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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 ?
The strength of my recommendation for exemestane plus ovarian function suppression following chemotherapy will be greater in that woman; I'll feel like maybe I should be recommending it rather than discussing it, because the advantage is so great.
pdf) released , "hormone suppressor, exemestane, reduces the risk of further breast cancer after surgery in young women by 34 percent, when compared with tamoxifen, a standard hormone treatment for preventing recurrence in young women with hormone-responsive breast cancer.
The task force considers FDA-approved medications only for the indication of breast cancer chemoprevention, and exemestane is approved only for breast cancer treatment, Dr.
Of those listed, tamoxifen and exemestane have the greatest risk of drug--herb interactions, as they are both extensively metabolized through the liver via CYP3A4.
In the phase III clinical trial, women who received the combination lived for a median of 11 months without the disease progressing, compared with about 4 months for women who received exemestane alone.
Aromatase inhibitors such as exemestane may provide better protection from breast cancer and cause fewer side effects than tamoxifen in patients with early stage breast cancer and are good candidates for use in preventing breast cancer.
The drug, called exemestane, may offer a preventive approach to combating the malignancy, researchers reported June 4 at a cancer meeting in Chicago and online in the New England Journal of Medicine.
Distant recurrences at median of 5-years among 9,779 postmenopausal women with hormone receptor-positive early breast cancer treated on the TEAM trial of adjuvant endocrine therapy (Abstract #213O, October 11)(8) - Effects of exemestane or tamoxifen on bone health within the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial: a meta-analysis (Abstract #225P, October 10)(9)
The Intergroup Exemestane Study (IES) [5] reported, at 58 months, a 7% fracture rate on the steroidal AI exemestane, compared to a lower fracture rate (5%) on tamoxifen (P<0.
We found that six years after changing treatment, women who got exemestane (Aromasin) were 18% more likely to remain disease free and were 14% less likely to die than those who stayed on tamoxifen," Charles Coombes, head of oncology at Imperial College in London said.
Women given the aromatase inhibitor exemestane after surgery were 19% less likely to suffer metastatic, or spreading, cancer than those receiving standard treatment.
After three years of a trial, those using a drug called exemestane were 19 per cent less likely to suffer metastatic, or spreading, cancer.