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Related to exemestane: letrozole, Fulvestrant


an aromatase inactivator structurally related to androstenedione; used as an antineoplastic in the treatment of advanced breast carcinoma in postmenpausal women, administered orally.



Pharmacologic class: Aromatase inhibitor

Therapeutic class: Hormonal antineoplastic

Pregnancy risk category D


Inhibits conversion of androgens to estrogen, which reduces estrogen concentrations and limits cancer cell growth in estrogen-dependent breast tumors


Tablets: 25 mg

Indications and dosages

Advanced breast cancer

Adults: 25 mg P.O. once daily after a meal


• Hypersensitivity to drug or its components

• Premenopausal women, including pregnant women


Use cautiously in:

• moderate to severe hepatic insufficiency or renal impairment

• concurrent use of estrogencontaining drugs

• breastfeeding patients

• children (safety and efficacy not established).


• Administer after meals with a full glass of water.

• Know that drug shouldn't be taken by premenopausal women or by patients receiving drugs that contain estrogen.

Adverse reactions

CNS: headache, dizziness, confusion, asthenia, fatigue, weakness, hypoesthesia, paresthesia, pain, anxiety, insomnia, depression

CV: hypertension, chest pain

EENT: sinusitis

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, anorexia

GU: urinary tract infection

Musculoskeletal: pathologic fractures, arthritis, back pain, skeletal pain

Respiratory: dyspnea, cough, bronchitis, upper respiratory tract infection

Skin: rash, itching, alopecia, diaphoresis

Other: increased appetite, fever, hot flashes, infection, flulike symptoms, edema, lymphedema


Drug-drug. CYP3A4 inducers: decreased exemestane blood level

Patient monitoring

• Monitor vital signs, especially blood pressure.

• Check for adverse GI reactions. Give antiemetics, as prescribed, for nausea and vomiting.

• Assess bowel elimination pattern. Increase fluids and administer stool softeners, as needed, to ease constipation.

• Monitor pain level. Administer analgesics, as prescribed, to relieve pain.

• Monitor liver function tests, CBC, and blood urea nitrogen, creatinine, and electrolyte levels.

Patient teaching

• Advise patient to take with full glass of water after a meal.

• Tell patient to report depression, insomnia, or excessive anxiety.

• Instruct patient to wear cotton clothing to let skin breathe if drug causes increased sweating or hot flashes.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.


/exe·mes·tane/ (ek″sĕ-mes´tān) an aromatase inactivator related to androstenedione; used as an antineoplastic.


an antineoplastic.
indication It is used to treat advanced breast cancer in postmenopausal patients whose cancer is unresponsive to other therapies.
contraindications Its use is prohibited in premenopausal women, pregnant women, and clients with known hypersensitivity to this drug.
adverse effects Adverse effects include fatigue, diarrhea, constipation, abdominal pain, increased appetite, hypertension, depression, insomnia, anxiety, cough, and dyspnea. Common side effects include nausea, vomiting, hot flashes, and headache.


An irreversible, steroidal aromatase-inactivating anti-oestrogen used in postmenopausal women with oestrogen-dependent/oestrogen-receptor-positive breast cancer.
Adverse effects
Hot flushes, nausea, fatigue, increased sweating.


A third-generation aromatase inhibitor drug capable of extending disease-free survival times in women who have been treated for oestrogen-receptor positive breast cancer with tamoxifen for two to three years.
References in periodicals archive ?
Disease-free survival, the trial's primary end point, was increased by approximately 25% in the women who were switched to exemestane, compared with women who remained on tamoxifen, with a P value of .
Patients in the trial were randomised to receive continuous therapy with everolimus 10 mg/day orally or placebo plus oral exemestane 25 mg/day.
Separately, results from the Tamoxifen, Exemestane, Adjuvant, Multicenter (TEAM) study did not show a difference in disease free survival (DFS) in women who took Aromasin for five years compared to those who switched from tamoxifen to Aromasin after two to three years (HR=0.
Physicians should consider offering tamoxifen for 2-3 years and the aromatase inhibitor exemestane for the balance of the 5-year period of adjuvant endocrine therapy, said Dr.
Disease-free survival was increased by about 25% in the women who were switched to exemestane, compared with women who were not, Dr.
There was a trend toward more cases of osteopnrosis in the exemestane group, and fractures were reported more often.
SAN ANTONIO -- The steroidal antiaromatase agent exemestane may not be saddled with the bone loss problems that have emerged as a significant drawback to the use of nonsteroidal aromatase inhibitors as adjuvant therapy in breast cancer, Dr.
There is some evidence that indicates a more favorable effect upon bone for steroidal aromatase inhibitors such as exemestane, which has a mild androgenic effect.
The following five investigators and studies have been awarded grants through the program to date:Sara Tolaney, MD, MPH, Dana-Farber Cancer Institute A Phase Ib/IIa Study of Palbociclib in Combination With Everolimus and Exemestane in Postmenopausal Women With Estrogen Receptor Positive and HER2 Negative Metastatic Breast Cancer,Ewa Mrozek, MD, The Ohio State University Comprehensive Cancer Center - Arthur G.
In a case report, administration of Exemestane caused the formation of intraepithelial cysts in the corneal epithelium14.
Upsher-Smith Laboratories LLC has released exemestane tablets 25 mg, a treatment for breast cancer.