Zemasin 25mg Tablet (Exemestane)

Zemasin 25mg Tablet contains exemestane, a steroidal irreversible aromatase inhibitor used as endocrine therapy for hormone-receptor-positive breast cancer in postmenopausal women. Aromatase converts androgens to estrogens in peripheral tissues after menopause. By permanently inactivating aromatase, the Exemestane 25mg tablet lowers circulating estrogen and reduces stimulation of estrogen-dependent breast cancer cells. However, it is taken orally once daily after food and can affect bone density, lipid profile, and menopausal symptoms.

The exemestane tablet is most frequently prescribed for hormone-dependent breast cancers. It is normally prescribed for:

• Early ER-positive breast cancer in postmenopausal women.
  
• Advanced breast cancer where the cancer has progressed despite treatment with anti-estrogens.
  
• Some premenopausal women might take this drug combined with drugs inhibiting estrogen synthesis in ovaries.
  

It can also be prescribed as a follow-up therapy after 2-3 years of tamoxifen in order to provide hormone therapy for 5 years altogether.

Zemasin 25mg Tablet structurally resembles a naturally occurring hormone known as androstenedione. The drug acts by irreversibly inhibiting an enzyme known as aromatase, which plays an important role in the biosynthesis of estrogen in the body.

Intergroup Exemestane Study (IES): Women who received Exemestane 25mg following 2 or 3 years of treatment with tamoxifen experienced better disease-free survival than women on continued tamoxifen treatment.

Advanced breast cancer trials: Exemestane 25mg tablets have been found to be beneficial for some women whose breast cancer has worsened following treatment with other hormone blockers.

Zemasin 25mg Tablet is a safe medication; however, there might be some adverse effects on the health of some individuals. These might range from mild adverse effects to those requiring medical treatment.

Common side effects

• Hot flushes
  
• Joint/muscle pain
  
• Fatigue
  
• Headache
  
• Insomnia
  
• Increased sweating
  
• Nausea

Serious side effects

• Bone loss/osteoporosis/fracture
  
• Cardiovascular events in susceptible patients
  
• Significant liver enzyme abnormalities
  
• Severe hypersensitivity
  

Important: Dose and regimen must be prescribed by the treating specialist. Tablet/vial strength is not necessarily the patient dose. Do not start, stop, split, combine, or substitute treatment based on website information.

Take the missed dose when remembered unless it is close to the next scheduled dose. Do not double without consulting a doctor.

• It is possible to assess bone strength through bone mineral density tests.
  
• The level of vitamin D can be evaluated if required.
  
• Levels of cholesterol and other heart-related risk factors can be evaluated.
  
• Liver functions can be tested if there are any worries regarding liver health.
  
• It is possible for doctors to monitor whether the drug is being taken consistently and ask about menopause symptoms.
  

• Current exemestane prescribing information (Aromasin/reference) https://www.accessdata.fda.gov/drugsatfda_docs/label/1999/20753LBL.PDF​
• Coombes RC, et al. Intergroup Exemestane Study. New England Journal of Medicine/Lancet updates https://pubmed.ncbi.nlm.nih.gov/15014181/​
• Current NCCN/ESMO breast-cancer guidelines https://www.esmo.org/guidelines/esmo-clinical-practice-guidelines-breast-cancer​​