Exemestane

What is Exemestane by Natco Pharma?

This product carries the plain generic name of its active substance. Exemestane by Natco Pharma is an oral tablet of 25 mg, sold in packs of 28, which corresponds to four weeks of once-daily use at the standard clinical dose. Natco Pharma is an Indian manufacturer with a strong focus on oncology medicines, and this is the same molecule that was first marketed under the brand Aromasin.

Exemestane is a third-generation aromatase inhibitor with a steroidal skeleton. It irreversibly inactivates aromatase, the enzyme that turns androgens into estrogens in fat tissue, muscle, the liver and elsewhere. Once an enzyme molecule has bound exemestane, it is out of action for good, so estrogen levels stay low until the body replaces the enzyme.

Indications and use in sport

The registered use of exemestane is adjuvant and advanced treatment of estrogen receptor positive breast cancer in women after menopause, when most estrogen comes from aromatase activity in peripheral tissues. It is often given after two to three years of tamoxifen to complete five years of hormonal therapy.

Bodybuilders use the same mechanism differently. On cycles built around testosterone or other aromatizing steroids, Exemestane keeps estradiol in check, which lowers the risk of gynecomastia, bloating, high blood pressure from fluid retention and estrogen-driven mood swings. Some also add it during post cycle therapy, when rising natural testosterone can briefly lift estradiol as well.

Dosage and administration

Patients with breast cancer take 25 mg once a day after a meal; a fatty meal increases absorption noticeably. Strong inducers of the liver enzyme CYP3A4, such as rifampicin or St John's wort, lower exemestane levels, and the label raises the dose to 50 mg daily in that situation. Men using it for estrogen control commonly report 12.5 to 25 mg daily or 25 mg every other day, begun with the cycle and adjusted after an estradiol test. The half-life of about a day supports once-daily or every-other-day use.

These ranges show what is typical, not what a given person should take: the actual amount and the length of the course have to be agreed with a qualified medical professional.

Side effects and contraindications

• Hot flushes, sweating and fatigue.
• Joint pain, muscle aches and stiffness.
• Headache, dizziness and insomnia.
• Nausea and increased appetite.
• Reduced bone mineral density during long treatment.
• Raised liver enzymes in some patients.

Exemestane is contraindicated in premenopausal women, during pregnancy and breastfeeding, and in people allergic to the substance. It should not be taken together with estrogen-containing products, which would counteract it.

Pack and ordering

The pack contains 28 tablets of exemestane 25 mg made by Natco Pharma. It can be ordered on MaxLabs.co; other aromatase inhibitors are listed in the anti-estrogens category.