Exemestane | for adjuvant treatment of early invasive stellar breast cancer
What is exemestane？
Exemestane is used for therapy of early invasive stellar breast cancer in postmenopausal women with estrogen receptor positive after 2-3 years of therapy until the completion of endocrine therapy for a total of 5 years. It is used for advanced breast cancer.
The efficacy of this product in patients with negative estrogen receptor is not clear.
Usage and dosage
Adults patients: the dose is 25 mg per day, one tablet each time.
Patients with early-stage breast cancer should continue to take this product until they complete 5 years of combined sequential endocrine therapy . Or take this product until tumor recurrence occurs.
Patients with advanced breast cancer should continue to take this product until tumor
Patients with liver or kidney dysfunction do not need to adjust the dose.
The recommended dose for the treatment of patients with early and late breast cancer is 25 mg, one tablet once a day, and it is recommended to take it after meals.
Patients with advanced breast cancer should continue to take this product until the tumor progresses.
When patients receive cytochrome P-450 (CYP) 3A4 inducer at the same time, such as rifampicin and phenytoin, the recommended dose of this product is 50 mg once a day after meals.
No long-term drug safety study has been conducted for patients with moderate or severe liver and kidney dysfunction. When the dose of exemestane was increased to 200 mg per day, there was a moderate increase in non life threatening adverse events. Based on the above experience, no dose adjustment was needed.
All clinical studies using exemestane at a standard dose of 25 mg per day showed that exemestane was generally well tolerated; Adverse reactions are usually mild to moderate.
Among the early breast cancer patients who received tamoxifen sequential exemestane adjuvant therapy, 7.4% withdrew from treatment due to adverse events. The most frequently reported adverse reactions were hot flashes (22%), arthralgia (18%) and fatigue (16%).
Among all patients with advanced breast cancer, 2.8% withdrew from the study due to adverse events. The most frequently reported adverse reactions were hot flashes (14%) and nausea (12%).
Most of the adverse reactions are normal pharmacological reactions (such as hot flashes) after estrogen production is blocked.
It should not be used for people who are known to be allergic to active ingredients of drugs or any excipients, as well as premenopausal and pregnant or lactating women.
Pregnant women taking exemestane may cause fetal injury. Based on the mechanism of action of exemestane, it is expected to cause adverse reproductive reactions. In non clinical studies in rats and rabbits, exemestane has embryotoxicity, fetal toxicity and abortion inducing effects.
Exemestane is contraindicated for pregnant or potential pregnant women. If the patient uses the drug during pregnancy, or if pregnancy occurs during the use of the drug, the patient should be informed of the potential harm of the drug to the fetus.
Matters needing attention
Athletes should use it with caution.
This product is not applicable to premenopausal women with endocrine status. Therefore, if clinically permissible, LH, FSH and estradiol levels should be tested to determine whether they are in a postmenopausal state. It should not be used in combination with drugs containing estrogen, which will affect its pharmacological effect.
Patients with liver function or renal function damage should use with caution.
Exemestane tablets contain sucrose, which should not be used in patients with rare genetic diseases with abnormal glucose tolerance, impaired glucose galactose absorption or insufficient sucrase isomaltase.
Exemestane tablets contain methyl-phosphorylated hydroxybenzene, which can cause allergic reactions (possibly delayed).
As this product is a powerful estrogen lowering drug, it is expected to cause bone density reduction. When exemestane is used as adjuvant therapy, women with osteoporosis or at risk of osteoporosis should have their BMD checked formally with BMD measurement at the beginning of treatment. Although there is not enough data to show that this product will cause bone mineral density to decrease, osteoporosis should be treated if necessary.
Patients receiving this product should carefully monitor bone mineral density.
Because severe vitamin D deficiency is extremely common in women with early-stage breast cancer, routine evaluation of 25 hydroxyvitamin D levels should be considered before starting aromatase inhibitor treatment.
Impact on driving and mechanical operation: there are reports of drowsiness, drowsiness, weakness and dizziness after using this product. Patients using this product should be reminded that if these symptoms occur, their physical and/or mental state of operating the machine or driving may be affected.
Drugs for pregnant and lactating women
Pregnant women: Pregnancy classification X
Exemestane may have fetal toxicity in pregnant women, and there is no proven clinical benefit in premenopausal women with breast cancer. Exemestane is contraindicated for pregnant or potential pregnant women. Exemestane has not been adequately studied and well controlled in pregnant women.
After rats were given 1 mg/kg exemestane orally, it was found that 14C labeled exemestane could penetrate the placenta. The concentrations of exemestane and its metabolites in maternal and embryonic blood were approximately equal. The rats were orally fed exemestane 14 days before mating until the 15th or 20th day of pregnancy, and then were given exemestane again on the 21st day of lactation. When the dose of exemestane reached 4 mg/kg/day (about 1.5 times the recommended dose for human use, calculated in mg/m2), the increase of placental weight could be observed. When the dose of exemestane is equal to or greater than 20mg/kg/day, overdue pregnancy and abnormal delivery or dystocia can be observed. At these doses, increased embryo absorption, decreased number of viable fetuses, decreased fetal weight, and delayed ossification were also observed. No fetal malformation was observed when exemestane was administered to pregnant rats at the stage of fetal organogenesis up to 810mg/kg/day (about 320 times the recommended dose for human use, calculated in mg/m2). The daily dose of exemestane given to rabbits at the stage of fetal organogenesis at the dose of 90mg/kg/day (about 70 times the recommended dose for human use, calculated in mg/m2) can lead to the decrease of placental weight. At the dose of 270 mg/kg/day, abortion, increased embryo absorption and fetal weight loss were observed. No increase in the incidence of fetal malformation was found in rabbits at medium dose up to 270 mg/kg/day (about 210 times the recommended dose for human use, calculated in mg/m2).
If the patient uses the drug during pregnancy, or if pregnancy occurs during the use of the drug, the patient should be informed of the potential harm of the drug to the fetus and the potential risk of abortion.
Drugs for children
The efficacy and safety of this product in children have not been evaluated. Not recommended for children.
Is it safe to buy Exemestane tablets online?
Taking exemestane purchased online or on the street can cause serious and unexpected complications. These purported "identical" drugs may be fake and may contain harmful ingredients.
It is safe to buy exemestane online from trusted and regulated sites like Hormonesale. Our doctors will only prescribe exemestane if it is safe for you to take, and we guarantee that it is the real medicine.
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Exemestane side effects