by Altraz (Anastrozole) vs. Top Aromatase Inhibitor Alternatives - Full Comparison
6 Oct, 2025Altraz vs. Other Aromatase Inhibitors Comparison Tool
Select two drugs and click "Compare" to see their differences.
Quick Takeaways
- Altraz (anastrozole) is a third‑generation aromatase inhibitor approved for hormone‑receptor‑positive breast cancer.
- Its main rivals are Aromasin (exemestane), Letrozole, Tamoxifen, and Fulvestrant.
- All five drugs suppress estrogen but differ in reversibility, side‑effect profile, and dosing convenience.
- Natural extracts such as chrysin or diindolylmethane may lower aromatase activity, yet they lack the potency and clinical data of prescription inhibitors.
- Choosing the right option hinges on cancer stage, previous therapy, cost, and individual tolerance.
What is Altraz (Anastrozole)?
Altraz is the brand name for anastrozole, a selective aromatase inhibitor that blocks the enzyme aromatase from converting androstenedione and testosterone into estradiol.
Approved by the FDA in 2002, Altraz is taken orally, usually 1mg once daily, and is prescribed after surgery or radiation for post‑menopausal women with estrogen‑receptor‑positive (ER+) breast cancer.
How does an aromatase inhibitor work?
The Aromatase enzyme (CYP19A1) resides mainly in adipose tissue, placenta, and the brain. By inhibiting CYP19A1, anastrozole reduces circulating estradiol to less than 10% of baseline levels, depriving hormone‑sensitive tumors of a key growth signal.
Because anastrozole binds reversibly, its effects subside within 48hours after stopping the drug, allowing clinicians to fine‑tune therapy.
Key attributes of Altraz
- Dosage: 1mg oral tablet once daily.
- Approval: FDA‑approved for adjuvant treatment of stageI‑III ER+ breast cancer in post‑menopausal women.
- Typical use: Post‑surgical adjuvant therapy, sometimes extended to five years.
- Cost (2025 US market): Approximately $150‑$200 for a 30‑day supply (generic version cheaper).
- Common side effects: Joint pain, hot flashes, mild bone density loss, nausea.
Alternatives to Altraz
The following drugs are the most widely used alternatives in clinical practice.
Aromasin (Exemestane)
Exemestane is a steroidal, irreversible aromatase inhibitor. It covalently binds to the enzyme, leading to longer suppression even after a missed dose.
- Dosage: 25mg oral daily.
- Approved for post‑menopausal women with early‑stage breast cancer and for patients who progressed on non‑steroidal inhibitors.
- Side‑effect profile includes slightly higher rates of insomnia and gastrointestinal upset, but lower incidence of joint pain compared with anastrozole.
Letrozole
Letrozole is another non‑steroidal inhibitor, chemically similar to anastrozole but with a longer half‑life (≈2days).
- Dosage: 2.5mg oral daily.
- Used both as adjuvant therapy and as first‑line hormonal treatment for metastatic ER+ breast cancer.
- Patients often report more severe hot flashes but comparable bone density loss.
Tamoxifen
Tamoxifen is a selective estrogen receptor modulator (SERM) rather than an aromatase inhibitor. It blocks estrogen receptors in breast tissue while acting as an estrogen agonist in bone and uterine tissue.
- Dosage: 20mg oral daily.
- Historically the first‑line hormonal therapy; still preferred for pre‑menopausal patients.
- Unique side effects: increased risk of endometrial cancer and blood clots.
Fulvestrant
Fulvestrant is an estrogen receptor degrader (SERD) administered by intramuscular injection. It completely removes estrogen receptors from cancer cells.
- Dosage: 500mg IM on days0,14,28, then monthly.
- Used for metastatic disease after progression on aromatase inhibitors.
- Side effects are generally mild but injection site pain is common.
Natural aromatase inhibitors
Compounds like Chrysin (found in passionflower), Resveratrol (red grapes), and Diindolylmethane (cruciferous vegetables) have shown modest aromatase‑inhibiting activity in vitro. Clinical trials are limited, and dosing is not standardized.
Side‑by‑Side Comparison
| Attribute | Altraz (Anastrozole) | Aromasin (Exemestane) | Letrozole | Tamoxifen (SERM) | Fulvestrant (SERD) |
|---|---|---|---|---|---|
| Mechanism | Reversible non‑steroidal aromatase inhibitor | Irreversible steroidal aromatase inhibitor | Reversible non‑steroidal aromatase inhibitor | Selective estrogen receptor modulator | Estrogen receptor degrader (injectable) |
| Typical dose | 1mg daily | 25mg daily | 2.5mg daily | 20mg daily | 500mg IM monthly |
| FDA‑approved use | Adjuvant therapy for post‑menopausal ER+ breast cancer | Adjuvant & post‑progression after non‑steroidal AI | Adjuvant & metastatic ER+ breast cancer | Adjuvant for pre‑ and post‑menopausal patients | Metastatic disease after AI failure |
| Cost (2025 US) | $150‑$200/30‑day supply | $180‑$230/30‑day supply | $170‑$220/30‑day supply | $120‑$160/30‑day supply | $2,000‑$2,500/4‑injection cycle |
| Key side effects | Joint pain, hot flashes, mild bone loss | Insomnia, GI upset, lower joint pain | Severe hot flashes, bone loss | Endometrial cancer risk, clotting | Injection site pain, mild nausea |
When to Choose Altraz over the Others
If you’re weighing Altraz against other options, consider these factors:
- Post‑menopausal status: Altraz, Aromasin, and Letrozole all require low estrogen baselines, making them ideal for post‑menopausal women.
- Convenient dosing: A once‑daily oral tablet is easier for most patients than weekly injections (Fulvestrant) or the higher pill burden of some regimens.
- Bone health concerns: Tamoxifen actually protects bone in post‑menopausal women, so if osteoporosis is a major issue, a SERM might be preferable.
- Cost sensitivity: Generic anastrozole is the least expensive prescription AI, while Fulvestrant remains the priciest.
- Previous AI exposure: Patients who progressed on a non‑steroidal AI often switch to Aromasin because of its irreversible binding.
Practical Tips & Common Pitfalls
- Always confirm menopausal status with serum estradiol; using a non‑steroidal AI in a pre‑menopausal woman can trigger ovarian stimulation.
- Monitor bone mineral density (DEXA) at baseline and annually; supplement with calcium and vitaminD as needed.
- Joint pain is the most frequent complaint-low‑impact exercise and occasional NSAIDs can help.
- If severe hot flashes are intolerable, discuss switching to an alternative AI or adding a low‑dose SSRI.
- Never combine two estrogen‑lowering agents without specialist guidance; additive toxicity can be significant.
Frequently Asked Questions
Can men use Altraz for low testosterone?
Off‑label use of anastrozole in men is sometimes employed to curb high estrogen levels that accompany testosterone therapy. Doses are usually 0.5mg weekly, but the practice lacks large‑scale trial data, so it should only be done under endocrinology supervision.
How long should I stay on Altraz after surgery?
Standard guidelines recommend five years of continuous therapy for most post‑menopausal patients, though some clinicians stop after two to three years if the tumor was low‑risk and the patient experiences intolerable side effects.
Is there a big difference in effectiveness between Altraz and Letrozole?
Head‑to‑head trials (e.g., the BIG 1‑98 study) showed virtually identical disease‑free survival rates for anastrozole and letrozole. Choice usually comes down to side‑effect profile, dosing convenience, and cost.
Can natural aromatase inhibitors replace prescription options?
Natural compounds may modestly lower estrogen but never achieve the >90% suppression needed for treating ER+ breast cancer. They can be considered adjuncts for wellness, not as primary therapy.
What should I do if I experience severe joint pain on Altraz?
First, discuss dose timing with your oncologist-sometimes taking the tablet in the evening helps. Physical therapy, omega‑3 supplements, and occasional acetaminophen are common mitigations. If pain persists, a switch to Aromasin or Letrozole may be advisable.
lindsey tran
October 6, 2025 AT 15:41Altraz is a game‑changer for many folks!
Krishna Sirdar
October 17, 2025 AT 01:41Reading through the comparison, it’s clear that each AI has its own niche. Anastrozole’s reversible binding makes dose adjustments relatively straightforward. If you’re worried about bone health, keep an eye on your DEXA scores and consider supplemental calcium. Many patients find the joint pain manageable with gentle exercise. Overall, the choice should align with your menopausal status and prior therapy history.
becca skyy
October 27, 2025 AT 11:41The table really helps visualise the differences. I like that letting the cost be upfront makes budgeting easier. Letrozole’s longer half‑life can be a blessing if you forget a dose. Still, the hot‑flash profile varies a lot from person to person. Bottom line: talk with your oncologist about what side‑effects you can tolerate.