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Foods to Avoid (and to Eat) When Taking Anastrozole

Navigating Treatment

February 22, 2024

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Photography by J. Anthony

Photography by J. Anthony



Medically Reviewed by:

Philip Ngo, PharmD




Medically Reviewed by:

Philip Ngo, PharmD


You don’t have to strictly avoid any foods when you’re taking anastrozole, but there are a few to keep an eye on. Some herbal supplements may also cause drug interactions.

If you’re taking anastrozole, you may wonder what you should and should not eat while taking it.

You can focus your diet on reducing short-term side effects of anastrozole, like nausea, and preventing potential longer-term side effects, like bone loss and heart issues.

Letting your doctor know your specific concerns is your best bet. They can help you choose foods to reduce your side effects and protect against longer-term health challenges.

Read on to get the details on diet and anastrozole.

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What is anastrozole?

Anastrozole (Arimidex) is a drug doctors prescribe to treat and manage breast cancer.

It’s from a class of drugs called aromatase inhibitors. These stop the action of an enzyme called aromatase, which normally converts androgens, like testosterone, to estrogens.

This is the main way the body produces estrogens. That’s why aromatase inhibitors can significantly reduce your levels of estrogen.

Reducing estrogens with anastrozole and other aromatase inhibitors can slow the growth of hormone receptor-positive breast cancer.

Doctors sometimes prescribe anastrozole off-label at a low dose with testosterone replacement therapy for males with low testosterone.

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30+ foods to avoid while taking anastrozole

There are no foods you need to 100% stop eating when taking anastrozole. Instead, consider avoiding or limiting foods that may trigger medication side effects for you. (See more on the side effects of anastrozole below.)

To avoid nausea

If you’re experiencing nausea or vomiting, consider avoiding or limiting:

  • fried foods, such as french fries, fried chicken, fish and chips, tempura, fried rice, or potato balls, like arancini
  • spicy foods, like curries and peppery or garlicky foods, or dishes that contain a lot of aromatic spices
  • highly acidic foods, like lemons, oranges, and tomatoes
  • foods with a strong smell, such as those that contain garlic, onion, or other spices
  • carbonated beverages, including soda and carbonated water
  • caffeinated drinks and foods, like coffee, tea, cola, and cocoa
  • large quantities of any food, as eating large quantities may contribute to nausea

To reduce hot flashes

If you’re experiencing hot flashes, consider avoiding or limiting:

  • alcoholic beverages, like beer, wine, and cocktails
  • spicy food, like curries and peppery or garlicky foods or sauces
  • caffeine, like coffee, tea, and cola

To prevent bone density loss

If you’re experiencing or are concerned about bone density loss, consider avoiding these foods linked to lower bone density:

  • high salt foods, like canned and packaged foods, processed meat, and aged cheese
  • foods high in simple sugars, like cake, cookies, many types of breakfast cereal, juice, and candy
  • alcoholic beverages, like beer, wine, and spirits

To improve your sleep

If you’re having difficulty sleeping, consider avoiding caffeinated foods, including:

  • coffee
  • caffeinated tea, like black or green tea
  • cocoa and chocolate
  • caffeinated cola or other soda

To promote your heart health

To promote the health of your heart and blood vessels, you can help reduce the risk of anastrozole’s cholesterol side effects by limiting certain foods.

For optimal heart health, the National Heart, Lung, and Blood Institute recommends limiting:

  • added sugars, like sugary snacks and sweetened drinks
  • salty foods
  • saturated fats
  • alcohol

20+ foods to eat while taking anastrozole

Again, there are no absolute musts here.

What you eat when taking anastrozole should mainly focus on maintaining your overall health and preventing any short- and long-term side effects.

For heart health

For optimal heart health, the National Heart, Lung, and Blood Institute recommends prioritizing:

  • protein-rich foods
  • low fat dairy
  • monounsaturated fats, like olive oil or avocado oil
  • fatty fish
  • nuts and seeds
  • soy products, like tofu
  • whole grains, like whole grain bread or tortillas, oatmeal, or brown rice
  • fruits
  • vegetables

For bone health

Since anastrozole is sometimes associated with weakened bones, eating foods to protect your bones may help.

Overall, a balanced diet rich in fruits, vegetables, dairy, and lean meat, like fish, is great for your bones. Aim to get lots of vitamins, fiber, and protein, which all support bone health.

Get vitamin D and try to eat 4–8 servings of calcium-rich foods each day, including:

  • low fat milk
  • yogurt
  • cheese
  • green leafy vegetables
  • nuts and seeds
  • beans and legumes
  • calcium-fortified juices and other foods

You can get vitamin D from supplements, sun exposure, and certain foods, such as salmon, sardines, and other fatty fish.

Fun fact: According to the Bone Health and Osteoporosis Foundation, eating 5–6 prunes per day may help lower the risk of hip fractures. Scientists believe this may be partly thanks to their high vitamin K content, which may support calcium balance.

For preventing and treating nausea and vomiting

When you’re feeling nauseous while taking anastrozole, consider trying:

  • ice chips
  • water
  • sports drinks
  • ginger ale
  • soothing herbal tea, like mint
  • lemonade
  • broth

When the nausea starts going away, you can start to consume more nutritious foods, such as:

  • fruit
  • yogurt
  • fruit smoothies
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How to take anastrozole safely and effectively

Pharmacists usually offer anastrozole in 1-milligram (mg) tablets, which you take orally once per day. It doesn’t matter whether you take it with food or on an empty stomach. Both are OK.

Take the tablet whole with a drink of water. Don’t chew or crush it into food.

It doesn’t matter what time of day you take it, but experts recommend taking it at the same time every day and continuing your prescription for as long as your doctor recommends.

If you miss a day, just continue the next day at your normal time. Don’t make up for the missed dose.

Anastrozole should not be taken at the same time as tamoxifen, a common cancer drug, unless your doctor prescribes it.

Do not take anastrozole at the same time as estrogen replacement therapy drugs, such as Premarin, Estrace, Estraderm, and others.

Managing anastrozole side effects

People taking anastrozole usually tolerate it well, and side effects are rare.

Taking anastrozole may affect your bone density, blood pressure, and cholesterol levels, so your doctor will likely monitor these and test them regularly.

When you’re taking anastrozole, you might experience symptoms similar to those a person would experience in menopause, including:

  • hot flashes and sweating
  • vaginal dryness
  • skin or hair changes, like hair loss or rashes
  • fatigue
  • trouble sleeping
  • muscle weakness
  • joint pain

The menopause-like side effects tend to go away over time as your body gets used to the medication.

Allergies and intolerances

Allergies to anastrozole are also possible. Speak with a healthcare professional right away if you experience symptoms of an allergic reaction after taking it.

Anastrozole tablets typically contain a small amount of lactose, which doesn’t affect most people but is important to note if you’re allergic to lactose or lactose intolerant.

Anastrozole is not recommended for people who are or may become pregnant.

Side effects in men and women

These side effects are common in females, which is the main group to whom doctors prescribe anastrozole.

But males may also take anastrozole or other aromatase inhibitors if their bodies produce excess estrogen, which can lead to various health conditions, including gynecomastia (breast pain) and fertility challenges.

Males may experience similar side effects of anastrozole, including reduced bone mineral density.

Anastrozole does not affect semen volume, sperm motility, or sperm count, according to research.

Ways to manage side effects

If you experience joint pain, it may be worth asking your doctor to test your vitamin D levels. Taking vitamin D can help reduce this symptom if you have low levels.

You may also want to try acupuncture. Research has also found it helped some people who experienced joint pain as a side effect of taking aromatase inhibitors like anastrozole.

Getting regular exercise can also help reduce side effects in a few ways. It can help build and maintain your joints and bones, guarding against joint pain and bone loss.

Exercise can also help manage body fat percentage, which helps reduce the estrogen produced in your fat cells. This can help lower your circulating levels of estrogen — which is the goal of anastrozole and how it treats hormone-sensitive breast cancer.

To manage the side effects of anastrozole, keep in close contact with your doctor and update them on any new symptoms you’re experiencing or concern you have.

Doing so helps them monitor your condition and recommend new approaches and testing as needed.


Anastrozole doesn’t have many drug interactions overall.

But it may be an issue if you’re taking certain medications, including:

  • aripiprazole (Abilify), pimozide (Orap), and other antiseizure medications
  • dofetilide (Tikosyn) and other heart medications
  • hydrocodone (Vicodin), methadone (Dolophine), and other pain medications

Avoid herbal supplements that contain phytoestrogens or increase estrogens in the body. Some of these are marketed as natural treatments for menopause symptoms.

The following herbal supplements may be dangerous if you take them in concentrated doses while taking anastrozole, but they are not harmful if you eat small amounts as part of regular meals:

  • aletris
  • alfalfa
  • androstenediol
  • androstenedione
  • anise
  • black or blue cohosh
  • chasteberry
  • deer velvet
  • diindolylmethane (DIM)
  • dong quai
  • fennel
  • flaxseed
  • ginseng
  • guggul
  • isoflavones (plant estrogens)
  • hu zhang
  • kudzu
  • licorice plant
  • maca
  • milk thistle
  • noni juice
  • Panax ginseng
  • red clover
  • red raspberry leaf
  • resveratrol
  • saw palmetto
  • scarlet pimpernel

Whey protein is another source of phytoestrogens to consider avoiding. It’s often included in protein drinks and bars, so read the label before you buy.

If you’re taking supplements for menopause or other reasons, make sure to tell the doctor who prescribed your anastrozole.

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Frequently asked questions

Here are quick answers to the most frequently asked questions about what to eat when you’re taking anastrozole.

What not to eat while on anastrozole?

There are no specific foods you must absolutely avoid when taking anastrozole. You don’t strictly have to avoid alcohol, either.

However, whey protein may alter the drug’s effectiveness, so it may be best to avoid it. It’s a common protein source used in high protein foods, like protein bars, drinks, and smoothies, so double-check food labels.

You might also want to avoid certain foods and drinks to reduce side effects you’re experiencing:

  • If you’re experiencing nausea, avoid or limit fried foods, spicy foods, and acidic foods.
  • If you’re having sleep difficulties, avoid or limit caffeinated beverages.
  • If you’re having hot flashes, avoid or limit spicy foods or sauces, alcohol, and caffeinated foods and beverages.
  • If you’re concerned about reduced bone density, avoid or limit high salt and sugary foods and alcohol.
  • If you want to maintain healthy cholesterol levels, avoid or limit salt, added sugar, alcohol, and saturated fats.

What vitamins should not be taken with anastrozole?

There are no vitamins you cannot take alongside anastrozole.

But experts recommend avoiding or limiting supplements, including herbal supplements, that contain estrogens and phytoestrogens while you’re taking anastrozole.

These include aletris, alfalfa, androstenediol, androstenedione, anise, black or blue cohosh, chasteberry, deer velvet, diindolylmethane (DIM), dong quai, fennel, flax seed, ginseng, guggul, isoflavones (plant estrogens), hu zhang, kudzu, licorice plant, maca, milk thistle, noni juice, Panax ginseng, red clover, red raspberry leaf, resveratrol, saw palmetto, and scarlet pimpernel.

What foods block estrogen in breast cancer?

Hundreds of foods and herbal products act as natural aromatase inhibitors, which lower the production of estrogen in the body.

Black or green tea, coffee, and cocoa have very high aromatase inhibitor activity.

Other foods with lower but still significant activity include asparagus, mushrooms (including white button, cremini, almond, and portobello), Spanish onions, green onions, mustard greens, collards, kale, romaine lettuce, parsley, and spinach.

Is it better to take anastrozole at night?

In general, experts recommend taking anastrozole at a consistent time of day that’s best for you. It doesn’t have to be at night.

However, if you’re experiencing hot flashes as a side effect of taking anastrozole, some healthcare professionals say taking it right before bed may help ease this symptom.

Does anastrozole prevent other cancers?

Doctors mainly prescribe anastrozole to treat breast cancer in females and males, but occasionally they prescribe it to prevent breast cancer in people with a high risk of developing breast cancer.

Sometimes, healthcare professionals prescribe anastrozole to treat prostate cancer.

Beyond this, anastrozole is not typically used to prevent other cancers.


No food is completely off-limits when taking anastrozole unless your doctor says so. But you might want to avoid or limit certain foods that can cause anastrozole side effects.

Keep your doctor up to date on what side effects you’re experiencing. They can advise you about what foods to avoid and eat to help optimize your treatment and help you feel at your best.

Medically reviewed on February 22, 2024

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