Aromasin Special Precautions

Because of its mode of action, exemestane should not be administered to women with pre-menopausal endocrine status.
Exemestane should not be co-administered with estrogen-containing medicines as these would negate its pharmacological action.
As exemestane is a potent estrogen lowering agent, reductions in bone mineral density can be anticipated. 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. Patients treated with exemestane should be carefully monitored and treatment for osteoporosis should be initiated as appropriate.
Routine assessment of 25-hydroxy vitamin D levels prior to the start of aromatase inhibitor treatment should be considered, due to the high prevalence of severe deficiency associated in women with early breast cancer (EBC). Women with vitamin D deficiency should receive supplementation with vitamin D.
Effects on Ability to Drive and Use Machines: The effect of exemestane on the ability to drive and use machinery has not been systematically evaluated.