Aromasin

Indications

Exemestane is used to treat hormone receptor-positive breast cancer in women who have gone through menopause. It is used after surgery to lower the chance of the cancer coming back (often after 2 to 3 years of Tamoxifen), and to treat advanced breast cancer that has grown despite other hormone treatment.

How It Works

After menopause, most oestrogen in the body is made from other hormones by an enzyme called aromatase. Some breast cancers need oestrogen to grow. Exemestane permanently blocks aromatase, so far less oestrogen is made, which slows or stops the growth of these cancer cells.

Dosage and Administration

Take exactly as prescribed by your cancer specialist. It is usually taken as one tablet once a day after a meal, at about the same time each day. Treatment is often continued for several years. Do not stop taking it without speaking to your doctor.

Interactions

Do not take with medicines that contain oestrogen, such as hormone replacement therapy or the combined contraceptive pill, as they cancel its effect. Strong enzyme inducers such as Rifampicin, Carbamazepine, Phenytoin and St John's wort may lower its level, and your doctor may need to adjust treatment. Tell your doctor about all medicines and herbal products you use.

Contraindications

Do not use if you are allergic to Exemestane, if you have not yet gone through menopause, or if you are pregnant or breastfeeding.

Side Effects

Common side effects include hot flushes, tiredness, joint and muscle pain or stiffness, headache, trouble sleeping, sweating, nausea, dizziness, low mood, hair thinning and weight gain. Long-term use can thin the bones (osteoporosis) and raise the risk of fractures. Some people get raised liver enzymes or high cholesterol, or tingling and numbness in the hands (carpal tunnel syndrome).

Get urgent medical help if you have signs of a serious allergic reaction, yellowing of the skin or eyes, severe stomach pain, chest pain, or sudden weakness, or pain and swelling in one leg.

Pregnancy and Lactation

Exemestane must not be used during pregnancy or breastfeeding, as it may harm the baby. It is meant only for women after menopause; if there is any chance you could become pregnant, use reliable non-hormonal contraception and talk to your doctor.

Precautions and Warnings

• Your doctor may check bone density before and during treatment and may advise calcium, vitamin D or other bone medicines.
• Tell your doctor about liver or kidney problems.
• It may cause tiredness or dizziness; take care when driving.
• Regular follow-up with your specialist is important.

Overdose

Single large doses have usually caused few problems, but contact a doctor or hospital if too many tablets are taken. There is no specific antidote; treatment is supportive.

Therapeutic Class

Antineoplastic hormone therapy, steroidal aromatase inhibitor

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.