Pancreatitis: cases of pancreatitis during treatment exemestane 25 mg have been described. Possible causes of pancreatitis in these cases were: lack of efficacy in patients with severe hypertriglyceridemia, a direct effect of the drug, as well as secondary phenomena associated with the presence of stones or sludge formation in the gall bladder, accompanied by obstruction of the common bile duct.
Muscles: When receiving , and other drugs that reduce the concentration of lipids are described cases of toxic effects on muscle tissue, including the very rare cases of rhabdomyolysis. The frequency of such disorders is increased in case of renal insufficiency and hypoalbuminemia history.
The toxic effect on muscle tissue can be suspected based on the patient’s complaints of weakness, diffuse myalgia, myositis, muscle spasms and cramps, and / or expressed increasing creatinine phosphokinase exemestane (more than 5 times the upper limit of normal). In these cases, treatment should be discontinued.
The risk of rhabdomyolysis may be increased in patients with a predisposition to myopathy and / or rhabdomyolysis, including age above 70 years, weighed down by history for a hereditary muscular disease, renal failure, hypothyroidism, alcohol abuse. Such patients should be prescribed only if the expected benefits outweigh the potential risk of rhabdomyolysis. When receiving together with inhibitors of exemestane 25 mg reductase inhibitors or other fibrates povppaetsya risk of serious toxic effects on muscle fibers especially if the patient prior to treatment suffered muscle disease. Therefore, co-administration exemestane 25 mg and a statin is only valid if the patient has severe mixed dyslipidemia and high cardiovascular risk, in the absence of muscle disease in history and in the conditions of close monitoring aimed at identifying signs of toxic effects on muscle tissue .
Renal function: In case of an increase in creatinine concentration of more than 50% above the upper limit of normal, treatment should be suspended. In the first three months of treatment is recommended to determine the concentration of creatinine.
Effects on ability to drive car and other machines
Using the drug were noted influence on the ability to exemestane 25 mg drive a car, and management mechanisms.