Other Brands/Names

Aromasin, Axeltane, Nateran.

How It Works

Exemestane is an aromatase inhibitor with antiestrogen and antineoplastic (anticancer) activity. By blocking the aromatase enzyme, it prevents the conversion of androgens into estrogen, which lowers circulating estrogen levels. In breast cancers whose growth depends on estrogen, reducing estrogen levels can support treatment of the disease.

Indications

Exemestane is used as adjuvant therapy for early-stage breast cancer in postmenopausal women. It may also be given to postmenopausal patients with advanced breast cancer after tamoxifen therapy has failed.

Contraindication

• Do not use in premenopausal women.

• Contraindicated during pregnancy.

• Contraindicated during breastfeeding.

Side Effects

Use of exemestane may lead to a range of adverse effects, and symptoms can vary between individuals. Reported side effects include:

• Headache

• Dizziness

• Sleep problems

• Anxiety

• Numbness or tingling in the limbs

• High blood pressure

• Diarrhea

• Nausea or vomiting

• Abdominal pain

• Constipation

• Arthritis

• Visual disturbances

• Fatigue or weakness

• Skin rash

• Decreased bone density, etc.

Types

Exemestane is supplied as 25 mg sugar-coated tablets.

Dosage

Therapy is tailored to the treatment objective and breast cancer stage. For early-stage disease, after 2–3 years of tamoxifen, give exemestane 25 mg once daily together with hormonal therapy for a total duration of 5 years; the medicine may be started earlier if tumor recurrence appears.

For postmenopausal women with advanced breast cancer, administer 25 mg once daily until clear evidence of tumor progression.

Safety

Pregnancy

Based on animal data and the drug’s mechanism, exemestane can harm the fetus when administered to laboratory animals. Human studies in pregnancy are limited, so information on potential risk remains insufficient.

Because of possible fetal risk, this medicine should be avoided in pregnant women.

Breastfeeding Mother

Breastfeeding is not recommended; mothers should avoid nursing for 1 month after receiving exemestane.

Drug Interactions

Blood levels of exemestane may decrease when used with:

• Anticonvulsants such as phenytoin and carbamazepine

• The antituberculosis agent rifampicin

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