Letrozole (Femara) is a medication often used to treat a specific type of breast cancer called hormone receptor-positive breast cancer. It works by reducing levels of the hormone estrogen in the body. This, in turn, helps stop the spread of certain cancer cells that rely on estrogen to grow.

Some common side effects of letrozole include lower bone density, higher cholesterol levels, and fatigue. Being mindful of your diet and lifestyle while taking letrozole can help minimize the risk of certain side effects and help you feel your best.

Check out three foods you may want to avoid while taking letrozole. Note that what you eat doesn’t change how your body absorbs letrozole.

1. Grapefruit

Grapefruit and grapefruit juice contain compounds that can interfere with the enzymes responsible for breaking down several medications. The manufacturers of letrozole don’t list grapefruit as causing a drug interaction with the medication, but combination therapies containing letrozole and ribociclib do interact with grapefruit juice.

If you’re a fan of grapefruit, double-check with your healthcare provider to see if it’s safe to eat or drink with your medication.

2. High-Fat Dairy Products

Calcium is important for your health, and if you take letrozole, it’s especially important to get enough because the drug can weaken your bones over time. Regular exercise can also lower your risk of osteoporosis, a disease that makes bones weaker and more likely to break. Ask your oncology provider about what types of exercise are safe for you.

Pick calcium-rich foods that don’t have a lot of extra saturated fat. High-fat dairy foods like ice cream and cheese can raise cholesterol levels, which is already a possible side effect of letrozole. Choose leaner sources of dairy, like low-fat Greek yogurt and cottage cheese, to maintain a healthy heart.

Your healthcare provider will also monitor your cholesterol while you’re on letrozole to watch for elevated levels and recommend additional treatment if needed.

3. Alcoholic Beverages

You may have wondered: Can you drink on letrozole? Drinking alcohol can be risky if you’re taking letrozole. Some publications list alcohol as a type of food. Alcohol can affect liver function and interfere with how your body processes medications, including letrozole.

Alcohol might also make certain side effects of letrozole worse, like hot flashes, dizziness, and fatigue. While you’re on treatment, limit how much alcohol you drink, or you may want to avoid it completely. This includes over-the-counter medications like cough syrup that contain alcohol.

Additional Tips To Keep in Mind

Talk openly with your healthcare provider about your diet and any supplements you’re taking or thinking about taking. They can provide personalized guidance based on your medical history and treatment plan.

You May Need To Switch Medications

If you’re struggling with unpleasant side effects, your doctor may be able to switch you to another treatment. “I was miserable on letrozole with pain and insomnia. My oncologist switched it to anastrozole, and I’m much better. They are very similar meds, but he says one of the meds might be easier for some people,” explained a MyBCTeam member.

Your Body Might Need Time To Adjust

Other MyBCTeam members found that they just needed to give their bodies some time to adjust. “I found that letrozole side effects evolve over time,” another member wrote. “I’ve been on it for 2.5 years, and at the four- to six-month mark, I think my body finally adjusted, and the side effects didn’t bother me so much. I do exercise and stretch daily, which helps.”

Eat a Healthy, Balanced Diet

No matter where you are in your breast cancer journey, try to follow a balanced diet that supports your overall health. Focus on whole foods, fruits, vegetables, lean proteins, and whole grains. In addition, drinking plenty of water can help support your body’s normal metabolic processes, including the breakdown and elimination of medications.

If you’re having trouble planning healthy meals, a registered dietitian nutritionist can help. Ask your doctor for a referral, or call your health insurance company to find providers in your network.

Find Your Team

On MyBCTeam, people share their experiences with breast cancer, get advice, and find support fro others who understand.

If you’ve taken letrozole, did you have any serious side effects? Let others know in the comments below.