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En mujeres posmenopausicas, los estrogenos se producen principalmente de la conversion de androgenos a estrogenos a traves de la enzima aromatasa en los tejidos perifericos. La privacion de estrogeno a traves de la inactivacion de la aromatasa es un tratamiento efectivo y selectivo para el cancer de mama dependiente de hormonas en mujeres posmenopausicas. En mujeres posmenopausicas, el exemestano redujo significativamente las concentraciones de estrogeno serico con una dosis inicial de 5 mg, y alcanzando la supresion maxima (> 90%) con dosis de 10-25 mg. En pacientes posmenopausicas con cancer de mama, tratadas con la dosis diaria de 25 mg, la aromatizacion completa del cuerpo se redujo en 98%. El exemestano no posee ninguna actividad progestagenica o estrogenica. Se ha observado una ligera actividad androgenica, probablemente debida a su derivado 17-hidro, principalmente en dosis altas. En estudios de dosis multiples diarias, el exemestano no tuvo efectos detectables sobre la biosintesis suprarrenal del cortisol o la aldosterona, medidos antes o despues de la estimulacion con ACTH, demostrandose asi su selectividad respecto a las otras enzimas involucradas en la via esteroidogenica. Estos datos indican que la terapia de reemplazo con glucocorticoides o mineralocorticoides no es necesaria. Se ha observado un ligero incremento en los niveles sericos de LH y FSH que no es dependiente de la dosis, aun con dosis bajas; este efecto es, sin embargo, el esperado para la clase farmacologica, y es probablemente el resultado de la retroalimentacion a nivel de la pituitaria, debido a la reduccion en los niveles de estrogeno que estimulan la secrecion de gonadotropinas en la pituitaria en mujeres posmenopausicas. Tratamiento coadyuvante del cancer de mama en estadios iniciales: En un estudio multicentrico, aleatorizado, doble ciego, realizado en 4,724 pacientes posmenopausicas con cancer de mama y receptor estrogenico positivo o desconocido, que habian permanecido sin la enfermedad, despues de recibir tratamiento coadyuvante con tamoxifeno durante 2 o 3 anos, fueron aleatorizadas para recibir exemestano (25 mg/dia) o tamoxifeno (20 o 30 mg/dia) durante 2 a 3 anos, hasta completar un total de 5 anos de terapia hormonal. Seguimiento medio de 35 meses: Despues de una duracion media del tratamiento de unos 27 meses y un seguimiento medio de aproximadamente 35 meses, los resultados mostraron que el tratamiento secuencial con exemestano despues de 2 a 3 anos de tratamiento coadyuvante con tamoxifeno, se asocio con una mejoria clinica y estadisticamente significativa en la supervivencia sin enfermedad (DFS) en comparacion con la continuacion del tratamiento con tamoxifeno. El analisis mostro que durante el periodo de estudio, el exemestano redujo el riesgo recidivante del cancer de mama 31% en comparacion con el tamoxifeno (indice de riesgo 0. El efecto benefico del exemestano sobre el tamoxifeno respecto a la DFS fue claro, independientemente del estado ganglionar o de una quimioterapia previa. De igual forma, el exemestano produjo una reduccion significativa del riesgo de cancer de mama contralateral (indice de riesgo 0. Mediana de seguimiento a 52 meses: Despues de una mediana de duracion de tratamiento de 30 meses y una mediana de seguimiento de aproximadamente 52 meses, los resultados mostraron que el tratamiento secuencial con exemestano despues de 2 a 3 anos de tratamiento adyuvante con tamoxifeno, se asocio con una mejoria clinica y estadisticamente significativa de la supervivencia libre de enfermedad en comparacion con la continuacion del tratamiento con tamoxifeno. El analisis mostro que mas alla del periodo de estudio, el exemestano redujo el riesgo de recurrencia de cancer de mama 24% en comparacion con el tamoxifeno (indice de riesgo 0. El efecto benefico de exemestano sobre el tamoxifeno respecto a la supervivencia libre de enfermedad, fue aparentemente independiente del estado ganglionar o de una quimioterapia previa. De igual forma, el exemestano produjo una reduccion significativa del riesgo de cancer de mama contralateral (indice de riesgo 0. Resultados de un subestudio endometrial indicaron que despues de 2 anos de tratamiento hubo una mediana de reduccion en el grosor endometrial de 33% en los pacientes tratados con exemestano en comparacion con una no notable variacion en los pacientes tratados con tamoxifeno. El engrosamiento endometrial, reportado al inicio del tratamiento de estudio, revirtio a la normalidad en 54% de los pacientes tratados con exemestano. Tratamiento del cancer de mama avanzado: En un estudio clinico, fase 3 realizado por la EORTC (Organizacion Europea para la Investigacion y Tratamiento del Cancer), el exemestano se comparo con el tamoxifeno como tratamiento de primera linea del cancer de mama avanzado. Los resultados indicaron que los pacientes en el grupo de tratamiento del exemestano presentaron una media mayor del tiempo de Supervivencia Sin Progresion (PFS), en comparacion con el tamoxifeno (9, clenbol 50 mcg antiestrogens clenbuterol. Asimismo, los pacientes tratados con exemestano presentaron un mayor indice de respuesta al tumor objetivo, en comparacion con el tamoxifeno (44 vs. En un estudio clinico, controlado, aleatorizado y revisado por expertos, se demostro que la dosis diaria de 25 mg de exemestano produce un aumento estadisticamente significativo en la supervivencia, del Tiempo hasta la Progresion (TTP) y del Tiempo hasta el Fracaso del Tratamiento (TFT), en comparacion con el tratamiento hormonal estandar con acetato de megestrol en pacientes posmenopausicas con cancer de mama avanzado, que ha progresado despues o durante el tratamiento con tamoxifeno, ya sea como terapia coadyuvante o como tratamiento de primera linea para la enfermedad avanzada. Absorcion: Despues de la administracion oral, el exemestano se absorbe rapidamente.
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Concomitant use of strong CYP 3A4 inducers decreases exemestane exposure, For patients receiving Aromasin with a strong CYP 3A4 inducer such as rifampicin or phenytoin, the recommended dose of Aromasin is 50 mg once daily after a meal [see Drug Interactions (7) and Clinical Pharmacology (12. Dosage Forms and Strengths. Aromasin Tablets are round, biconvex, and off-white to slightly gray. Each tablet contains 25 mg of exemestane, clenbol 50 mcg antiestrogens clenbuterol. The tablets are printed on one side with the number “7663” in black. Aromasin is contraindicated in patients with a known hypersensitivity to the drug or to any of the excipients. Reductions in Bone Mineral Density (BMD) Reductions in bone mineral density (BMD) over time are seen with exemestane use. Table 1 describes changes in BMD from baseline to 24 months in patients receiving exemestane compared to patients receiving tamoxifen (IES) or placebo (027). Concomitant use of bisphosphonates, vitamin D supplementation, and calcium was not allowed. Percent Change in BMD from Baseline to 24 months, Exemestane vs. Control 1 IES 027 BMD Exemestane N=29 Tamoxifen 1 N=38 Exemestane N=59 Placebo 1 N=65 Lumbar spine (%) -3. During adjuvant treatment with exemestane, women with osteoporosis or at risk of osteoporosis should have their bone mineral density formally assessed by bone densitometry at the commencement of treatment. Monitor patients for bone mineral density loss and treat as appropriate. Routine assessment of 25-hydroxy vitamin D levels prior to the start of aromatase inhibitor treatment should be performed, due to the high prevalence of vitamin D deficiency in women with early breast cancer (EBC). Women with vitamin D deficiency should receive supplementation with vitamin D. Administration with Estrogen-Containing Agents. Aromasin should not be coadministered with estrogen-containing agents as these could interfere with its pharmacologic action. In patients with early breast cancer, the incidence of hematological abnormalities of Common Toxicity Criteria (CTC) grade ?1 was lower in the exemestane treatment group, compared with tamoxifen. Incidence of CTC grade 3 or 4 abnormalities was low (approximately 0. Approximately 20% of patients receiving exemestane in clinical studies in advanced breast cancer experienced CTC grade 3 or 4 lymphocytopenia. undefined Evista (Raloxifene) Raloxifene is used to treat osteoporosis in postmenopausal women, clenbol 50 mcg antiestrogens clenbuterol. Clenbol 50 mcg Antiestrogens Clenbuterol, price order steroids online visa card. Clenbuterol hydrochloride (clen) is one of the famous ped products among our usa clients. Manufacturer:phoenix remedies; brand name:clenbuterol. Clenbuterol 20 mg (50 pills). 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