{"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\/nl\/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;\">&#9889; Quick Answer &mdash; What is Xtane?<\/h3>\n<p style=\"margin:0;\"><strong>Xtane<\/strong> is een orale tablet van Natco Pharma met <strong>exemestane 25 mg<\/strong> &mdash; a third-generation <strong>steroidal aromatase inactivator<\/strong>. Adjuvant and metastatic therapy for <strong>hormone-receptor-positive breast cancer in postmenopausal women<\/strong>. Standard dose: <strong>25 mg once daily after a meal<\/strong>, typically for <strong>5&ndash;10 years<\/strong> in adjuvant setting. Exemestane irreversibly inactivates aromatase (suicide inhibitor) versus the reversible binding of anastrozole\/letrozole. Often the AI of choice for sequential therapy after 2&ndash;3 years of <a href=\"https:\/\/medsbase.com\/nl\/tamilong\/\">tamoxifen<\/a> (per IES trial), or after intolerance of a non-steroidal AI. <strong>Postmenopausal women only.<\/strong> Same bone-density and arthralgia issues as other AIs &mdash; mandatory DEXA monitoring + calcium\/vitamin D + consider bisphosphonate.<\/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>Wat u krijgt bij MedsBase:<\/strong> WHO-GMP gecertificeerde fabrikant \u00b7 Discrete verpakking \u00b7 Wereldwijde verzending \u00b7 1.400+ geverifieerde <a href=\"https:\/\/medsbase.com\/nl\/reviews\/\">klantbeoordelingen<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Elke bestelling is gedekt door onze <a href=\"https:\/\/medsbase.com\/nl\/medsbase-re-shipment-assurance-policy\/\"><strong>Reshipment Assurance Policy<\/strong><\/a> \u2014 als uw pakket niet binnen 20 werkdagen arriveert, sturen wij het opnieuw.<\/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 Specialistisch toezicht vereist.<\/strong> Kankermedicatie moet worden voorgeschreven door een behandelend oncoloog met een bevestigde diagnose, baseline-stadi\u00ebring en een gedefinieerd behandelplan. Start, stop, wijzig de dosis of gebruik kankermedicatie nooit buiten een door oncologie geleid zorgplan. De meeste kankermedicijnen vereisen regelmatige bloedtestmonitoring (FBC, LFT, nierfunctie), zijn absoluut gecontra-indiceerd tijdens zwangerschap en hebben significante geneesmiddelinteracties.<\/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 Versleutelde Afrekenprocedure<\/strong> \u00b7 <strong>\ud83d\udcb3 Geverifieerde Betaalprocessor<\/strong> \u00b7 <strong>\ud83d\ude9a Wereldwijde Verzending<\/strong> \u00b7 <strong>\u2b50 4.9\/5 van 1.400+ klanten<\/strong>\n<\/div>\n<h2 class=\"wp-block-heading\">What Is Xtane?<\/h2>\n<p>Xtane is an oral tablet from Natco Pharma containing <strong>exemestane 25 mg<\/strong>. Exemestane is a third-generation, <strong>steroidal<\/strong> aromatase inactivator &mdash; structurally and mechanistically distinct from the non-steroidal aromatase inhibitors anastrozole and letrozole. It is used for adjuvant and metastatic treatment of hormone-receptor-positive (HR+) breast cancer in <strong>postmenopausal women<\/strong>. Originally developed by Pfizer (brand name Aromasin), exemestane is now a widely-used generic.<\/p>\n<h2 class=\"wp-block-heading\">How Does Xtane Work?<\/h2>\n<p>Exemestane is a <strong>suicide substrate inhibitor<\/strong> (irreversible inactivator) of aromatase, the enzyme that converts androgens to oestrogens in postmenopausal peripheral tissue. Mechanistically:<\/p>\n<ul>\n<li><strong>Steroidal structure<\/strong> resembling the natural androgen substrate (androstenedione) &mdash; binds the aromatase active site and is then irreversibly converted to a covalent enzyme adduct that permanently inactivates the enzyme molecule.<\/li>\n<li><strong>Suppresses circulating oestrogen by ~95%<\/strong> within days &mdash; comparable to anastrozole and letrozole.<\/li>\n<li><strong>No cross-resistance with non-steroidal AIs<\/strong> &mdash; patients who progressed on anastrozole or letrozole sometimes respond to exemestane (and vice-versa) because the mechanism is structurally distinct.<\/li>\n<li><strong>Mild androgenic effect<\/strong> &mdash; exemestane and its main metabolite have weak androgen-receptor activity, which may slightly mitigate the bone-density loss seen with non-steroidal AIs (though clinical significance debated).<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Toepassingen en Indicaties<\/h2>\n<ul>\n<li><strong>Adjuvante therapie<\/strong> for early HR+ breast cancer in postmenopausal women, typically as sequential therapy after 2&ndash;3 years of <a href=\"https:\/\/medsbase.com\/nl\/tamilong\/\">tamoxifen<\/a> (per IES trial) or as primary AI<\/li>\n<li><strong>Metastatic HR+ breast cancer<\/strong> after progression on a non-steroidal AI (anastrozole or letrozole)<\/li>\n<li><strong>Combined with everolimus<\/strong> for HR+ HER2- metastatic breast cancer after non-steroidal AI failure (BOLERO-2)<\/li>\n<li><strong>Off-label gebruik:<\/strong> chemoprevention in high-risk postmenopausal women (MAP.3 trial); ovulation induction in PCOS (specialist)<\/li>\n<\/ul>\n<p>Xtane is <strong>niet<\/strong> indicated for: premenopausal women without ovarian suppression, HR-negative breast cancer, or non-cancer cosmetic indications.<\/p>\n<h2 class=\"wp-block-heading\">Xtane Dosage and How to Take<\/h2>\n<p>Standaard dosering: <strong>25 mg once daily after a meal<\/strong>. Food increases exemestane bioavailability by approximately 40% &mdash; so this is more than just a tolerability rule.<\/p>\n<h3 class=\"wp-block-heading\">How to Take Xtane Properly<\/h3>\n<ol>\n<li><strong>Take one 25 mg tablet once daily after a meal.<\/strong> Food significantly increases absorption &mdash; do NOT take on an empty stomach.<\/li>\n<li><strong>Same time each day<\/strong> for consistency.<\/li>\n<li><strong>Slik de tablet heel door met water.<\/strong><\/li>\n<li><strong>Verplichte monitoring:<\/strong> baseline DEXA bone-density scan, repeat every 2 years. Annual lipid panel.<\/li>\n<li><strong>Bone protection:<\/strong> calcium 1,000&ndash;1,200 mg\/day + vitamin D 800&ndash;2,000 IU\/day. Bisphosphonate or denosumab if osteopenia develops.<\/li>\n<li><strong>Joint pain management:<\/strong> regular exercise, paracetamol\/NSAIDs as needed. Switching to <a href=\"https:\/\/medsbase.com\/nl\/anaridex\/\">anastrozole<\/a> of <a href=\"https:\/\/medsbase.com\/nl\/letroheal\/\">letrozole<\/a> may help if exemestane arthralgia is intolerable.<\/li>\n<li><strong>Kuurlengte:<\/strong> 5 years total endocrine therapy (or longer in higher-risk disease) in adjuvant setting; until progression in metastatic.<\/li>\n<li><strong>Niet stoppen zonder instructie van oncoloog.<\/strong><\/li>\n<\/ol>\n<h2 class=\"wp-block-heading\">Side Effects of Xtane<\/h2>\n<p><strong>Common (oestrogen-deprivation symptoms):<\/strong><\/p>\n<ul>\n<li>Hot flushes (35&ndash;40%)<\/li>\n<li>Arthralgia and myalgia (~30%)<\/li>\n<li>Vaginal dryness, dyspareunia<\/li>\n<li>Mood changes, fatigue<\/li>\n<li>Milde haarverdunning<\/li>\n<li>Increased sweating<\/li>\n<li>Nausea (mild, usually settles)<\/li>\n<\/ul>\n<p><strong>Important long-term:<\/strong><\/p>\n<ul>\n<li>Accelerated bone-density loss and increased fracture risk &mdash; possibly slightly less than non-steroidal AIs (mild androgenic effect of exemestane), but clinical significance debated<\/li>\n<li>Mild androgenic side effects (acne, hair changes) &mdash; uncommon but distinctive<\/li>\n<li>Hyperlipidemie (mild)<\/li>\n<\/ul>\n<p><strong>Less common but seek review:<\/strong><\/p>\n<ul>\n<li>Hepatotoxicity (mild LFT rises common)<\/li>\n<li>Lymphocytopaenia, thrombocytopaenia<\/li>\n<li>Severe hypersensitivity<\/li>\n<li>Carpal tunnel syndrome<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Waarschuwingen en voorzorgsmaatregelen<\/h2>\n<ul>\n<li><strong>Pregnancy: ABSOLUTE CONTRAINDICATION.<\/strong> Exemestane is teratogenic. Postmenopausal patients usually past childbearing potential, but perimenopausal patients need reliable contraception.<\/li>\n<li><strong>Premenopauzale vrouwen:<\/strong> ineffective unless combined with ovarian suppression under specialist guidance.<\/li>\n<li><strong>Bone health:<\/strong> baseline DEXA, repeat every 2 years. Calcium + vitamin D + bisphosphonate\/denosumab if osteopenia.<\/li>\n<li><strong>Hepatic and renal impairment:<\/strong> no dose adjustment for mild-moderate; caution in severe.<\/li>\n<li><strong>Concurrent oestrogen therapy:<\/strong> avoid &mdash; defeats the purpose.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Geneesmiddelinteracties<\/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;\">Combineren met<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Effect<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Wat te doen<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sterke CYP3A4-induceerders (rifampicine, fenyto\u00efne, carbamazepine, Sint-Janskruid)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Lower exemestane levels significantly &mdash; treatment failure risk<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Avoid combination. If CYP3A4 inducer is essential, double exemestane to 50 mg\/day under specialist guidance.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Oestrogen-containing HRT or vaginal oestrogen<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Defeats mechanism &mdash; treatment fails<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Avoid. Use non-hormonal vaginal moisturisers.<\/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 reduces exemestane levels<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Use sequentially, not concurrently.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Bisphosphonates \/ denosumab<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Synergistic bone protection<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Add when osteopenia develops.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Everolimus (mTOR inhibitor)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Standard combination for metastatic HR+ HER2- breast cancer (BOLERO-2)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Specialist oncology prescribing.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Bewaaradvies<\/h2>\n<ul>\n<li>Bewaren bij kamertemperatuur, <strong>15\u201330\u00b0C<\/strong>. Bewaar in de originele blister.<\/li>\n<li>Buiten bereik van kinderen en huisdieren houden.<\/li>\n<li>Breng ongebruikte tabletten terug naar een apotheek voor vernietiging.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Gerelateerde alternatieven op MedsBase<\/h2>\n<p>Andere oncologische medicijnen die naast dit product wordt aangeboden:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/nl\/anaridex\/\"><strong>Anaridex (anastrozol 1 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/fempro\/\"><strong>Fempro (letrozole 2,5 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/letroheal\/\"><strong>Letroheal (letrozole 2,5 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/tamilong\/\"><strong>Tamilong (tamoxifen 10 \/ 20 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/tamodex\/\"><strong>Tamodex (tamoxifen 10 \/ 20 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/tamoxilon\/\"><strong>Tamoxilon (tamoxifen 10 \/ 20 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/cytotam\/\"><strong>Cytotam (tamoxifen 10 \/ 20 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/caditam\/\"><strong>Caditam (tamoxifen 20 mg)<\/strong><\/a><\/li>\n<\/ul>\n<p><a href=\"https:\/\/medsbase.com\/nl\/anti-cancer-medication\/\">Bekijk alle anti-kankermedicijnen \u2192<\/a><\/p>\n<p><!-- medsbase-why-order --><\/p>\n<h3>Waarom bestellen bij MedsBase<\/h3>\n<p>Elke batch wordt ingekocht bij een <strong>WHO-GMP gecertificeerde fabrikant<\/strong>. Bestellingen worden verzonden in eenvoudige, ongemarkeerde verpakkingen door onze logistieke partners en vallen onder onze <a href=\"\/nl\/medsbase-re-shipment-assurance-policy\/\">Reshipment Assurance Policy<\/a>: als een pakket niet binnen 20 werkdagen arriveert, sturen wij kosteloos een nieuwe zending, zonder vragen te stellen.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Gerelateerde Antikankermedicijnen<\/h3>\n<p>Andere oncologische medicijnen die naast dit product wordt aangeboden:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/nl\/anaridex\/\">Anaridex (anastrozol 1 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/letroheal\/\">Letroheal (letrozole 2,5 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/fempro\/\">Fempro (letrozole 2,5 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/tamilong\/\">Tamilong (tamoxifen 10\/20 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/tamodex\/\">Tamodex (tamoxifen 10\/20 mg)<\/a><\/li>\n<\/ul>\n<h2 id=\"faqs\">Veelgestelde vragen<\/h2>\n<h3 class=\"wp-block-heading\">Why must Xtane be taken with food?<\/h3>\n<p>Food increases exemestane bioavailability by approximately <strong>40%<\/strong> &mdash; this is a true pharmacokinetic effect, not just a tolerability rule. Taking exemestane on an empty stomach significantly underdoses you. Take after the first major meal of the day for consistent absorption.<\/p>\n<h3 class=\"wp-block-heading\">How is Xtane different from anastrozole and letrozole?<\/h3>\n<p>Exemestane is a <strong>steroidal<\/strong> aromatase inactivator that irreversibly destroys aromatase enzyme molecules. Anastrozole and letrozole are <strong>non-steroidal<\/strong> reversible inhibitors. The clinical implications: (1) no cross-resistance &mdash; patients who progress on anastrozole or letrozole may still respond to exemestane; (2) mild androgenic effect of exemestane (sometimes used to argue marginally lower bone-loss, though clinical significance debated); (3) different food-effect (exemestane absorption increases 40% with food).<\/p>\n<h3 class=\"wp-block-heading\">When is Xtane preferred over anastrozole or letrozole?<\/h3>\n<p>Three common scenarios: (1) sequential therapy after 2&ndash;3 years of tamoxifen (the IES trial used exemestane in this setting); (2) after progression on anastrozole or letrozole &mdash; the structurally distinct mechanism may give renewed response; (3) after intolerable arthralgia on a non-steroidal AI &mdash; about 30% of patients tolerate one AI but not another.<\/p>\n<h3 class=\"wp-block-heading\">How long do I take Xtane for?<\/h3>\n<p>Standard adjuvant duration is <strong>5 jaar<\/strong> total endocrine therapy (this may include tamoxifen or another AI in the first 2&ndash;3 years if exemestane is used in sequential setting). For higher-risk node-positive disease, extended therapy to <strong>7&ndash;10 years<\/strong> is increasingly used. For metastatic disease, until progression or intolerable toxicity.<\/p>\n<h3 class=\"wp-block-heading\">Will Xtane weaken my bones?<\/h3>\n<p>Yes &mdash; like all aromatase inhibitors. Some data suggest exemestane may produce slightly less bone-loss than anastrozole or letrozole because of its mild androgenic effect, but the clinical significance is debated and the safe assumption is that bone protection is needed. Mandatory baseline DEXA, repeat every 2 years. Calcium + vitamin D supplementation. Bisphosphonate (zoledronic acid IV every 6 months) or denosumab (60 mg SC every 6 months) if osteopenia.<\/p>\n<h3 class=\"wp-block-heading\">How do I manage joint pain on Xtane?<\/h3>\n<p>Same approach as other AIs: regular exercise (yoga, walking, swimming), vitamin D supplementation, paracetamol or short NSAID courses, weight management. If intolerable, switching to <a href=\"https:\/\/medsbase.com\/nl\/anaridex\/\">anastrozole<\/a> of <a href=\"https:\/\/medsbase.com\/nl\/letroheal\/\">letrozole<\/a> sometimes helps. Acupuncture has modest evidence in AI-induced arthralgia.<\/p>\n<h3 class=\"wp-block-heading\">Can I use HRT or vaginal oestrogen on Xtane?<\/h3>\n<p>Generally not &mdash; even low-dose vaginal oestrogen produces measurable systemic absorption that can defeat AI therapy. First-line for vaginal symptoms: non-hormonal moisturisers (Replens, hyaluronic acid gels) and water-based lubricants. Specialists occasionally consider very low-dose vaginal oestriol on an individual risk-benefit basis.<\/p>\n<h3 class=\"wp-block-heading\">Are there drug interactions I need to worry about?<\/h3>\n<p>The main one is <strong>strong CYP3A4 inducers<\/strong> (rifampicin, phenytoin, carbamazepine, St John&#39;s wort) which significantly reduce exemestane levels. If a CYP3A4 inducer is essential, the dose may be doubled to 50 mg\/day under specialist guidance. Avoid St John&#39;s wort entirely. Otherwise, exemestane has relatively few drug interactions.<\/p>","protected":false},"excerpt":{"rendered":"<p>\u2705 Lowers estrogen levels<br \/>\n\u2705 Reduces cancer growth<br \/>\n\u2705 Supports breast health<br \/>\n\u2705 Effective post-surgery<br \/>\n\u2705 Lowers recurrence risk<\/p>\n<p>Xtane contains <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\/nl\/wp-json\/wp\/v2\/product\/64863","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/comments?post=64863"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/media\/64866"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/media?parent=64863"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_brand?post=64863"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_cat?post=64863"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_tag?post=64863"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}