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Exemestane is a selective, irreversible steroid Aromatase inhibitor that prevents the conversion of Androgen to Estrogen in peripheral tissues. The drug is therefore often used to treat certain types of breast cancer or to prevent the cancer from coming back.
1. Uses of the drug Exemestane
Drug Exemestane 25mg works to prevent the conversion of Androgen to Estrogen in peripheral tissues, thereby reducing the amount of circulating Estrogen in patients (Estrogen is a growth factor of breast cancer). Exemestane has a particularly favorable mechanism of action over other drugs because it irreversibly binds to the estrogen-producing enzyme, preventing estrogen production, until a new enzyme is produced. This causes the tumor to be "starved" of estrogen, unable to grow.
Exemestane is indicated in the following cases:
Late-stage breast cancer in postmenopausal women (natural or artificial) after failure of treatment with anti-estrogen drugs; Adjuvant treatment of early-stage, estrogen-receptor-positive breast cancer in postmenopausal women after an initial 2-3 year course of Tamoxifen.
2. How to use Exemestane?
Exemestane is used orally, after meals. The reference dose is usually 25 mg/day and must be maintained until there is evidence of tumor reduction. Patients with early breast cancer must take the drug for as long as 5 years under sequential adjuvant therapy (Tamoxifen followed by Exemestane). If tumor recurs, discontinue Exemestane.
Patients with advanced breast cancer must take Exemestane until there are signs of good disease progression. In addition, patients need to be supplemented with vitamin D and calcium. Because this medicine is absorbed through the skin and lungs, women who are pregnant or may become pregnant should not handle or breathe dust from the tablets.
3. Side effects of the drug Exemestane
Exemestane is contraindicated in cases of allergy to any of its ingredients, non-menopausal women, pregnant women or suspected pregnancy. The undesirable effects that may be encountered when taking the drug include:
Increased blood pressure; Fatigue, insomnia, headache, depression; Sweatwear; Hot flashes; Nausea, abdominal pain; Athritis; Edema, myocardial ischemia, angina; Dermatitis, rash; Shortness of breath, bronchitis , rhinitis, sinusitis; Flu-like syndrome. The majority of side effects are due to estrogen depletion, mainly monitoring manifestations and supportive symptomatic treatment. In addition, osteoporosis should be prevented by monitoring bone density, supplementing vitamin D and calcium in the diet.
4. Drug interactions with Exemestane
Common drug interactions with Exemestane are:
CYP3A4 isoenzyme inducers such as Rifampicin, Phenytoin, Deferasirox reduce Exemestane concentrations. Therefore, the dose of Exemestane should be increased to 50 mg/day in patients receiving these drugs concomitantly; Hypericum perforatum reduces the concentration of Exemestane; Sangma or sugar should not be used in patients with estrogen-dependent breast cancer; Do not use concomitantly with estrogen-containing drugs because of the loss of effect of Exemestane; Exemestane reduces the concentration and effect of Maraviroc (a drug that prevents HIV from entering CD4 T cells by blocking the CCR5 receptor). In a nutshell, Exemestane is commonly used to treat certain types of breast cancer or to prevent the cancer from coming back. Patients need to use the drug exactly as prescribed by the doctor to ensure safety and maximize the effectiveness of treatment.
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