Exemestane

• Treatment of advanced breast cancer in postmenopausal women whose disease has progressed following tamoxifen therapy.
• Adjuvant (follow-on) treatment of postmenopausal women with oestrogen-receptor positive or unknown early breast cancer, following an initial course of adjuvant tamoxifen therapy.

When should one not use Exemestane

• If you have a known hypersensitivity to exemestane or any ingredient of this medicine.

Common side effects of this drug are:

• Low white blood cell count (leucopenia)
• Insomnia
• Headache, dizziness
• Hot flushes
• Abdominal pain, nausea
• Excessive sweating (hyperhidrosis)
• Joint and musculoskeletal pain
• General pain, fatigue
• Raised liver enzymes, blood bilirubin, and alkaline phosphatase (seen on blood tests)
• Low platelet count (thrombocytopenia)
• Loss of appetite
• Carpal tunnel syndrome, tingling sensations (paraesthesia)
• Vomiting, diarrhoea, constipation, indigestion
• Hair loss (alopecia), rash, hives, itching
• Bone fracture, osteoporosis
• Swelling of the limbs (peripheral oedema), weakness (asthenia)
• Hypersensitivity reactions
• Rare Side Effects
• Excessive sleepiness (somnolence)
• Hepatitis, cholestatic hepatitis
• Acute generalised exanthematous pustulosis (a severe skin reaction)
• Decreased lymphocyte count

Other General Warnings

• You are still having menstrual periods or are unsure of your menopausal status, as Exemestane is only for use in postmenopausal women.
• You have liver or kidney problems.
• You have osteoporosis or risk factors for osteoporosis, as this medicine can reduce bone density and increase fracture risk.
• You have a rare hereditary condition such as fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency, as this medicine contains sucrose.
• You have had allergic reactions to preservatives in medicines, as this tablet contains methyl parahydroxybenzoate, which may rarely, and possibly with delay, cause allergic reactions.
• You are taking any oestrogen-containing medicine, as it should not be combined with Exemestane.
• You develop yellowing of the skin or eyes, severe skin rash or blistering, or any signs of a severe allergic reaction.
• You notice unusual bruising, bleeding or symptoms of low blood counts such as frequent infections.
• You are pregnant, breastfeeding or could become pregnant.
• Take Exemestane after a meal to help your body absorb it better.
• Keep all scheduled appointments, including any bone density assessments your doctor recommends.
• Report hot flushes, joint pain or fatigue to your doctor if they become severe or hard to manage. Supportive treatment may help.
• Report any yellowing of the skin or eyes, dark urine or severe skin rash to your doctor promptly.
• Watch for unusual bruising or bleeding and report it to your doctor.
• Do not take oestrogen-containing medicines, including certain hormone therapies, while on this medicine.
• Inform all your healthcare providers that you are taking this medication before any other medical or dental procedure.

How Does It Work?

Interactions with other medicines

• Rifampicin: A strong inducer of the CYP3A4 enzyme. It has been shown to significantly reduce exemestane levels in the body and may reduce how well this medicine works.
• Anticonvulsant medicines such as phenytoin and carbamazepine: These are also CYP3A4 inducers and may reduce the efficacy of Exemestane in the same way as rifampicin.
• Herbal preparations containing St. John's Wort (Hypericum perforatum): These induce CYP3A4 and may reduce the efficacy of Exemestane.

Interactions with food items

Overdose

Missed a Dose