Generic Aromasin (Exemestane)

General information

Breast cancer (BC) firmly occupies a leading place in the statistics of oncological morbidity and mortality of the females in the economically developed countries of the world. Every year in the world more than one million newly detected incidents of this disease are recorded.

Breast malignant disease is a disease characterized by the malignant tumor development in one or both mammary glands.

Breast oncology today has become one of the most common health disorders of the century. Malignant cells are mutant cells which are not characteristic of normal body tissues.

It ought to be stated that there exists breast (mammary gland) malignant disease in men, which occurs about 10 times less compared to females. The main reasons for mammary gland cancer in men are gynecomastia (growth in size because of breast tissue proliferation), radiation, taking female hormones, and hepatic cirrhosis.

Basic symptoms and signs of mammary gland cancerous growth in men do not differ from those manifested in females: for example, an unusual lump in the breast, an unusual contour of the breasts (nipple retraction, shrunken skin, etc.), discharge from the nipple, armpit lymph nodes growth etc.

A sharp case rate was identified in the late 70s mainly in post-menopausal females. Today, the age of this serious disease has changed, it became younger and these days women aged 25 years and older suffer from this pathology.

The key methodologies of mammary growth treatment include surgical interference, beam-therapy, chemotherapy, and glandular therapy course.

Glandular treatment includes hormonal agent intake blocking the receptors of malignant cells to female sex hormones. The method is utilized both separately and in combination with one or several chemotherapy courses.

There is a number of hormone therapy methods, which differ from each other. These methods are mainly implemented in case of diagnosed mammary cancer after surgery and radiation therapy in order to decrease the recurrent malignant disease risk. Glandular therapy course is mainly used after chemotherapy course. Glandular therapy is effective only when receptors of estrogen and progesterone are on the surface of the tumor cells.

The aromatase inhibitors block the estrogen production in tissues, thus reducing the total number of estrogen in the body. The aromatase inhibitors are prescribed only to women experiencing menopause. Anastrazole (Arimidex), Letrozole (Femara) and Aromasin (Exemestane) are most commonly used medications in this treatment course.

According to international clinical studies data and the results of other observations, Aromasin (Exemestane), which is actually an aromatase inhibitor, is a safe and most effective medication aimed at therapy in postmenopausal females diagnosed with receptor-positive mammary growth.

Aromasin (Exemestane) does not affect the uterus and does not cause endometrial hyperplasia and, accordingly, does not increase the womb carcinoma risk; also it does not increase the blood clots risk.

Precautions

Taking Aromasin (Exemestane) during long time can result in brittle bones. Your health care provider should conduct regular bone examinations and, if necessary, recommend you to take medications called bisphosphonates to prevent bone fragility.

Aromasin (Exemestane) as many other agents is not recommended to those patients who have hypersensitivity to the active ingredient of the medication including any other substance containing in the drug. This medication is also contraindicated during the premenopausal period, as well as during pregnancy and breastfeeding.

In the case of signs of tumor disease progress or in case of contralateral mammary cancer development, the Aromasin (Exemestane) treatment course should be immediately stopped.

This drug is not intended for the use in children under 18 years old.

In addition, it should be indicated about the asthenia, drowsiness and dizziness possible development during the Aromasin (Exemestane) therapy course. When these symptoms occur, patients are advised to refrain from driving including other potentially hazardous activities, requiring increased concentration as well as psychomotor abilities.

Dosage

There is a common recommendation related to dosage of the discussed medication: 25 mg once a day. It is better to take medication after a meal.

It is not required to adjust dose for those patients who suffer from liver or kidney failure.

How to take Aromasin?

Most often Aromasin (Exemestane) is taken as a pill. The best way of this medication use is when it is taken at about the same time every day.

Those patients who are diagnosed with early mammary cancer, it is recommended that therapy course with Aromasin is continued until the 5-year adjuvant glandular therapy (treatment course using Aromasin continued after Tamoxifen treatment course) is completed or until tumor recurrence.

Therapy course with Aromasin (Exemestane) in patients who have advanced mammary cancer has to be continued until tumor progression is visible.

Aromasin Side-effects

Aromasin (Exemestane), like other agents, has some adverse reactions. In many women, the drug does not cause any reactions, in others it may have minor side effects.

Since aromatase inhibitors began to be prescribed relatively recently, no side effects have yet been identified. However, according to some women, the drug causes:

• redness
• feeling nauseous
• joint pain
• dry vagina

The drug Aromasin (Exemestane) has a number of the following adverse reactions – nausea; often – anorexia, bellyache, constipation, vomiting, diarrhea, indigestion; very often – insomnia, headache; often – depression, dizziness, flushing, sweating, rash, joint as well as musculoskeletal ache, weakness, pain of unspecified localization, peripheral edema or legs swelling.

In about 20% of women (especially those with baseline lymphopenia) there was a periodic reduction of the lymphocytes amount. However, the average amount of lymphocytes in such patients did not change significantly, and there was no incidence of concomitant increase of viral infections.

Overdose

Data on the Aromasin (Exemestane) intake in single doses of 600-800 mg prove its good tolerability in these doses. There is no data regarding a single dose of Aromasin (Exemestane) which could cause life-threatening situations. In animal experiments, – death can come after a dose equivalent to 2,000 and 4,000 mg / m2, respectively, in humans. There is no specific antidote.

Interactions

During pharmacokinetic studies of interaction with such medication as Rifampicin, which is a strong inhibitor of CYP 3A4, there were many pharmacokinetic effects; as for pharmacologic activity of the agent (that is, estrogen inhibition).

You should not use Aromasin (Exemestane) with medications that contain estrogen, because when when you use it simultaneously – they have a negative pharmacological effect.

Alcohol interaction

Why is it such a strict taboo?

The answer is simple: alcohol, even in its small amount, influences the behavior of the medical drug and its active ingredients. Such a combination can result in unpredictable situations. There are numerous reviews and stories of patients, as well as doctors who faced with such cases in their practice can confirm this statement.

In pharmacology, there are some medications causing a very strong adverse effect on the human body even with a negligible quantity of alcohol found in the blood.

Doctors do not recommend using alcohol simultaneously with drugs like Aromasin (Exemestane), as alcohol significantly increases the manifestation of adverse reactions.

Aromasin Reviews

Below there are comments and opinions about the drug Aromazin provided by both medical practitioners and patients:

Oncologist: Since some time ago, I have started prescribing this medication, because I believe that for patients who have already administered Tamoxifen during 2–3 years, switching to aromatase inhibitors, namely Aromasin (Exemestane), may give much better results than 5 years course of Tamoxifen therapy.

Clinical trials prove that aromatase inhibitors of the third-generation are now an integral part of the glandular therapy in postmenopausal females who have a diagnose of endocrine-sensitive breast cancerous growth.

Theresa: My mother is 68 and three years ago she got a diagnose of mammary cancer. The same year she had a surgery and two courses of chemotherapy. Afterwards doctors prescribed her Aromasin (Exemestane), which she is taking until now. She did not experience any adverse reactions.

The cancerous growth does not develop and there is no secondary tumour development as well. We believe that she has such a good results due to regular intake of this medication.

Anna: I got a diagnose of cancer seven years ago. After breast surgery and several courses of chemotherapy, doctors prescribed me to take Tamoxifen. In three years my oncologist switched me for another medication, which is Aromasin (Exemestane). I take it already it for more than two years. I have to say that I tolerate it well without any side effects. Results of my tests are fine and I hope that everything bad in the past.

Victoria: My mother got a diagnoses of breast cancer. She is still young and there was a fear that Aromasin (Exemestane) would lead to permanent menopause. However, doctor told her that it is temporary. She tolerated Aromasin (Exemestane) treatment easily. At the same time there was something we didn't expect in this situation – she began losing her hair.

The doctor again said that it was temporary and there was no need to put a spoke in the wheels, and hope for the best. After that, she underwent a course of chemotherapy.

Finally the tumor became almost invisible, and almost disappeared. Now all her thoughts are about hair. In addition her periods are restoring. That means that menopause was temporary, as the doctor said. I myself believe that everything will be fine, and I do all my best to make my mother think the same. The doctor says, it helps a lot to successful treatment.