{"id":64863,"date":"2024-11-02T12:47:51","date_gmt":"2024-11-02T12:47:51","guid":{"rendered":"https:\/\/medsbase.com\/?post_type=product&#038;p=64863"},"modified":"2026-04-30T10:23:28","modified_gmt":"2026-04-30T10:23:28","slug":"xtane","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/xtane\/","title":{"rendered":"Xtane"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 co je Xtane?<\/h3>\n<p style=\"margin:0;\"><strong>Xtane<\/strong> je peror\u00e1ln\u00ed tableta od Natco Pharma obsahuj\u00edc\u00ed <strong>exemestane 25 mg<\/strong> \u2014 t\u0159et\u00ed generace <strong>steroidn\u00ed inaktiv\u00e1tor aromat\u00e1zy<\/strong>. Adjuvantn\u00ed a metastatick\u00e1 l\u00e9\u010dba pro <strong>hormon\u00e1ln\u011b receptorov\u011b pozitivn\u00ed karcinom prsu u postmenopauz\u00e1ln\u00edch \u017een<\/strong>. Standardn\u00ed d\u00e1vka: <strong>25 mg jednou denn\u011b po j\u00eddle<\/strong>, obvykle po dobu <strong>5\u201310 let<\/strong> v adjuvantn\u00edm re\u017eimu. Exemestan nevratn\u011b inaktivuje aromat\u00e1zu (inhibitor typu suicide) na rozd\u00edl od reverzibiln\u00ed vazby anastrozolu\/letrozolu. \u010casto volen\u00fd AI pro sekven\u010dn\u00ed l\u00e9\u010dbu po 2\u20133 letech <a href=\"https:\/\/medsbase.com\/cs\/tamilong\/\">tamoxifen<\/a> (dle studie IES), nebo po intoleranci nesteroidn\u00edho AI. <strong>Pouze pro postmenopauz\u00e1ln\u00ed \u017eeny.<\/strong> Stejn\u00e9 probl\u00e9my s hustotou kost\u00ed a artralgi\u00ed jako u ostatn\u00edch AI \u2014 povinn\u00e9 monitorov\u00e1n\u00ed DEXA + v\u00e1pn\u00edk\/vitam\u00edn D + zv\u00e1\u017eit bisfosfon\u00e1ty.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:0 0 24px 0;border-radius:4px;font-size:14px;\"><strong>\u26a0 Vy\u017eaduje se odborn\u00fd dohled.<\/strong> L\u00e9ky na rakovinu mus\u00ed b\u00fdt p\u0159edeps\u00e1ny o\u0161et\u0159uj\u00edc\u00edm onkologem s potvrzenou diagn\u00f3zou, vstupn\u00edm stagingem a definovan\u00fdm l\u00e9\u010debn\u00fdm pl\u00e1nem. Nikdy neza\u010d\u00ednejte, nep\u0159eru\u0161ujte, nem\u011b\u0148te d\u00e1vkov\u00e1n\u00ed ani neu\u017e\u00edvejte l\u00e9ky na rakovinu mimo onkologick\u00fd l\u00e9\u010debn\u00fd pl\u00e1n. V\u011bt\u0161ina l\u00e9k\u016f na rakovinu vy\u017eaduje pravideln\u00e9 monitorov\u00e1n\u00ed krevn\u00edch test\u016f (krevn\u00ed obraz, jatern\u00ed testy, funkce ledvin), je absolutn\u011b kontraindikov\u00e1na v t\u011bhotenstv\u00ed a m\u00e1 v\u00fdznamn\u00e9 l\u00e9kov\u00e9 interakce.<\/div>\n<div style=\"background:#f4f8fb;border:1px solid #d6e4ec;padding:12px 18px;margin:14px 0;border-radius:4px;font-size:14px;color:#3a5160;text-align:center;\">\n<strong>\ud83d\udd12 \u0160ifrovan\u00e9 platby<\/strong> \u00b7 <strong>\ud83d\udcb3 Ov\u011b\u0159en\u00fd platebn\u00ed procesor<\/strong> \u00b7 <strong>\ud83d\ude9a Doprava do cel\u00e9ho sv\u011bta<\/strong> \u00b7 <strong>\u2b50 4,9\/5 od 1 400+ z\u00e1kazn\u00edk\u016f<\/strong>\n<\/div>\n<h2 class=\"wp-block-heading\">Co je Xtane?<\/h2>\n<p>Xtane jsou peror\u00e1ln\u00ed tablety od Natco Pharma obsahuj\u00edc\u00ed <strong>exemestane 25 mg<\/strong>. Exemestan je t\u0159et\u00ed generace, <strong>steroidn\u00ed<\/strong> inaktiv\u00e1tor aromat\u00e1zy \u2014 struktur\u00e1ln\u011b a mechanisticky odli\u0161n\u00fd od nesteroidn\u00edch inhibitor\u016f aromat\u00e1zy anastrozolu a letrozolu. Pou\u017e\u00edv\u00e1 se pro adjuvantn\u00ed a metastatickou l\u00e9\u010dbu hormon\u00e1ln\u011b receptorov\u011b pozitivn\u00edho (HR+) karcinomu prsu u <strong>postmenopauz\u00e1ln\u00ed \u017eeny<\/strong>. P\u016fvodn\u011b vyvinut\u00fd spole\u010dnost\u00ed Pfizer (pod zna\u010dkou Aromasin), exemestan je nyn\u00ed \u0161iroce pou\u017e\u00edvan\u00fd generick\u00fd l\u00e9k.<\/p>\n<h2 class=\"wp-block-heading\">Jak Xtane funguje?<\/h2>\n<p>Exemestan je <strong>inhibitor sebevra\u017eedn\u00e9ho substr\u00e1tu<\/strong> (nevratn\u00fd inaktiv\u00e1tor) aromat\u00e1zy, enzymu, kter\u00fd p\u0159em\u011b\u0148uje androgeny na estrogeny v perifern\u00ed tk\u00e1ni u postmenopauz\u00e1ln\u00edch \u017een. Mechanismus:<\/p>\n<ul>\n<li><strong>Steroidn\u00ed struktura<\/strong> podobn\u00e1 p\u0159irozen\u00e9mu androgenn\u00edmu substr\u00e1tu (androstendionu) \u2014 v\u00e1\u017ee se na aktivn\u00ed m\u00edsto aromat\u00e1zy a je n\u00e1sledn\u011b nevratn\u011b p\u0159em\u011bn\u011bna na kovalentn\u00ed enzymov\u00fd adukt, kter\u00fd trvale inaktivuje molekulu enzymu.<\/li>\n<li><strong>Potla\u010duje cirkuluj\u00edc\u00ed estrogen o ~95 %<\/strong> b\u011bhem n\u011bkolika dn\u00ed \u2014 srovnateln\u00e9 s anastrozolem a letrozolem.<\/li>\n<li><strong>\u017d\u00e1dn\u00e1 zk\u0159\u00ed\u017een\u00e1 rezistence s nesteroidn\u00edmi inhibitory aromat\u00e1zy<\/strong> \u2014 u pacient\u016f, u kter\u00fdch do\u0161lo k progresi p\u0159i l\u00e9\u010db\u011b anastrozolem nebo letrozolem, m\u016f\u017ee n\u011bkdy doj\u00edt k odpov\u011bdi na exemestan (a naopak), proto\u017ee mechanismus je struktur\u00e1ln\u011b odli\u0161n\u00fd.<\/li>\n<li><strong>M\u00edrn\u00fd androgenn\u00ed \u00fa\u010dinek<\/strong> \u2014 exemestan a jeho hlavn\u00ed metabolit maj\u00ed slabou aktivitu na androgenn\u00ed receptor, co\u017e m\u016f\u017ee m\u00edrn\u011b zm\u00edrnit ztr\u00e1tu hustoty kost\u00ed pozorovanou u nesteroidn\u00edch inhibitor\u016f aromat\u00e1zy (a\u010dkoli klinick\u00fd v\u00fdznam je diskutov\u00e1n).<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Pou\u017eit\u00ed a indikace<\/h2>\n<ul>\n<li><strong>How long do I stay on Keytruda?<\/strong> u \u010dasn\u00e9ho HR+ karcinomu prsu u postmenopauz\u00e1ln\u00edch \u017een, obvykle jako sekven\u010dn\u00ed terapie po 2\u20133 letech <a href=\"https:\/\/medsbase.com\/cs\/tamilong\/\">tamoxifen<\/a> (podle studie IES) nebo jako prim\u00e1rn\u00ed inhibitor aromat\u00e1zy<\/li>\n<li><strong>Metastatick\u00fd HR+ karcinom prsu<\/strong> po progresi na nesteroidn\u00edm inhibitoru aromat\u00e1zy (anastrozol nebo letrozol)<\/li>\n<li><strong>V kombinaci s everolimem<\/strong> u HR+ HER2- metastatick\u00e9ho karcinomu prsu po selh\u00e1n\u00ed nesteroidn\u00edho inhibitoru aromat\u00e1zy (BOLERO-2)<\/li>\n<li><strong>Mimo indikaci:<\/strong> chemoprevence u vysoce rizikov\u00fdch postmenopauz\u00e1ln\u00edch \u017een (studie MAP.3); indukce ovulace u PCOS (specialista)<\/li>\n<\/ul>\n<p>Xtane je <strong>ne<\/strong> indikov\u00e1n pro: premenopauz\u00e1ln\u00ed \u017eeny bez ovari\u00e1ln\u00ed suprese, HR-negativn\u00ed karcinom prsu nebo neonkologick\u00e9 kosmetick\u00e9 indikace.<\/p>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed Xtane a zp\u016fsob u\u017e\u00edv\u00e1n\u00ed<\/h2>\n<p>Standardn\u00ed d\u00e1vka: <strong>25 mg jednou denn\u011b po j\u00eddle<\/strong>. Potrava zvy\u0161uje biologickou dostupnost exemestanu p\u0159ibli\u017en\u011b o 40 % \u2014 nejde tedy pouze o pravidlo pro lep\u0161\u00ed sn\u00e1\u0161enlivost.<\/p>\n<h3 class=\"wp-block-heading\">Jak spr\u00e1vn\u011b u\u017e\u00edvat Xtane<\/h3>\n<ol>\n<li><strong>U\u017e\u00edvejte jednu tabletu 25 mg jednou denn\u011b po j\u00eddle.<\/strong> Potrava v\u00fdrazn\u011b zvy\u0161uje vst\u0159eb\u00e1v\u00e1n\u00ed \u2014 NEu\u017e\u00edvejte nala\u010dno.<\/li>\n<li><strong>Ve stejnou dobu ka\u017ed\u00fd den<\/strong> pro konzistenci.<\/li>\n<li><strong>Polykejte cel\u00e9 s vodou.<\/strong><\/li>\n<li><strong>Povinn\u00e9 monitorov\u00e1n\u00ed:<\/strong> vstupn\u00ed DEXA vy\u0161et\u0159en\u00ed hustoty kost\u00ed, opakujte ka\u017ed\u00e9 2 roky. Ro\u010dn\u00ed lipidov\u00fd profil.<\/li>\n<li><strong>Ochrana kost\u00ed:<\/strong> v\u00e1pn\u00edk 1 000\u20131 200 mg\/den + vitamin D 800\u20132 000 IU\/den. Bisfosfon\u00e1ty nebo denosumab p\u0159i rozvoji osteopenie.<\/li>\n<li><strong>Zvl\u00e1d\u00e1n\u00ed bolesti kloub\u016f:<\/strong> pravideln\u00fd pohyb, paracetamol\/NSAID podle pot\u0159eby. P\u0159echod na <a href=\"https:\/\/medsbase.com\/cs\/anaridex\/\">anastrozol<\/a> nebo <a href=\"https:\/\/medsbase.com\/cs\/letroheal\/\">letrozol<\/a> m\u016f\u017ee pomoci, pokud je artralgie z exemestanu nesnesiteln\u00e1.<\/li>\n<li><strong>D\u00e9lka l\u00e9\u010dby:<\/strong> Celkem 5 let endokrinn\u00ed terapie (nebo d\u00e9le u vy\u0161\u0161\u00edho rizika) v adjuvantn\u00edm re\u017eimu; do progrese u metastatick\u00e9ho onemocn\u011bn\u00ed.<\/li>\n<li><strong>Nep\u0159eru\u0161ujte l\u00e9\u010dbu bez pokyn\u016f onkologa.<\/strong><\/li>\n<\/ol>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky Xtane<\/h2>\n<p><strong>B\u011b\u017en\u00e9 (p\u0159\u00edznaky deprivace estrogenu):<\/strong><\/p>\n<ul>\n<li>N\u00e1valy horka (35\u201340 %)<\/li>\n<li>Artralgie a myalgie (~30 %)<\/li>\n<li>Vagin\u00e1ln\u00ed suchost, dyspareunie<\/li>\n<li>Zm\u011bny n\u00e1lady, \u00fanava<\/li>\n<li>M\u00edrn\u00e9 \u0159\u00eddnut\u00ed vlas\u016f<\/li>\n<li>Zv\u00fd\u0161en\u00e9 pocen\u00ed<\/li>\n<li>Nevolnost (m\u00edrn\u00e1, obvykle ustupuje)<\/li>\n<\/ul>\n<p><strong>D\u016fle\u017eit\u00e9 dlouhodob\u00e9:<\/strong><\/p>\n<ul>\n<li>Zrychlen\u00e1 ztr\u00e1ta hustoty kost\u00ed a zv\u00fd\u0161en\u00e9 riziko zlomen\u00ed \u2014 mo\u017en\u00e1 o n\u011bco m\u00e9n\u011b ne\u017e inhibitory AI (nesteroid\u00e1ln\u00ed inhibitory), ale klinick\u00fd v\u00fdznam je diskutov\u00e1n<\/li>\n<li>M\u00edrn\u00e9 androgenn\u00ed vedlej\u0161\u00ed \u00fa\u010dinky (akn\u00e9, zm\u011bny vlas\u016f) \u2014 m\u00e9n\u011b \u010dast\u00e9, ale charakteristick\u00e9.<\/li>\n<li>Hyperlipidemie (m\u00edrn\u00e1)<\/li>\n<\/ul>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9, ale vy\u017eaduj\u00ed kontrolu:<\/strong><\/p>\n<ul>\n<li>Hepatotoxicita (m\u00edrn\u00e9 zv\u00fd\u0161en\u00ed jatern\u00edch test\u016f b\u011b\u017en\u00e9)<\/li>\n<li>Lymfocytopenie, trombocytopenie<\/li>\n<li>Z\u00e1va\u017en\u00e1 hypersenzitivita<\/li>\n<li>Syndrom karp\u00e1ln\u00edho tunelu<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Varov\u00e1n\u00ed a opat\u0159en\u00ed<\/h2>\n<ul>\n<li><strong>T\u011bhotenstv\u00ed: ABSOLUTN\u00cd KONTRAINDIKACE.<\/strong> Exemestan je teratogenn\u00ed. U postmenopauz\u00e1ln\u00edch pacientek je obvykle vylou\u010dena mo\u017enost ot\u011bhotn\u011bn\u00ed, ale perimenopauz\u00e1ln\u00ed pacientky pot\u0159ebuj\u00ed spolehlivou antikoncepci.<\/li>\n<li><strong>Premenopauz\u00e1ln\u00ed \u017eeny:<\/strong> ne\u00fa\u010dinn\u00e9, pokud nen\u00ed kombinov\u00e1no s potla\u010den\u00edm ovari\u00e1ln\u00ed funkce pod odborn\u00fdm dohledem.<\/li>\n<li><strong>Zdrav\u00ed kost\u00ed:<\/strong> v\u00fdchoz\u00ed DEXA, opakovat ka\u017ed\u00e9 2 roky. V\u00e1pn\u00edk + vitamin D + bisfosfon\u00e1t\/denosumab p\u0159i osteopenii.<\/li>\n<li><strong>Jatern\u00ed a ren\u00e1ln\u00ed insuficience:<\/strong> Nen\u00ed nutn\u00e1 \u00faprava d\u00e1vky u m\u00edrn\u00e9 a\u017e st\u0159edn\u00ed poruchy; opatrnost u t\u011b\u017ek\u00e9.<\/li>\n<li><strong>Soub\u011b\u017en\u00e1 estrogenov\u00e1 terapie:<\/strong> vyvarujte se \u2013 ru\u0161\u00ed \u00fa\u010del l\u00e9\u010dby.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<table style=\"border-collapse:collapse;width:100%;margin:12px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Kombinujte s<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u00da\u010dinek<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Co d\u011blat<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Siln\u00ed induktory CYP3A4 (rifampicin, fenytoin, karbamazepin, t\u0159ezalka te\u010dkovan\u00e1)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">V\u00fdznamn\u011b sni\u017euje hladiny exemestanu \u2013 riziko selh\u00e1n\u00ed l\u00e9\u010dby<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vyhn\u011bte se kombinaci. Pokud je induktor CYP3A4 nezbytn\u00fd, zdvojn\u00e1sobte d\u00e1vku exemestanu na 50 mg\/den pod odborn\u00fdm dohledem.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">HRT obsahuj\u00edc\u00ed estrogen nebo vagin\u00e1ln\u00ed estrogen<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Por\u00e1\u017e\u00ed mechanismus \u2014 l\u00e9\u010dba selh\u00e1v\u00e1<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vyvarujte se. Pou\u017e\u00edvejte nehormon\u00e1ln\u00ed vagin\u00e1ln\u00ed zvlh\u010dova\u010de.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Tamoxifen<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Tamoxifen sni\u017euje hladiny exemestanu<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Pou\u017e\u00edvejte postupn\u011b, nikoli sou\u010dasn\u011b.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Bisfosfon\u00e1ty \/ denosumab<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Synergick\u00e1 ochrana kost\u00ed<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">P\u0159idejte p\u0159i rozvoji osteopenie.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Everolimus (inhibitor mTOR)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Standardn\u00ed kombinace pro metastatick\u00fd HR+ HER2- karcinom prsu (BOLERO-2)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Specializovan\u00e9 onkologick\u00e9 p\u0159edepisov\u00e1n\u00ed.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Pokyny k uchov\u00e1v\u00e1n\u00ed<\/h2>\n<ul>\n<li>Skladujte p\u0159i pokojov\u00e9 teplot\u011b, <strong>15\u201330\u00b0C<\/strong>. Uchov\u00e1vejte v p\u016fvodn\u00edm blistru.<\/li>\n<li>Uchov\u00e1vejte mimo dosah d\u011bt\u00ed a dom\u00e1c\u00edch zv\u00ed\u0159at.<\/li>\n<li>Nepou\u017eit\u00e9 tablety vra\u0165te do l\u00e9k\u00e1rny k likvidaci.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy na MedsBase<\/h2>\n<p>Dal\u0161\u00ed onkologick\u00e9 l\u00e9ky skladem vedle tohoto produktu:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/anaridex\/\"><strong>Anaridex (anastrozol 1 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/fempro\/\"><strong>Fempro (letrozol 2,5 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/letroheal\/\"><strong>Letroheal (letrozol 2,5 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tamilong\/\"><strong>Tamilong (tamoxifen 10 \/ 20 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tamodex\/\"><strong>Tamodex (tamoxifen 10 \/ 20 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tamoxilon\/\"><strong>Tamoxilon (tamoxifen 10 \/ 20 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cytotam\/\"><strong>Cytotam (tamoxifen 10 \/ 20 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/caditam\/\"><strong>Caditam (tamoxifen 20 mg)<\/strong><\/a><\/li>\n<\/ul>\n<p><a href=\"https:\/\/medsbase.com\/cs\/anti-cancer-medication\/\">Prohl\u00e9dn\u011bte v\u0161echny protin\u00e1dorov\u00e9 l\u00e9ky \u2192<\/a><\/p>\n<p><!-- medsbase-why-order --><\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Ka\u017ed\u00e1 \u0161ar\u017ee je dod\u00e1v\u00e1na od <strong>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/strong>. Objedn\u00e1vky jsou expedov\u00e1ny v nen\u00e1padn\u00fdch obalech bez loga od na\u0161ich partnersk\u00fdch sklad\u016f a jsou pokryty na\u0161\u00ed <a href=\"\/cs\/medsbase-re-shipment-assurance-policy\/\">Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a>: pokud z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, za\u0161leme zdarma n\u00e1hradn\u00ed z\u00e1silku, bez dotaz\u016f.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed protin\u00e1dorov\u00e9 l\u00e9ky<\/h3>\n<p>Dal\u0161\u00ed onkologick\u00e9 l\u00e9ky skladem vedle tohoto produktu:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/anaridex\/\">Anaridex (anastrozol 1 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/letroheal\/\">Letroheal (letrozol 2,5 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/fempro\/\">Fempro (letrozol 2,5 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tamilong\/\">Tamilong (tamoxifen 10\/20 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tamodex\/\">Tamodex (tamoxifen 10\/20 mg)<\/a><\/li>\n<\/ul>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Pro\u010d mus\u00ed b\u00fdt Xtane u\u017e\u00edv\u00e1n s j\u00eddlem?<\/h3>\n<p>J\u00eddlo zvy\u0161uje biologickou dostupnost exemestanu p\u0159ibli\u017en\u011b o <strong>40%<\/strong> \u2014 toto je skute\u010dn\u00fd farmakokinetick\u00fd \u00fa\u010dinek, nikoli pouze pravidlo tolerance. U\u017e\u00edv\u00e1n\u00ed exemestanu nala\u010dno v\u00fdrazn\u011b sni\u017euje jeho d\u00e1vkov\u00e1n\u00ed. U\u017e\u00edvejte po prvn\u00edm hlavn\u00edm j\u00eddle dne pro konzistentn\u00ed absorpci.<\/p>\n<h3 class=\"wp-block-heading\">Jak se Xtane li\u0161\u00ed od anastrozolu a letrozolu?<\/h3>\n<p>Exemestan je <strong>steroidn\u00ed<\/strong> inaktiv\u00e1tor aromat\u00e1zy, kter\u00fd nevratn\u011b ni\u010d\u00ed molekuly enzymu aromat\u00e1zy. Anastrozol a letrozol jsou <strong>nesteroidn\u00ed<\/strong> reverzibiln\u00ed inhibitory. Klinick\u00e9 d\u016fsledky: (1) \u017e\u00e1dn\u00e1 zk\u0159\u00ed\u017een\u00e1 rezistence \u2014 pacienti, u kter\u00fdch dojde k progresi na anastrozolu nebo letrozolu, mohou st\u00e1le reagovat na exemestan; (2) m\u00edrn\u00fd androgenn\u00ed \u00fa\u010dinek exemestanu (n\u011bkdy uv\u00e1d\u011bn\u00fd jako argument pro m\u00edrn\u011b ni\u017e\u0161\u00ed \u00fabytek kostn\u00ed hmoty, a\u010dkoli klinick\u00fd v\u00fdznam je diskutov\u00e1n); (3) odli\u0161n\u00fd vliv potravy (absorpce exemestanu se s j\u00eddlem zvy\u0161uje o 40 %).<\/p>\n<h3 class=\"wp-block-heading\">Kdy je Xtane up\u0159ednost\u0148ov\u00e1n p\u0159ed anastrozolem nebo letrozolem?<\/h3>\n<p>T\u0159i b\u011b\u017en\u00e9 sc\u00e9n\u00e1\u0159e: (1) sekven\u010dn\u00ed terapie po 2\u20133 letech tamoxifenu (studie IES pou\u017eila exemestan v tomto re\u017eimu); (2) po progresi na anastrozolu nebo letrozolu \u2014 strukturn\u011b odli\u0161n\u00fd mechanismus m\u016f\u017ee poskytnout obnovenou odpov\u011b\u010f; (3) po intolerovateln\u00e9 artralgii na nesteroidn\u00edm AI \u2014 asi 30 % pacient\u016f toleruje jeden AI, ale ne druh\u00fd.<\/p>\n<h3 class=\"wp-block-heading\">Jak dlouho m\u00e1m u\u017e\u00edvat Xtane?<\/h3>\n<p>Standardn\u00ed doba adjuvantn\u00ed l\u00e9\u010dby je <strong>5 let<\/strong> celkov\u00e1 endokrinn\u00ed terapie (to m\u016f\u017ee zahrnovat tamoxifen nebo jin\u00e9 AI v prvn\u00edch 2\u20133 letech, pokud je exemestan pou\u017eit v sekven\u010dn\u00edm re\u017eimu). U vy\u0161\u0161\u00edho rizika onemocn\u011bn\u00ed s posti\u017een\u00edm uzlin se doporu\u010duje prodlou\u017een\u00e1 terapie a\u017e do <strong>7\u201310 let<\/strong> se st\u00e1le \u010dast\u011bji pou\u017e\u00edv\u00e1. U metastatick\u00e9ho onemocn\u011bn\u00ed a\u017e do progrese nebo nesnesiteln\u00e9 toxicity.<\/p>\n<h3 class=\"wp-block-heading\">M\u016f\u017ee Xtane oslabit m\u00e9 kosti?<\/h3>\n<p>Ano \u2013 stejn\u011b jako v\u0161echny inhibitory aromat\u00e1zy. N\u011bkter\u00e9 \u00fadaje nazna\u010duj\u00ed, \u017ee exemestan m\u016f\u017ee zp\u016fsobovat o n\u011bco men\u0161\u00ed \u00fabytek kostn\u00ed hmoty ne\u017e anastrozol nebo letrozol d\u00edky sv\u00e9mu m\u00edrn\u00e9mu androgenn\u00edmu \u00fa\u010dinku, ale klinick\u00fd v\u00fdznam je sporn\u00fd a bezpe\u010dn\u00fdm p\u0159edpokladem je, \u017ee je nutn\u00e1 ochrana kost\u00ed. Povinn\u00e9 v\u00fdchoz\u00ed vy\u0161et\u0159en\u00ed DEXA, opakovat ka\u017ed\u00e9 2 roky. Dopln\u011bk v\u00e1pn\u00edku a vitaminu D. Bisfosfon\u00e1ty (zoledronov\u00e1 kyselina IV ka\u017ed\u00fdch 6 m\u011bs\u00edc\u016f) nebo denosumab (60 mg SC ka\u017ed\u00fdch 6 m\u011bs\u00edc\u016f) p\u0159i osteopenii.<\/p>\n<h3 class=\"wp-block-heading\">Jak zvl\u00e1dnout bolesti kloub\u016f p\u0159i u\u017e\u00edv\u00e1n\u00ed Xtane?<\/h3>\n<p>Stejn\u00fd p\u0159\u00edstup jako u ostatn\u00edch inhibitor\u016f aromat\u00e1zy: pravideln\u00e9 cvi\u010den\u00ed (j\u00f3ga, ch\u016fze, plav\u00e1n\u00ed), dopln\u011bk vitaminu D, paracetamol nebo kr\u00e1tk\u00e9 k\u00fary NSAID, kontrola hmotnosti. Pokud jsou nesnesiteln\u00e9, p\u0159echod na <a href=\"https:\/\/medsbase.com\/cs\/anaridex\/\">anastrozol<\/a> nebo <a href=\"https:\/\/medsbase.com\/cs\/letroheal\/\">letrozol<\/a> n\u011bkdy pom\u016f\u017ee. Akupunktura m\u00e1 m\u00edrn\u00e9 d\u016fkazy \u00fa\u010dinnosti u artralgie vyvolan\u00e9 inhibitory aromat\u00e1zy.<\/p>\n<h3 class=\"wp-block-heading\">Mohu pou\u017e\u00edvat HRT nebo vagin\u00e1ln\u00ed estrogen p\u0159i u\u017e\u00edv\u00e1n\u00ed Xtane?<\/h3>\n<p>Obecn\u011b ne \u2013 i n\u00edzk\u00e9 d\u00e1vky vagin\u00e1ln\u00edho estrogenu vedou k m\u011b\u0159iteln\u00e9mu syst\u00e9mov\u00e9mu vst\u0159eb\u00e1v\u00e1n\u00ed, kter\u00e9 m\u016f\u017ee sn\u00ed\u017eit \u00fa\u010dinnost terapie inhibitory aromat\u00e1zy. Prvn\u00ed volba pro vagin\u00e1ln\u00ed p\u0159\u00edznaky: nehormon\u00e1ln\u00ed zvlh\u010dova\u010de (Replens, gely s kyselinou hyaluronovou) a vodn\u00e9 lubrikanty. Specialist\u00e9 ob\u010das zva\u017euj\u00ed velmi n\u00edzk\u00e9 d\u00e1vky vagin\u00e1ln\u00edho estriolu na individu\u00e1ln\u00edm z\u00e1klad\u011b s ohledem na rizika a p\u0159\u00ednosy.<\/p>\n<h3 class=\"wp-block-heading\">Existuj\u00ed l\u00e9kov\u00e9 interakce, na kter\u00e9 bych si m\u011bl d\u00e1t pozor?<\/h3>\n<p>Hlavn\u00ed je <strong>siln\u00e9 induktory CYP3A4<\/strong> (rifampicin, fenytoin, karbamazepin, t\u0159ezalka te\u010dkovan\u00e1), kter\u00e9 v\u00fdznamn\u011b sni\u017euj\u00ed hladiny exemestanu. Pokud je induktor CYP3A4 nezbytn\u00fd, d\u00e1vka m\u016f\u017ee b\u00fdt pod odborn\u00fdm dohledem zdvojn\u00e1sobena na 50 mg\/den. T\u0159ezalce te\u010dkovan\u00e9 se zcela vyhn\u011bte. Jinak m\u00e1 exemestan relativn\u011b m\u00e1lo l\u00e9kov\u00fdch interakc\u00ed.<\/p>","protected":false},"excerpt":{"rendered":"<p>\u2705 Sni\u017euje hladinu estrogenu<br \/>\n\u2705 Omezuje r\u016fst n\u00e1dor\u016f<br \/>\n\u2705 Podporuje zdrav\u00ed prsou<br \/>\n\u2705 Efektivn\u00ed po operaci<br \/>\n\u2705 Sni\u017euje riziko recidivy<\/p>\n<p>Xtane obsahuje <strong>Exemestane<\/strong>.<\/p>","protected":false},"featured_media":64866,"comment_status":"open","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[3595],"product_tag":[5326,5325],"class_list":{"0":"post-64863","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-anti-cancer-medication","7":"product_tag-exemestane","8":"product_tag-xtane","10":"first","11":"instock","12":"shipping-taxable","13":"purchasable","14":"product-type-variable","15":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/64863","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=64863"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/64866"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=64863"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=64863"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=64863"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=64863"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}