Should conduct appropriate treatment to eliminate the cause of secondary hypercholesterolemia, for example, in diseases such as uncontrolled type 2 diabetes mellitus, hypothyroidism, nephrotic syndrome, Dysproteinemia, obstructive liver disease, the effects of drug therapy Before treatment , alcoholism.
Efficacy of therapy should be evaluated on lipid content (total cholesterol, exemestane side effects cholesterol, triglyceride) in the blood serum. In the absence of a therapeutic effect after a few months of therapy (usually after 3 months -x) to consider whether the use of alternative or concomitant therapy.
Patients with hyperlipidemia taking estrogen or hormonal contraceptives containing estrogens vyusnit necessary, whether primary or secondary hyperlipidemia nature. In such cases, increase of lipid levels may be caused by intake of estrogens
Liver function: When you receive , and other drugs that reduce the concentration of lipids in some patients described povppenie level of “liver” transaminases. In most cases, this increase was temporary, minor and asymptomatic. During the first 12 months of treatment, it is recommended to control the level of transaminases every 3 months. Patients on treatment with increased transaminase concentrations, require attention, and in the case of increasing the concentration is more than 3 times compared to the upper limit of normal stop taking the drug.
Pancreatitis: Cases of pancreatitis have been described during treatment exemestane side effects. 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 Traykora 160 mg, 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 possibility of this complication increases in cases of hypoalbuminaemia and renal failure.
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 (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 side effects reductase inhibitors or other fibrates increases the risk of serious toxic effects on muscle fibers especially if the patient prior to treatment suffered muscle disease. Co-administration and a statin is only valid if the patient 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 exemestane side effects of creatinine.
Using the drug were noted influence on the ability to drive a car, and management mechanisms.