exemestane

exemestane

 [ek″sĕ-mes´tān]

an aromatase inactivator structurally related to androstenedione; used as an antineoplastic in the treatment of advanced breast carcinoma in postmenpausal women, administered orally.

exemestane

Aromasin

Pharmacologic class: Aromatase inhibitor

Therapeutic class: Hormonal antineoplastic

Pregnancy risk category D

Action

Inhibits conversion of androgens to estrogen, which reduces estrogen concentrations and limits cancer cell growth in estrogen-dependent breast tumors

Availability

Tablets: 25 mg

Indications and dosages

➣ Advanced breast cancer

Adults: 25 mg P.O. once daily after a meal

Contraindications

• Hypersensitivity to drug or its components

• Premenopausal women, including pregnant women

Precautions

Use cautiously in:

• moderate to severe hepatic insufficiency or renal impairment

• concurrent use of estrogencontaining drugs

• breastfeeding patients

• children (safety and efficacy not established).

Administration

• Administer after meals with a full glass of water.

• Know that drug shouldn't be taken by premenopausal women or by patients receiving drugs that contain estrogen.

Adverse reactions

CNS: headache, dizziness, confusion, asthenia, fatigue, weakness, hypoesthesia, paresthesia, pain, anxiety, insomnia, depression

CV: hypertension, chest pain

EENT: sinusitis

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, anorexia

GU: urinary tract infection

Musculoskeletal: pathologic fractures, arthritis, back pain, skeletal pain

Respiratory: dyspnea, cough, bronchitis, upper respiratory tract infection

Skin: rash, itching, alopecia, diaphoresis

Other: increased appetite, fever, hot flashes, infection, flulike symptoms, edema, lymphedema

Interactions

Drug-drug. CYP3A4 inducers: decreased exemestane blood level

Patient monitoring

• Monitor vital signs, especially blood pressure.

• Check for adverse GI reactions. Give antiemetics, as prescribed, for nausea and vomiting.

• Assess bowel elimination pattern. Increase fluids and administer stool softeners, as needed, to ease constipation.

• Monitor pain level. Administer analgesics, as prescribed, to relieve pain.

• Monitor liver function tests, CBC, and blood urea nitrogen, creatinine, and electrolyte levels.

Patient teaching

• Advise patient to take with full glass of water after a meal.

• Tell patient to report depression, insomnia, or excessive anxiety.

• Instruct patient to wear cotton clothing to let skin breathe if drug causes increased sweating or hot flashes.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.

exemestane

/exe·mes·tane/ (ek″sĕ-mes´tān) an aromatase inactivator related to androstenedione; used as an antineoplastic.

exemestane

an antineoplastic.

indication It is used to treat advanced breast cancer in postmenopausal patients whose cancer is unresponsive to other therapies.

contraindications Its use is prohibited in premenopausal women, pregnant women, and clients with known hypersensitivity to this drug.

adverse effects Adverse effects include fatigue, diarrhea, constipation, abdominal pain, increased appetite, hypertension, depression, insomnia, anxiety, cough, and dyspnea. Common side effects include nausea, vomiting, hot flashes, and headache.

Aromasin

An irreversible, steroidal aromatase-inactivating anti-oestrogen used in postmenopausal women with oestrogen-dependent/oestrogen-receptor-positive breast cancer.
 
Adverse effects
Hot flushes, nausea, fatigue, increased sweating.

exemestane

A third-generation aromatase inhibitor drug capable of extending disease-free survival times in women who have been treated for oestrogen-receptor positive breast cancer with tamoxifen for two to three years.