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When taking exemestane (Aromasin), it is crucial to be aware of certain risks and precautions to ensure safe use. Below are important safety considerations that you should discuss with your healthcare provider:

• Vitamin D Levels: Women with early breast cancer often have low vitamin D levels. Your oncologist may monitor these levels through laboratory tests before and during your treatment with exemestane. Based on the results, a vitamin D supplement such as cholecalciferol (vitamin D3) may be recommended.

• Bone Health: Long-term use of exemestane can lead to weakened bones, increasing the risk of osteoporosis and fractures. This is especially important for individuals with a history of, or high risk for, osteoporosis.

• Kidney and Liver Health: Exemestane may cause changes in blood test results related to kidney and liver function, which could indicate damage. Symptoms such as reduced urination, swelling in limbs, jaundice, and abdominal pain or swelling should prompt immediate consultation with your cancer care team.

• Blood Cell Counts: This medication can lower white blood cell counts, weakening the immune system and increasing infection risk. Regular monitoring of blood cell counts is necessary. Notify your healthcare team if you experience fever or illness.

• Pregnancy Risks: Animal studies suggest exemestane may harm an unborn baby and increase miscarriage risks. It should not be used during pregnancy.

These warnings are provided to ensure the safe administration of exemestane. Always consult with your healthcare provider for personalized advice and report any concerning symptoms promptly.

Common side effects:

• hot flashes
• fatigue
• joint pain
• headaches
• trouble sleeping
• increased sweating
• dizziness

• high blood pressure

  Less common but important to monitor:

• nausea
• diarrhea
• stomach pain
• general pain
• hair thinning or hair loss
• mood changes such as depression

• changes in vision

  Serious side effects:

• symptoms of blood clots (shortness of breath, chest pain, confusion, sudden dizziness, pain or warmth in the legs, speech difficulties)
• severe allergic reactions (rash, swelling of the face or throat, severe dizziness, trouble breathing)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Carbamazepine
• Enzalutamide
• Fosphenytoin
• Mitotane
• Phenytoin
• Primidone
• Rifabutin
• Rifampin
• Rifapentine
• St John's Wort

Interactions with low risk that usually do not require a change in therapy:

• Ethinyl Estradiol
• Conjugated estrogens
• Anastrozole
• Tamoxifen
• Tibolone