attack, heart failure), high blood pressure, kidney problems, liver problems.
This drug may make you dizzy or tired or rarely blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or tired. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This medication must not be used during pregnancy. It may harm an unborn baby. Levinox is used mainly in women after menopause. If you have recently gone through menopause, discuss the need for use of reliable forms of birth control while taking this medication and for 3 weeks after stopping treatment with your doctor. Do not use birth control products containing estrogen. Consult your doctor for more details. If you become pregnant or think you may be pregnant, tell your doctor right away. (See also How to Use section.)
It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug and for at least 3 weeks after stopping treatment is not recommended. Consult your doctor before breast-feeding.
For the Consumer
Applies to Levinox: oral tablet
Along with its needed effects, Levinox may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking Levinox:
- Bone fracture
- breast pain
- chest pain
- chills, fever, or flu-like symptoms
- mental depression
- swelling of the feet or lower legs
- Continuing or severe nervousness
- dizziness or lightheadedness
- fast heartbeat
- heart attack
- increased sweating
- pain in the chest, groin, or legs, especially the calves
- severe and sudden, unexplained troubled breathing
- severe, sudden headache
- slurred speech
- sudden loss of coordination
- sudden, severe weakness or numbness in the arm or leg
- swollen glands
- vaginal bleeding
- vision changes
Incidence not known
- Black, tarry stools
- blurred vision
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- chest discomfort
- dark urine
- decreased vision
- dilated neck veins
- extreme tiredness or weakness
- general tiredness or weakness
- increased need to urinate
- irregular breathing
- irregular heartbeat
- light-colored stools
- painful or difficult urination
- passing urine more often
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- unusual bleeding or bruising
- unusual tiredness or weakness
- upper right abdominal pain
- weight gain
- white or brownish vaginal discharge
- yellow eyes and skin
Some side effects of Levinox may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Back pain
- bone pain
- hot flashes (sudden sweating and feeling of warmth)
- joint pain
- muscle pain
- dry mouth
- increased thirst
- loss of appetite or weight loss
- metallic taste
- skin rash or itching
- spinning or whirling sensation causing loss of balance
- stomach pain or upset
- trouble sleeping
Incidence not known
- Bad, unusual, or unpleasant (after) taste and thirst
- being forgetful
- change in taste
- dryness of the skin
- hair loss
- hives or welts
- increased appetite
- red, sore eyes
- redness of the skin
- swelling or inflammation of the mouth
Results of a safety trial in 263 postmenopausal women with resected receptor positive early breast cancer in the adjuvant setting comparing the effect on lumbar spine (L2-L4) BMD of adjuvant treatment with Levinox to that with tamoxifen showed at 24 months a median decrease in lumbar spine BMD of 4.1% in the Levinox arm compared to a median increase of 0.3% in the tamoxifen arm (difference = 4.4%) (P
The following adverse reactions were also identified in less than 5% of the 2049 patients treated with Levinox and not included in the table: fall, vertigo, hyperbilirubinemia, jaundice, and chest pain.
Levinox and Grapefruit Juice
You should avoid eating grapefruit and drinking grapefruit juice while taking Levinox.
Grapefruit juice slows down how quickly the body is able to break down the Levinox, which could cause Levinox levels in the blood to rise dangerously high.
What are some things I need to know or do while I take Levinox?
- Tell all of your health care providers that you take Levinox. This includes your doctors, nurses, pharmacists, and dentists.
- Avoid driving and doing other tasks or actions that call for you to be alert until you see how Levinox affects you.
- This medicine may cause weak bones. This may happen more often if used for a long time. This may raise the chance of broken bones. Call your doctor right away if you have bone pain.
- Have a bone density test as you have been told by your doctor. Talk with your doctor.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- Take calcium and vitamin D as you were told by your doctor.
- If you are 65 or older, use Levinox with care. You could have more side effects.
- This medicine may affect fertility. Fertility problems may lead to not being able to get pregnant or father a child. Talk with the doctor.
- This medicine may cause harm to the unborn baby if you take it while you are pregnant.
- If you are able to get pregnant, a pregnancy test will be done to show that you are NOT pregnant before starting Levinox. Talk with your doctor.
- Use birth control that you can trust to prevent pregnancy while taking Levinox and for at least 3 weeks after your last dose.
- If you get pregnant while taking Levinox or within 3 weeks after your last dose, call your doctor right away.
Use in Cancer
Levinox is approved to be used alone or with other drugs to treat:
- Breast cancer in postmenopausal women who have any of the following types of breast cancer--
- Early-stage, hormone receptor–positive (HR+) breast cancer in women who have already received other treatment.
- Early-stage breast cancer that has been treated with tamoxifen citrate for at least five years.
- Breast cancer that is locally advanced or has metastasized (spread to other parts of the body), is HER2 positive (HER2+) and HR+.
- Breast cancer that is locally advanced or has metastasized and it is not known whether the cancer is HR+ or hormone receptor negative (HR-).
- Advanced breast cancer that has gotten worse after antiestrogentherapy.
Levinox is also being studied in the treatment of other types of cancer.
Levinox is an anti-estrogen of the Aromatase Inhibitor (AI) family and is one of the most potent and powerfully effective of all AI’s. In fact, its potency is sometimes too much for some to handle when used for off label use. Levinox first gained U.S. FDA approval in 1997 and would hit the market under the brand name Femara through Novartis. Although Femara is the dominating trade name of the AI, unlike most AI’s it is the only one generally known by its chemical name Levinox far more commonly than its dominating brand name.
Levinox was first developed in an effort to combat breast cancer in post-menopausal women. In fact, it would prove to be virtually identical to the already popular AI in Arimidex (Anastrozole). While intended for breast cancer treatment, like many AI’s, it has found a welcomed home among anabolic steroid users. Levinox is one of the most commonly used anti-estrogens among steroid users during steroid use to combat possible estrogenic related side effects. It is so effective as an anti-estrogen in this regard many anabolic steroids have effectively reversed gynecomastia symptoms with Levinox.
After a median of 8 years of follow-up from a large randomized trial, women with estrogen receptor positive breast cancer who received 5 years of treatment with the aromatase inhibitor Levinox were less likely to have their cancer recur or to die during follow-up than women who had 5 years of treatment with tamoxifen. In addition, 5 years of sequential treatment—either 2 years of Levinox followed by 3 years of tamoxifen or 2 years of tamoxifen followed by 3 years of Levinox—was not better than 5 years of Levinox alone at preventing recurrence or death. These results, from the BIG 1-98 trial, were published online October 20, 2011 in Lancet Oncology.
Researchers from 27 countries enrolled 8,010 postmenopausal women with invasive breast cancer that could be removed surgically in the trial. After surgery, the women were randomly assigned to one of four groups: 5 years of Levinox (Levinox monotherapy), 5 years of tamoxifen (tamoxifen monotherapy), or one of the two sequential treatment groups. Novartis, the maker of Levinox, provided funding for the trial, along with NCI and the International Breast Cancer Study Group.
In 2005, preliminary results from the trial showed that Levinox alone was better than tamoxifen at preventing early recurrences, and when given the option to cross over, 619 of the 2,459 women in the tamoxifen-only arm chose to cross over to receive Levinox. Since crossover can complicate interpretation of trial results, the researchers performed a traditional intention-to-treat analysis (which includes only data from the original treatment assignments) and a type of analysis designed to account for crossover.
In the intention-to-treat analysis, women who received Levinox alone had a disease-free survival rate of 73.8 percent at 8 years, compared with a rate of 70.4 percent for women who received tamoxifen alone. Women who received Levinox alone also had better overall survival at 8 years than women receiving tamoxifen alone (83.4 versus 81.2 percent). The differences between the groups were slightly greater in the analysis accounting for the crossover. Neither of the two sequential treatments provided better results than Levinox alone.
Although these updated results show that Levinox reduces risk of relapse and improves survival compared with tamoxifen, "use of a sequence might be reasonable for patients at low-to-intermediate risk of relapse, those for whom starting or continuing Levinox is contraindicated, or in cases where 5 years of Levinox might not be available," concluded the authors.