Hormone therapy in oncology and rheumatology encompasses a range of agents that modulate hormonal signalling pathways implicated in cancer growth and autoimmune inflammation. Aromatase inhibitors (AIs) and selective estrogen receptor modulators (SERMs) represent two clinically complementary strategies for managing hormone receptor-positive (HR+) breast cancer: AIs reduce estrogen synthesis by blocking aromatase, while SERMs competitively block estrogen receptors at target tissues. Disease-modifying antirheumatic drugs (DMARDs) including methotrexate are a separately classified group used alongside or independent of hormonal pathways, though methotrexate has oncology applications as well.
These medicines require specialist prescribing and ongoing oncology, haematology, or rheumatology monitoring. They are prescription-only in all markets. The decision to initiate, continue, or switch between agents requires careful risk-benefit analysis, tumour hormone receptor profiling (for oncology indications), and patient-specific comorbidity assessment.
Hormone Therapy Medications at Lucas Clinic
- Arimidex (Anastrozole) — Rx; 1 mg tablets; third-generation aromatase inhibitor; reduces estrogen by blocking aromatase; for HR+ breast cancer in postmenopausal women (adjuvant and advanced disease); taken once daily for 5 years in adjuvant setting
- Methotrexate — Rx; 2.5 mg tablets (also 25 mg/mL injection); antimetabolite folate antagonist; for rheumatoid arthritis and psoriatic arthritis (weekly DMARD dosing); also used in oncology and for ectopic pregnancy; folic acid supplementation required; pregnancy category X
- Nolvadex (Tamoxifen) — Rx; 10/20 mg tablets; selective estrogen receptor modulator (SERM); for ER+ breast cancer adjuvant therapy 5–10 years and high-risk prevention; metabolised by CYP2D6; hot flushes, endometrial cancer risk, thromboembolism monitoring required
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