Arostanil Special Precautions

Exemestane should not be administered to women with premenopausal endocrine status. Therefore, whenever clinically appropriate, the postmenopausal status should be ascertained by assessment of LH, FSH and oestradiol levels.
Exemestane should be used with caution in patients with hepatic or renal impairment.
Exemestane tablets contain a prohibited substance which can produce positive results in doping control tests.
Exemestane is a potent oestrogen lowering agent; a reduction in bone mineral density and an increased fracture rate have been observed following administration (see Pharmacology: Pharmacodynamics under Actions). During adjuvant treatment with exemestane, women with osteoporosis or at risk of osteoporosis should have their bone mineral density formally assessed by bone densitometry using DEXA (Dual-Energy X-Ray Absorptiometry) at the commencement of treatment. Although there are no adequate data available to show the effects of therapy in the treatment of the bone mineral density loss caused by exemestane, treatment for osteoporosis should be initiated in at-risk patients. Patients treated with exemestane should be carefully monitored.
Effects on ability to drive and use machines: Drowsiness, somnolence, asthenia and dizziness have been reported with the use of exemestane. Patients should be advised that, if these events occur, their physical and/or mental abilities required for operating machinery or driving a car may be impaired. If a hypoglycaemic episode is severe or prolonged, and even if it is temporarily controlled by intake of sugar, immediate medical treatment or even hospitalization is required.