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Timing of aromatase inhibitors (AIs) - taking day or night?

Posted by trixie1313 @trixie1313, Mar 7, 2019

I've seen many messages about anastrozole, but does anyone prefer to take this in the morning or evening? I'm wondering if side effects are less via day or night?

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anjalima | @anjalima | Apr 30, 2024
In reply to @diason "For hot flashes, I eat 2 tablespoons of "freshly ground" flax seeds every day, usually mixed..." + (show)
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For hot flashes, I eat 2 tablespoons of "freshly ground" flax seeds every day, usually mixed in oatmeal or other foods. It must be ground and consumed fresh daily. I've tried so many times to skip the flax seeds and the hot flashes come on strong if I don't eat the ground flax seeds. Supposedly the ground flax seeds trap the estrogen in the bowels. I'm 63 and it's been 3 years since diagnosed ER/PR+ Her2-. Just started Anastrozole 6 weeks ago. I take it at night and no problems so far except I am having a terrible time sleeping. I only get 3-4 hours of sleep at night. Not sure if it's the Anastrozole or not. I am also gaining weight but not sure if it's the Anastrozole or Buspirone they put me on for anxiety.

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Look into melatonin for possible sleep relief. It “ may” have benefits beyond sleep for breast cancer . Read up on it and check with provider.

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diason | @diason | Apr 30, 2024
In reply to @anjalima "Look into melatonin for possible sleep relief. It “ may” have benefits beyond sleep for breast..." + (show)
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Look into melatonin for possible sleep relief. It “ may” have benefits beyond sleep for breast cancer . Read up on it and check with provider.

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Thank you. I do take melatonin but it only gets me to sleep quicker but doesn't keep me asleep. I was following Doris Loh and taking high dose melatonin during the day for about a year. I'll revisit that.

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kimogi57 | @kimogi57 | Apr 30, 2024
In reply to @buckimom "@karendb - I decided to take my AI at night. My thinking was if I was..." + (show)
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@karendb - I decided to take my AI at night. My thinking was if I was going to have side effects I’d be asleep. Solid reasoning? Who knows? It’ll be interesting to see what others have done. All the best to you 😊

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I'm doing the same by taking the Anastrozole at night. I am also doing something I haven't talked to my oncologis about because she is out of the office for a few months and I son't want to talk to just any oncologist. I am taking it every other day. When I first started taking it I had Itchy hives on my face. Mostly a swelling spot under my eyes. Since taking it every other day the spot/hives have disappeared. This also happens when I eat things I am sensitive to--mostly tomatoes. I've been taking this for about 2 months. Occasionally I have hot flashes but nothing I can't live with. So far I'm doing well. Just a note, I have a hard time with medications. It seems like if I take 1/2 of most I do better and have no side effects. I see my oncologist in 2 weeks and i will try to get back about what she has to say about every other day. Hugs

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roscop | @roscop | Mar 17, 2025
In reply to @sueinmn "Hello Ruby, It seems that a number of antihistamines have an anti-inflammatory effect. When you think..." + (show)
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Hello Ruby, It seems that a number of antihistamines have an anti-inflammatory effect.
When you think about the mechanisms of allergies (your body is flooded with irritating histamine) and inflammation (overactive immune cells causing irritation) it makes sense that "quieting" reactions helps.
In our family we have long been aware that an allergy flare is often accompanied by a worsening arthritis pain, and that promptly and consistently treating allergy symptoms can avoid a major flare-up. We just didn't know why.
So someone undertook a study to figure out why:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999734/
I don't pretend to understand the whole thing, but it seems "... Loratadine Targets the AP-1 Signaling Pathway to Reduce Inflammatory Responses..." meaning it actually reduces the inflammation, doesn't just mask the pain.
Well, now we have an idea - I can no longer use NSAIDS, so I will be talking to my docs about trying this route!
Sue

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Thank you for commenting because I'm thinking environmental triggers. My pulmonologist mentioned the Loratadine also. I also cannot take Nsaids. I also now have Osteoporosis and Osteoarthritis and can't take Prednisone. I'm 57

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roxanne1414 | @roxanne1414 | Apr 18, 2025

I started taking it 2 weeks ago. At first I felt like they snuff out my spark and then I started having nightmares, not super scary but vivid dreams for sure. I was taking in morning and may switch to night and see if better.

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katrii | @katrii | Apr 18, 2025
In reply to @roxanne1414 "I started taking it 2 weeks ago. At first I felt like they snuff out my..." + (show)
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I started taking it 2 weeks ago. At first I felt like they snuff out my spark and then I started having nightmares, not super scary but vivid dreams for sure. I was taking in morning and may switch to night and see if better.

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I, too had trouble taking Anastrozole, for several reasons. Exemestane works better for me, every other day. Bedtime.

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sally484 | @sally484 | Apr 19, 2025

I do the same as you Katrii. I take Exemestane every other day before I go to bed. When I was on Anastrozole, it made me miserable!!

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ksue3 | @ksue3 | Dec 17, 2025

I am on Exemestane and had been taking it following my breakfast. I also take my other routine meds at that time. I get so tired and sleepy about 2 hours later. My B/P med could do that even though been on it forever without that happening. I have just shifted the Exemestane to noon. Anyone else have that issue? I know fatigue is a huge problem with AI drugs and I guess some of that is to be expected. Just wondering if time of day helps.

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seabright2001 | @seabright2001 | Dec 18, 2025
In reply to @ksue3 "I am on Exemestane and had been taking it following my breakfast. I also take my..." + (show)
Profile picture for ksue3 @ksue3

I am on Exemestane and had been taking it following my breakfast. I also take my other routine meds at that time. I get so tired and sleepy about 2 hours later. My B/P med could do that even though been on it forever without that happening. I have just shifted the Exemestane to noon. Anyone else have that issue? I know fatigue is a huge problem with AI drugs and I guess some of that is to be expected. Just wondering if time of day helps.

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My oncologist told me to take my letrozole at bedtime because it may make you sleepy.

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mistymar | @mistymar | Dec 18, 2025
In reply to @ksue3 "I am on Exemestane and had been taking it following my breakfast. I also take my..." + (show)
Profile picture for ksue3 @ksue3

I am on Exemestane and had been taking it following my breakfast. I also take my other routine meds at that time. I get so tired and sleepy about 2 hours later. My B/P med could do that even though been on it forever without that happening. I have just shifted the Exemestane to noon. Anyone else have that issue? I know fatigue is a huge problem with AI drugs and I guess some of that is to be expected. Just wondering if time of day helps.

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I took Anastrazole in the morning and it had side effects that would seem to hit about 6 hours after I took it - mostly joint pain, some nausea. Switched to evening and it seemed to help. Switched to exemestane a year ago (because of those other side effects) and started that mornings but it did wipe me out about 3pm - would nod off reading or working on computer and have to go lay down. Switched to evenings with this one but didn’t really help much, still extreme fatigue mid day and added insomnia. Currently on a 30 day “holiday” to see if helps. So not sure I can help you with this one.

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