Short Description and Application:
Exemestane - aromatase inhibitor.
    Action is due to blocking enzymes responsible for estrogen synthesis. Aromasin is approved for breast cancer treatment at patients in post-menopausal age, which unsuccessfully was treated with tamoxifen.
    Exemestane is maybe the most effective aromatase inhibitor of nowadays-suppresses an average 85% of estrogen.
    Bodybuilder prefers Exemestane, relative to other antiestrogens. If you turn it into your courses, it will do a good job of preventing gynecomastia, fat accumulation and water.
    It is important to point out that there are still some disadvantages of using this drug. The most famous negative effect is synthesis of "good" cholesterol.

Action:
   EXEMESTANE is an irreversible steroidal aromatase inhibitor, which is similar in structure to natural steroid androstenedione. In postmenopaus at women, estrogens are produced primarily by conversion of androgens to estrogens, under action of aromatase enzyme in peripheral tissues. Blocking estrogen formation by inhibiting aromatase is a selective treatment in hormone-dependent breast cancer, in postmenopaus at women. Drug mechanism of action occurs due to irreversible binding to the active fragment of enzyme, causing its inactivation. Exemestane not possess progestogenic and estrogenic activity. Revealed only a slight androgenic activity, mainly when is used in high doses. In trials, with multiple doses taking throughout the day, Exemestane had no effect on biosynthesis of cortisol and aldosterone in adrenal glands, which confirms the selectivity of drug. In this regard, there is no need for substitution treatment of glucocorticoid and mineralocorticoid.
    The slight increase of LH and FSH levels in serum is observed even at low doses.

Pharmacokinetics:
Absorption:
    After oral administration, exemestane rapidly and extensively is absorbed. Was found that food improves absorption: achieved level of exemestane in plasma is at 40% higher (than in case of drug administration on an empty stomach).
Distribution:
    After reaching the maximum, level of active substance in plasma is reduced; the final T1 / 2 is approximately 24 hours.

Indicated for:
- Treatment of advanced breast cancer at women in the natural or induced postmenopausal, at which revealed progression of disease against antiestrogen therapy;
- Third-line hormonal therapy in case of advanced breast cancer at women in the natural or induced postmenopausal, at which revealed progression of disease against antiestrogen therapy, or non-steroidal aromatase inhibitor therapy/ progestins.

Contraindications:
- Pregnancy
- Breastfeeding;
-Hypersensitivity to the drug.

Dosing regimen:
    To adults and elder patients, Exemestane is recommended to take of 25 mg 1 time / day, preferably after meals. Treatment should continue until progression of tumour disease. In case of hepatic or renal insufficiency, dose adjustment isn’t required.

Side effect
Exemestane has mild to moderate bad effects, like:
-frequently: fatigue, dizziness,
-sometimes: headache, insomnia, depression, asthenia.
From part of digestive system:
- common – nausea
- sometimes - abdominal pain, anorexia, constipation, dyspepsia,
- rarely - increased liver function test parameters in serum, increased alkaline phosphatase. 
From the part of endocrine system: 
-often - hot flashes (hot flushes).
Dermatological reactions: 
-sometimes - skin rash, alopecia.
Hematopoietic system: 
-episodes of lymphocytes reduction (20% of patients),
-rarely - thrombocytopenia, leukopenia.
From the part of metabolism:
-sometimes - peripheral edema (swelling of the feet, legs).
Other:
-often - sweating.

Overdose
Symptoms: was not established.

Cautions:
-Exemestane should not be given to women with premenopausal endocrine status.
-Patients with an initial lymphopenia- elevated risk of reducing the number of lymphocytes.
-Exemestane not recommended for children use.

Conditions and terms of keeping:
    Drug should be stored at temperature below 30 ° C, out of reach of children. Shelf life - 3 years. The drug should not be used beyond the expiration date printed on the package.