Lower dose of Exemestane (<25 mg)

Posted by lauranc @lauranc, Aug 17, 2021

I started to take Exemestane to avoid some of the side effects that I had from Letrazole that made me extremely fatigued. Even though I feel better with Exemestane I do have joint pains. I wanted to know if somebody knows of clinical trials to study doce reduction. Could I try a lower dose and still have the benefit of the drug but with lower side effects? If you know of any trials or doctors that are working with a doce reduction please let me know

Interested in more discussions like this? Go to the Breast Cancer group.

I had to go find this because I just read it a few days back, but I couldn’t remember where. I am not sure if this will answer your questions or not but it might at least help you to begin the conversation with your doctor.
How long have you been on exemestane?
https://www.medpagetoday.com/hematologyoncology/breastcancer/94006

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Thanks for your help. I just started 2 months ago

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My doctor okayed half dose or alternate days of Femara. The company's insert says that a 20% dose was effective in studies. I am sure this would apply to your situation as well However, I admit, I continued on a full dose for 5 years.

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When I discussed this with my oncologist in July, reducing the dosage of Arimidex (Anastrozole), she said it had only been approved for Tamoxifen which I have no interest in taking. At this time I am not taking anything due to severe joint pain, bone loss, and other side effects.

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@lauranc

Thanks for your help. I just started 2 months ago

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I am hopeful that you can find a way to continue on some form of therapy, as it can lower your risk of recurrence. It does seem like a smaller dose or intermittent dose would be better than giving up altogether. Also there are still a few other choices if you are willing to try them.

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@whr

When I discussed this with my oncologist in July, reducing the dosage of Arimidex (Anastrozole), she said it had only been approved for Tamoxifen which I have no interest in taking. At this time I am not taking anything due to severe joint pain, bone loss, and other side effects.

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This article was just a few days ago, but if you are comfortable with the choice of not taking endocrine therapy then that is good, if you are not, then that is not so good. It is an individual cost versus benefit decision. Every person is different and every cancer is different. Truth is no one can predict for sure how it will act or not moving forward. Are you comfortable with this choice or feeling like there should be a better answer?

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@auntieoakley

This article was just a few days ago, but if you are comfortable with the choice of not taking endocrine therapy then that is good, if you are not, then that is not so good. It is an individual cost versus benefit decision. Every person is different and every cancer is different. Truth is no one can predict for sure how it will act or not moving forward. Are you comfortable with this choice or feeling like there should be a better answer?

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I can't say I'm "comfortable" not taking it but I was pretty miserable so felt there wasn't a choice, I was offered Tamoxifen or try another brand of the same thing. I don't feel there has been enough done to determine if it is right for everyone and feel your hormone levels should be checked before beginning treatment so you have a benchmark during treatment to see if it is doing what it was intended to do.

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@auntieoakley

This article was just a few days ago, but if you are comfortable with the choice of not taking endocrine therapy then that is good, if you are not, then that is not so good. It is an individual cost versus benefit decision. Every person is different and every cancer is different. Truth is no one can predict for sure how it will act or not moving forward. Are you comfortable with this choice or feeling like there should be a better answer?

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Thank you, I sent the article to my oncologist, I would be willing to try a reduced dosage, something to discuss.

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@whr

I can't say I'm "comfortable" not taking it but I was pretty miserable so felt there wasn't a choice, I was offered Tamoxifen or try another brand of the same thing. I don't feel there has been enough done to determine if it is right for everyone and feel your hormone levels should be checked before beginning treatment so you have a benchmark during treatment to see if it is doing what it was intended to do.

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I understand your feeling of wanting to know if it is working, but I think it designed to bind to estrogen in our bodies and remove it from our system so that it cannot feed the cancer. I am not sure if knowing what that level is becomes important. However much it can remove is better than not removing any in this case. That being said, if you cannot tolerate it and your quality of life is not there, then that absolutely has to be part of the decision. You have to be living, not just breathing. If you are wanting, you might just start that conversation again with your doctor. There are certainly more choices than just tamoxifen and anastrazole. How long has it been since you quit your therapy?

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I quit in March, I had been on it since October, 2019.

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@whr

Thank you, I sent the article to my oncologist, I would be willing to try a reduced dosage, something to discuss.

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Good for you we have to advocate for ourselves where we can. Please keep me posted, I will be thinking about you.

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I've questioned virtually everything since this nightmare began, she's very patient with me.

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