Exemestane: Uses, Dosage, Side Effects & Breast Cancer Treatment

Summary of Key Points

Exemestane is a medication primarily used to treat certain types of breast cancer in postmenopausal women. As an aromatase inhibitor, it works by lowering estrogen levels, which helps slow or stop the growth of hormone-sensitive tumors. Exemestane is often prescribed after other treatments, such as tamoxifen, have been tried. Always consult your healthcare provider before making any changes to your treatment plan. You can easily schedule a telemedicine appointment with one of our providers for personalized care.

Names of Medication

US Brand Name: Aromasin

Generic Name: Exemestane

The generic name refers to the chemical composition of the medication, while the brand name is given by the manufacturer. In this article, the generic name is listed in parentheses.

Pharmacologic Category: Aromatase Inhibitors

Exemestane belongs to the aromatase inhibitor class of medications. Other drugs in this category include anastrozole (Arimidex) and letrozole (Femara). These medications reduce estrogen levels in the body, helping to treat certain types of breast cancer.

Exemestane Dosing

Exemestane is used to treat several types of breast cancer in postmenopausal women. Dosing may vary depending on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before adjusting your dose. You can also schedule a telemedicine visit with one of our providers to discuss your treatment plan.

Breast Cancer (Hormone Receptor-Positive, Estrogen Receptor-Positive, Early-Stage, Postmenopausal, Invasive, Localized, Recurrent): The typical dose is 25 mg taken orally once daily after a meal. Treatment duration may vary, but it is often prescribed for several years to reduce the risk of cancer recurrence.

Advanced Breast Cancer (Metastatic, Postmenopausal): The usual dose is 25 mg taken orally once daily after a meal. Exemestane is typically used after other treatments, such as tamoxifen, have been tried. Treatment may continue as long as the cancer responds to the medication.

Dosage Forms and Strengths

Tablet: 25 mg

Administration Instructions for Exemestane

Exemestane should be taken once daily, preferably after a meal to improve absorption. Swallow the tablet whole with water. Do not crush, chew, or split the tablet. If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose to make up for a missed one. Always follow your healthcare provider’s instructions, and if you have any questions, feel free to schedule a telemedicine visit with one of our providers.

Exemestane Side Effects and Adverse Reactions

Like all medications, Exemestane can cause side effects. Some are common, while others are less frequent but more serious. If you experience any side effects, contact your healthcare provider right away. You can also schedule a telemedicine appointment with one of our providers to discuss any concerns.

Common Side Effects (Affecting More Than 10% of Patients)

1. Hot flashes: Sudden feelings of warmth, often in the face, neck, and chest.
2. Fatigue: Feeling unusually tired or weak.
3. Joint pain: Discomfort or pain in the joints, which can affect daily activities.

Less Common Side Effects (Affecting 1-10% of Patients)

1. Headache: Mild to moderate pain in the head or neck area.
2. Insomnia: Difficulty falling or staying asleep.
3. Increased sweating: More frequent or intense sweating than usual.

Serious Side Effects (Affecting Less Than 1% of Patients)

1. Osteoporosis: Thinning of the bones, which can increase the risk of fractures.
2. Liver problems: Yellowing of the skin or eyes, dark urine, or severe stomach pain.
3. Heart problems: Chest pain, shortness of breath, or irregular heartbeat.

Contraindications for Exemestane

A contraindication is a specific situation or condition where a medication should not be used because it may cause harm. In the case of Exemestane, there are certain conditions where taking the medication could be dangerous or ineffective.

Pregnancy: Exemestane is contraindicated in pregnant women because it can harm the developing fetus. It works by lowering estrogen levels, which are essential for fetal development.

Premenopausal Women: Exemestane is only approved for use in postmenopausal women. In premenopausal women, estrogen levels are still high, and the medication may not work effectively.

Allergy to Exemestane: If you have a known allergy to Exemestane or any of its ingredients, you should not take this medication, as it could cause a severe allergic reaction.

Severe Liver or Kidney Disease: Patients with severe liver or kidney impairment may not be able to process Exemestane properly, leading to an increased risk of side effects or toxicity.

Drug-to-Drug Interactions

Exemestane can interact with other medications, which may affect how well it works or increase the risk of side effects. It’s important to inform your healthcare provider of all medications you are taking. Some known drug interactions include:

Rifampin (Rifadin): This antibiotic can reduce the effectiveness of Exemestane by speeding up its breakdown in the body.

Phenytoin (Dilantin): This anti-seizure medication may also reduce the effectiveness of Exemestane by increasing its metabolism.

Carbamazepine (Tegretol): Another anti-seizure medication that can lower the levels of Exemestane in the body, making it less effective.

St. John’s Wort: This herbal supplement can decrease the effectiveness of Exemestane by increasing its breakdown in the liver.

Exemestane in Pregnancy

Is it safe to take Exemestane when pregnant? No, Exemestane is not safe during pregnancy. It can harm the developing fetus by reducing estrogen levels, which are crucial for normal fetal growth. If you are pregnant or planning to become pregnant, it is important to avoid taking Exemestane. Should you become pregnant while using this medication, contact your healthcare provider immediately for guidance.

Exemestane while Breastfeeding

Is it safe to take Exemestane while breastfeeding? No, Exemestane is not recommended during breastfeeding. Although it is unclear whether Exemestane passes into breast milk, its impact on hormone levels could potentially harm a nursing infant. If you are breastfeeding or planning to breastfeed, discuss alternative treatment options with your healthcare provider.

Estimated Cost of Exemestane Medication

The cost of a 30-day supply of Exemestane (25 mg tablets) without insurance typically ranges from $50 to $150, depending on the pharmacy. However, using a GoodRx coupon may lower the price to approximately $30 to $70. Prices can vary, so it’s a good idea to check with your local pharmacy or explore discount services like GoodRx for potential savings.

Possible Alternatives to Exemestane

There are several alternative treatments and lifestyle adjustments that may be considered for the conditions Exemestane is used to treat. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine consultation with one of our providers for personalized advice.

Breast Cancer

Alternatives to Exemestane include other hormone therapies such as Tamoxifen or Anastrozole. In some cases, chemotherapy or radiation therapy may also be recommended.

Hormone Receptor-Positive Breast Cancer

For hormone receptor-positive breast cancer, medications like Tamoxifen and Letrozole are commonly used to block estrogen. Surgery and radiation may also be part of the treatment plan, depending on the individual case.

Estrogen Receptor-Positive Breast Cancer

Similar to hormone receptor-positive breast cancer, Tamoxifen and Letrozole are frequently prescribed alternatives. Additionally, lifestyle changes, such as maintaining a healthy weight and reducing alcohol consumption, may help manage the condition.

Advanced Breast Cancer

In cases of advanced breast cancer, treatment options beyond Exemestane include chemotherapy, targeted therapies like Trastuzumab (Herceptin), or other hormone therapies.

Early-Stage Breast Cancer

Treatment for early-stage breast cancer often involves surgery (such as a lumpectomy or mastectomy) and radiation. Hormone therapy with medications like Tamoxifen or Anastrozole may also be part of the treatment plan.

Metastatic Breast Cancer

Treatment options for metastatic breast cancer include hormone therapy, chemotherapy, targeted therapies, and immunotherapy. Your healthcare provider may also suggest participating in clinical trials to explore new treatment options.

Postmenopausal Breast Cancer

For postmenopausal breast cancer, hormone therapies such as Letrozole or Anastrozole are viable alternatives to Exemestane. Surgery and radiation may also be considered, depending on the specific case.

Invasive Breast Cancer

Treatment for invasive breast cancer may involve a combination of surgery, radiation, chemotherapy, and hormone therapy. Targeted therapies like Trastuzumab (Herceptin) may also be recommended based on the cancer’s characteristics.

Localized Breast Cancer

For localized breast cancer, surgery and radiation are common treatments. If the cancer is hormone receptor-positive, hormone therapy may also be part of the treatment plan.

Recurrent Breast Cancer

Treatment for recurrent breast cancer depends on the location of the recurrence. Options may include hormone therapy, chemotherapy, radiation, and surgery. Clinical trials may also be available as a treatment option.

Recent Updates on Exemestane Research

Recent studies have focused on the long-term effectiveness of Exemestane in preventing breast cancer recurrence in postmenopausal women. A 2022 study found that Exemestane, when used in combination with other hormone therapies, significantly reduced the risk of breast cancer recurrence. Ongoing research is also exploring the use of Exemestane alongside newer targeted therapies to improve outcomes for patients with advanced or metastatic breast cancer.

Additionally, researchers are investigating the potential role of Exemestane in preventing breast cancer in high-risk postmenopausal women who have not yet been diagnosed. Early findings are promising, but further research is needed to confirm these results.

If you have any questions about Exemestane or your treatment plan, consider scheduling a telemedicine appointment with one of our providers to discuss your options.

James Kingsley

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