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Related to exemestane: letrozole, Fulvestrant
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.
CNS: headache, dizziness, confusion, asthenia, fatigue, weakness, hypoesthesia, paresthesia, pain, anxiety, insomnia, depression
CV: hypertension, chest pain
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
• 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.
• 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.
exemestane/exe·mes·tane/ (ek″sĕ-mes´tān) an aromatase inactivator related to androstenedione; used as an antineoplastic.
AromasinAn irreversible, steroidal aromatase-inactivating anti-oestrogen used in postmenopausal women with oestrogen-dependent/oestrogen-receptor-positive breast cancer.
Hot flushes, nausea, fatigue, increased sweating.