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Exemestane (Aromasin)

Warning:  Reductions in bone mineral density (BMD) over time are seen with exemestane use. The medication can cause potential drug interactions in patient suffering from liver or kidney problems. Therefore, before you begin treatment you should tell your oncologist if you have kidney disease, liver disease, and osteoporosis.

 

Indications: Exemestane is used to treat certain types of breast cancer and is one of several drugs known as aromatase inhibitors.  Some breast cancer cells use estrogen as a source of nourishment and to spread.  This drug stops the making of estrogen in the body, thus slowing down the spread of the cancer cells.  It is used mainly on women who have already gone through the menopausal cycle and is used not only to slow cancer growth but also to prevent the cancer from coming back.

While extremely rare, there have been some cases involving serious side effects such as mood changes, depression, anxiety, vaginal bleeding, small bone fractures, and blood clots.  There are also reported instances where the blood clots resulted in heart attack and stroke, so it is important to contact your physician at once if you exhibit these symptoms.  If you experience more serious effects such as shortness of breath, numbness on the left side, chest pain, vision problems, or pain in the groin, you should notify your doctor as soon as possible.

 

Exemestane has several common side effects and these include:  diarrhea, joint or muscle pain, abnormal sweating from the glands, hair loss, hot flashes, and nausea.  While irritating, they are normal, but if you have concerns, you should address them with your doctor.  Any symptom that appears to be more severe should be reported to your doctor as well.

 

Dosage:  Exemestane comes in tablet form to be taken by mouth. When using the medication for the first time and upon each refill of the prescription, it is important to read everything that you are given to read concerning this drug.  This drug is taken once a day orally in a pill form and should be taken while eating or immediately after.  Do not stop taking this drug unless directed to do so by your doctor. 

Overdose:  all chemotherapy drugs including Exemestane  can cause serious health problems when overdosed. Contact your doctor or a local poison control center near you immediately if you experience symptoms indicating Exemestane  overdose.   Do not neglect to see your physician; an overdose of Exemestane can lead to death.

Missing dose:  in case you forget to take a dose of Exemestane  , take the missed one as soon as you remember if it is not almost times for the following dose; do not  double the next dose to recover the missed one; it can be dangerous. You can contact your doctor or wait to go back to your regular schedule.  

Contraindications  : Exemestane is contraindicated for children and women who are:  

 

  • pregnant 
  • breastfeeding 
  • premenopausal  
  • being treated with estrogen   
  • Allergic to Exemestane or one of its constituents.   

Before beginning a breast cancer treatment with Exemestane, tell your doctor if you have any of these health problems:  

  • Severe liver failure  
  • chronic kidney failure   
  • Glucose and galactose malabsorption.   

Mechanism of action (MOA):  Exemestane is an enzyme inhibitor that is used in the treatment of hormone-receptor-positive (or estrogen-responsive) breast cancer. It works by reducing the amount of estrogen produced by the body which cancer cells need to live.  

Interactions: Some drugs and herbal treatments are known to remove this drug at a faster rate from your body than normal absorption.  Therefore, it is important to tell your doctor of all medications, herbs, and herbal treatments that you are using.  Your doctor will need to know this so that an adjustment in your dose may be made, if necessary.

 

Any drugs containing estrogen in them should be avoided while taking Exemestane to prevent a reduction in the effectiveness of this drug.

 combination of Exemestane with carbamazepine (Carbatrol, Epitol, and Tegretol) and all treatments containing estrogens is not recommended.

The following drugs can affect the healing action of Exemestane, or increase the risk of side effects. talk to your doctor before taking any of the following:  

  • phenobarbital   
  • Phenytoin (Dilantin)  
  • Rifampin (Rifadin, in Rifater, in Rifamate)  
  • hormone replacement therapy   
  • Hormonal contraceptives: birth control pills, patches, rings, and injections.  

Also, do not consume the following without first talking to your health care provider:

  • cigarette
  • decongestants
  • St John's wort 

Side effects: in the combat against breast cancer cells, Exemestane can bring good results; however, by attacking cancer, the drug also affect healthy cells that multiply rapidly, which can cause adverse effects in most patients. The most common Exemestane side effects include:  

  • diarrhea
  • hair loss
  • red, itchy skin
  • hot flushes
  • sweating

Exemestane can cause serious side effects which require immediate medical attention; contact your doctor immediately if you experience any of these symptoms: 

  • chest pain 
  • shortness of breath  
  • Difficulty swallowing or breathing.