How does Exemestane work?
The female sex hormones estrogen and progesterone have been shown to encourage the growth of several breast cancers. These types of breast cancer are referred to as hormone-sensitive or hormone-receptor-positive malignancies of the breast. Breast cancer may be treated by inhibiting the effects of these hormones.
It is believed that estrogen is created primarily via the conversion of androgens (male sexual hormones) released by the adrenal glands into estrogens in postmenopausal women. Aromatisation is the term used to describe this process, which occurs mostly in fatty tissues, muscles, and the skin. Aromatase is a specific enzyme required for this process.
Exemestane is a compound that inhibits the aromatization process. As a result, the quantity of estrogen in the body is reduced. Taking exemestane in the early stages of breast cancer may help to prevent the disease from returning. It is possible that cancer cells in advanced breast cancer may grow more slowly or perhaps cease to develop entirely.
What are Aromatase inhibitors?
When taken orally, estrogen levels are reduced because aromatase inhibitors (AIs) prevent other hormones from being converted into estrogen by an enzyme found in adipose tissue (called aromatase). (Estrogen has been shown to promote the proliferation of breast cancer cells.)
These medications do not prevent the ovaries from producing estrogen. They only have a negative effect on estrogen levels in women whose ovaries are not producing estrogen (such as women who have already gone through menopause). Women who have previously gone through menopause are more likely to benefit from them as a result of this.
The following AIs have been demonstrated in trials to reduce the chance of developing breast cancer:
Exemestane (Arimidex) Anastrozole (Arimidex) (Aromasin)
These medications, like tamoxifen, are more often used to treat hormone receptor-positive breast cancer than to reduce the chance of developing breast cancer.
When used to reduce the risk of breast cancer, these medications are generally taken for 5 years. They are pills that need to be taken once a day.
Is it possible for aromatase inhibitors to reduce the risk of breast cancer?
Both anastrozole and exemestane have been found in major trials to reduce the incidence of breast cancer in postmenopausal women who are at greater risk for the disease.
Despite the fact that these medications have not been authorized by the FDA to decrease breast cancer risk, several expert organizations consider them to be viable alternatives (together with tamoxifen and raloxifene) for post-menopausal women who are at elevated risk of developing the disease. Examples include women who have an elevated risk of blood clots and should not take tamoxifen or raloxifene and women who are pregnant or breastfeeding.
In what ways can aromatase inhibitors pose a danger and cause negative effects?
The most prevalent adverse effects of AIs are symptoms of menopause, such as hot flashes, nocturnal sweats, and vaginal dryness, which are typical among women.
Muscle and joint discomfort are also possible side effects of these medications. This negative effect may be severe enough to lead some women to discontinue taking the medication altogether.
AIs, in contrast to tamoxifen and raloxifene, have been shown to accelerate bone weakening, which may lead to osteoporosis. Those who suffer from osteoporosis are more prone to suffer from shattered bones. As a result, physicians often urge patients have their bone density checked before taking one of these medications.
AIs have the potential to elevate cholesterol. A study found that women with pre-existing heart problems who took an AI had a greater chance of developing a heart issue in the future.
When Exemestane is administered
Exemestane is often administered after surgery in order to lessen the chance of breast cancer recurring or spreading.
You will be advised by your doctor when it is appropriate to begin exemestane treatment if you are receiving chemotherapy or radiation.
Exemestane may be used as first-line therapy for breast cancer in certain cases, such as when surgery is not recommended or has to be postponed. It is occasionally administered before surgery in order to decrease a big breast cancer that has spread.
Exemestane may also be used to treat breast cancer that has returned after being treated before (recurrence). The medicine may also be used to treat breast cancer that has progressed to another region of the body (secondary breast cancer), in which case it is often used in conjunction with another therapy.
Exemestane(Aromasin) in bodybuilding
For bodybuilding purposes, there is no FDA-approved dosing regimen. Aromasin is not licensed for any other applications outside the treatment of early and advanced breast cancer, according to the FDA.
In Aromasin, the active element exemestane is present. Exemestane is a steroid. In order to act, Aromasin must first bind to aromatase, which is the enzyme in the body responsible for the conversion of testosterone (the primary sex hormone in males*) to estrogen (the primary sex hormone in females*). When this occurs, the amount of testosterone in the body rises, with effects that are comparable to those of testosterone replacement treatment (TRT).
Aromasin is regarded to be an abuse of the medicine if it is used for bodybuilding reasons. Aromasin is also listed as a prohibited drug by the World Anti-Doping Agency, which prohibits it from being used in any sport, including bodybuilding.
What is the difference between the doses of Aromasin and Arimidex?
Arimidex is a drug that works in a similar way to Aromasin in that it is used to treat some forms of early and advanced breast cancer. The doses for these medications, on the other hand, vary.
The suggested dose for Aromasin is one 25-milligram (mg) tablet given once a day after a meal, according to the manufacturer. Arimidex is prescribed as one 1-mg tablet once per day, with or without meals, and should be taken once per day.
Aromatase inhibitors’ other uses
Aromatase inhibitors are also used for the following reasons: to reduce the production of estrogen.
Treatment of unwanted side effects of testosterone: Because some of the testosterone in the bloodstream is converted into estrogen by the enzyme aromatase, men who take an excessive amount of testosterone may develop breasts, experience unwanted fat deposits, or experience fertility problems if they take an excessive amount of testosterone.
Aromatase inhibitors are occasionally used by anabolic-androgenic steroid (AAS) users to avoid certain negative effects of their usage, despite the fact that they are not recommended for this purpose.
Increasing fertility in women with the polycystic ovarian syndrome (PCOS): Some research has shown that aromatase inhibitors may be able to assist premenopausal women with polycystic ovary syndrome in carrying a pregnancy to term.
Taking aromatase inhibitors may lessen the risk of breast cancer in women who are at high risk, but these medications are not presently licensed for this reason in the United States.
Symptoms and side effects
The frequency with which side effects occur and the severity with which they manifest themselves might vary from person to person. They are also dependent on the various therapies that you are doing. For example, if you are taking other medications or receiving radiation, your adverse effects may be exacerbated.
When should you get in touch with your team?
The potential adverse effects will be discussed with you by your doctor, nurse, or pharmacist. They will attentively monitor your progress during treatment and will inquire about your well-being at your sessions. If any of the following apply, contact your advice line as soon as possible:
- You are suffering from serious adverse effects.
- Your side effects are not getting any better any time soon, unfortunately.
- Your side effects are becoming more severe.
Early therapy may aid in the better management of adverse effects.
If you see any indications of infection, such as a fever that is higher than 37.5C or lower than 36C, call your doctor or nurse right once.
We have not included all of the possible negative effects here. Remember that it is very improbable that you would have all of these adverse effects at the same time, but it is possible that you could experience some of them at the same time.
Consequences that are common
These adverse effects occur in more than ten out of every hundred patients (more than 10 percent ). It is possible that you have one or more of them. They are as follows:
- Increased likelihood of contracting an illness
The decreased number of white blood cells increases the likelihood of contracting an illness. In addition to feeling poorly, symptoms include a change in body temperature, aching muscles, headaches, being cold or shivery, and feeling generally unwell. Depending on where the infection is located, you may have other symptoms.
Infections may be life-threatening in certain instances. If you suspect you may have an infection, you should call your advice line as soon as possible.
- Sleeping problems are a common occurrence (insomnia)
If you make a few little adjustments to your sleep routine, it may be beneficial. If possible, set your alarm around the same time every day and spend some time resting before bed. A few minutes of mild exercise each day may also be beneficial.
Immediately notify your doctor or nurse if you are experiencing depression. They may make arrangements for you to speak with someone and, if required, provide therapy.
Headaches and dizziness
If you are experiencing headaches, notify your doctor or nurse. They may be able to provide you with painkillers. If you are feeling dizzy, avoid driving or using the equipment.
- Flushes or sweats when you are hot
We offer some suggestions for dealing with hot flushes, as well as information on available therapies for both men and women. Consult your doctor if you are having trouble dealing with your hot flushes. They may be able to provide you with certain prescription medications.
- Pain in the tummy (abdomen).
Inform your medical team if you are suffering from this condition. They can determine the source of the problem and prescribe medication to alleviate it.
This is generally just a minor irritation. If you think you may have it, tell your doctor or nurse.
- Changes in the liver
It is possible that you may experience liver alterations, which are normally modest and will not produce any symptoms. When therapy is completed, they normally return to their previous state. You get frequent blood tests to ensure that there are no changes in the way your liver is functioning in the future.
Inform your doctor or nurse if you notice that you are perspiring much more than usual. There are therapies available, as well as things you may take to assist regulate the condition.
You may have discomfort in several places of your body, including your muscles and joints. Consult with your doctor or nurse to find out what kind of medicines you may use to alleviate your discomfort.
- Tiredness and a feeling of weakness
You can be feeling very fatigued and as if you do not have enough energy.
Different activities, such as exercise, may aid in the reduction of fatigue and the ability to manage it. It has been shown in several studies that doing light exercise might provide you with additional energy. It is critical to strike a balance between physical activity and rest.
Other potentially life-threatening adverse effects of Aromasin include:
In part, because Aromasin reduces estrogen levels in the body, less estrogen is available to bone cells, resulting in bone thinning and weakness, as well as an increased risk of shattering or breaking a bone. As a result, if you have been diagnosed with osteopenia or osteoporosis, it is probable that your doctor will monitor your bone density while you are on Aromasin.
Because many women with early-stage breast cancer have low vitamin D levels, your doctor will likely check your vitamin D levels while you are on Aromasin to be sure you are getting enough.
According to research, up to half of the women who are given Aromasin or another hormone treatment medication discontinue taking the medication early, often due to bothersome or severe side effects, which are common in this population. In any case, it is important to understand that receiving hormone treatment for the recommended period of time may lower the chance of recurrence by 50 percent and the risk of dying from breast cancer by around 30 percent.
If you are experiencing negative side effects as a result of taking Aromasin or any hormone treatment medication, contact your doctor immediately. There are several measures you may take to alleviate some of the most prevalent adverse effects, including the following:
It has been shown that some medications may lower the frequency and intensity of hot flashes.
Alternative and complementary treatments, such as acupuncture and mindfulness meditation, have been demonstrated to alleviate pain, particularly joint pain, in certain cases.
Joint discomfort may be alleviated and bone density can be increased via exercise, according to research.
There is also the possibility of changing your hormone treatment medication or changing the dosage you are taking.
Is there anything more I should know?
Other medications, meals, and beverages
It is possible for cancer therapies to interact with other medications and natural preparations. Inform your doctor or pharmacist if any medications you are currently taking. Vitamins, herbal supplements, and over-the-counter medications are examples of this.
If you are on exemestane treatment, you should refrain from taking hormone replacement therapy.
When using exemestane, it is important to take caution when taking the following medications. Inform your doctor if you are using any of the following medications:
- Carbamazepine or phenytoin
In addition to being a herbal medicine, St John’s wort may also be used as a supplemental therapy for mild to severe depression.
- Sugar intolerance
This medication includes sucrose, which is a form of sugar. Inform your doctor if you have a sensitivity to any sort of sugar.
- Pregnancy and contraception
Exemestane has the potential to damage an unborn child while in the womb. If you are unsure if you have gone through menopause or if you are taking medication to halt your periods, it is critical that you utilize contraception while taking this medication. Consult with your doctor or nurse about the most effective methods of contraception. They may advise you on how long you should continue to use contraception after you have stopped using exemestane.
It is not known whether or whether this medication passes through the mammary glands. Breastfeeding is not recommended during this therapy, according to most doctors.
- Treatment for a variety of additional ailments
Always inform other physicians, nurses, pharmacists, or dentists that you are receiving this therapy if you need care for anything else, such as teeth issues, while you are receiving this treatment.
Is Aromasin the appropriate medication for you?
Aromasin is a medication that is used to treat post-menopausal women who have been diagnosed with hormone receptor-positive breast cancer, whether it be in the early stages or the advanced stages.
Aromasin is not often used to treat pre-menopausal women, despite its effectiveness.
Aromasin should not be used in conjunction with any medication or nutritional supplement that includes the hormone estrogen.
Taking Aromasin is not recommended if you are nursing, pregnant, attempting to conceive, or if there is any risk that you could be pregnant at the time of taking it. Aromasin has the potential to cause harm to develop embryos. While using Aromasin, you should utilize a reliable non-hormonal method of birth control to prevent pregnancy. Consult with your doctor to determine which method of non-hormonal birth control is most appropriate for you. It is recommended that you continue using birth control for at least one month following your final dosage of Aromasin.
What to expect while receiving Aromasin therapy
Aromasin is a tablet that must be taken once a day. It is accessible in the form of a generic medication.
For example, if you were diagnosed with early-stage breast cancer, you would transition from tamoxifen to Aromasin after two to three years of treatment, for a total of five years of continuous hormonal therapy treatment.
After being diagnosed with advanced-stage breast cancer, you would be prescribed Aromasin if cancer returned after being treated with tamoxifen for the disease. You would continue to take Aromasin for as long as you were reaping the effects of the medication.
Certain medications and supplements should be avoided when using Aromasin, including the following:
A CYP3A4 inducer, a kind of medication that inhibits the effects of Aromasin, should not be used since it diminishes their effectiveness. There are a number of medications in this category, such as Rifamate (chemical name: rifampin), which is an antibiotic used to treat TB, and Carbatrol (chemical name: carbamazepine), which is used to manage some kinds of seizures in persons suffering from epilepsy. St. John’s wort, a herbal supplement, is likewise regarded to be a CYP3A4 inducer, and as such, should not be used in conjunction with Aromasin if possible.
Duration of dosage
The length of time you take exemestane may vary depending on your unique circumstances, however, it is normally between five and 10 years.
Some women begin using exemestane after a few years of taking the hormone treatment medication tamoxifen, while others begin taking it sooner.
Exemestane is often used to treat breast cancer that has returned or progressed to another region of the body. You will continue to take it for as long as the medication is effective in controlling the disease.
When to stop taking Exemestane
When you should stop taking exemestane will be determined by your treatment team. There will be no need to taper down your dose gradually.
There is evidence that exemestane continues to lower the chance of breast cancer recurring for several years after you stop taking it, which may alleviate some of the concerns about ceasing therapy.
However, failing to take the medication for the required amount of time may raise your chances of developing breast cancer again. For whatever reason, you should consult with your doctor before discontinuing exemestane use altogether. It may be feasible to switch to a different hormone pill in some circumstances.
Hormone therapy is a highly frequent treatment for secondary breast cancer, and many women continue to use it for a long period of time after being diagnosed. If exemestane ceases to be effective, your doctor may prescribe another hormone treatment to replace it.
Aromasin has been authorized for the treatment of which conditions? When combined with tamoxifen (Nolvadex®), Aromasin is approved for the treatment of hormone-positive breast cancer in postmenopausal women who have previously had anti-estrogen therapy.
What is the method through which the activity is carried out? Aromasin is a medicine that belongs to a class of medications known as anti-aromatase agents. Aromasin’s anti-cancer properties are derived from its ability to block the synthesis of the female hormone estrogen in the body. One kind of breast cancer, known as estrogen- or hormone-positive breast cancer, is pushed to develop by estrogen, which circulates in the bloodstream and attaches to the cancer cells. When the synthesis of estrogen is inhibited, the growth stimulation provided to cancer cells is reduced, resulting in the cancer cells ceasing to develop and/or die.
How is Aromasin commonly delivered (administered)? Aromasin is taken orally once a day, after a meal, and is not addictive. Whenever possible, patients should attempt to take Aromasin at the same time each day.
What kind of monitoring do patients normally receive? Patients who are receiving Aromasin will often have planned follow-up appointments throughout their therapy. Physical examinations, scans, and other tests may be performed by physicians to evaluate side effects and response to treatment. A physician may conduct bone density scans before or during Aromasin therapy if he or she believes that a patient is at risk for osteoporosis (a decrease in bone density). This is because the risk of bone fractures may arise during treatment.
In order to ease or avoid pain and adverse effects, what can patients do to help?
Patients who have hot flashes may find it beneficial to dress in light clothes, remain in a cool atmosphere, and apply cold clothes to their bodies or heads to alleviate their symptoms.
Over-the-counter pain relievers may be effective in alleviating the aches and pains that may be induced by therapy; nevertheless, it is crucial to consider these choices with a physician before taking any action.
Pay close attention to the doctor’s instructions and notify him or her if you have any adverse effects or discomfort.
Maintain a healthy level of rest and nourishment.
Wear sunscreen and protective clothing, and try to keep your exposure to the sun to a minimum.
Drink lots of drinks to keep your body hydrated. (Patients should consult with their physician on the number of fluids they should eat during the day.)
Consume modest meals on a regular basis to help relieve nausea.
Are there any additional precautions that patients should be aware of prior to beginning their treatment regimen?
It is important for patients to tell their doctor if they are pregnant or nursing since exemestane is normally exclusively prescribed to postmenopausal female patients.
If a patient has any pre-existing diseases (chickenpox, heart disease, renal disease, liver disease, lung disease, etc.), it is critical that they tell their doctor about them since these problems may worsen as a result of taking this medication.
All additional medications (prescription or over-the-counter, including vitamins, herbs, and other supplements) should be disclosed to the physician since they may interfere with the therapy.
Before beginning any new medication or nutritional supplement, patients should consult with their doctor for approval.
Patients should advise their doctor if they have any known drug or food allergies, as well as any previous drug or food responses they may have had.
In order to determine their specific reaction to the medicine, patients should refrain from driving or doing other duties that require mental alertness until their individual response to the medication is known.