exemestane
Exemestane, also known by its brand name Aromasin, is an oral medication that’s used for treating certain types of breast cancer in people who’ve gone through menopause. It’s a form of hormonal therapy called an aromatase inhibitor that lowers the amount of estrogen in the body. Exemestane (Aromasin) is a tablet that's taken once a day. But it can cause side effects like hot flashes and tiredness.
What is Exemestane (Aromasin)?
What is Exemestane (Aromasin) used for?
Early breast cancer in postmenopausal women who've had 2 to 3 years of treatment with tamoxifen
Advanced breast cancer in postmenopausal women whose cancer has worsened following treatment with tamoxifen
How Exemestane (Aromasin) works
Exemestane (Aromasin) is an aromatase inhibitor. Aromatase is a protein in your body that helps turn other hormones into estrogen.
By blocking aromatase, exemestane (Aromasin) lowers the amount of estrogen in your body. This is helpful for treating breast cancer because estrogen can fuel the growth of certain types of breast cancer cells. Without estrogen, these cancer cells won’t have the “fuel” they need to grow or spread.
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What are the side effects of Exemestane (Aromasin)?
Common Side Effects
- Hot flashes (21%)
- Fatigue (16%)
- Joint pain (15%)
- Headache (13%)
- Trouble sleeping (12%)
- Sweating more often or being sweatier (12%)
- Dizziness (10%)
- High blood pressure (10%)
Other Side Effects
- Nausea
- Diarrhea
- Stomach pain
- Pain
- Hair thinning or hair loss
- Depression
- Changes in vision
Source: DailyMed
More on Exemestane (Aromasin) side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Cough or hoarseness
difficult or labored breathing
fever or chills
lower back or side pain
mental depression
swelling of the hands, ankles, feet, or lower legs
tightness in the chest
Less common
difficult, burning, or painful urination
frequent urge to urinate
headache
unexplained broken bones
Incidence not known
Abdominal or stomach pain
clay-colored stools
confusion
dark urine
decreased urine output
difficulty with speaking
dilated neck veins
dizziness
double vision
inability to move the arms, legs, or facial muscles
inability to speak
irregular breathing
irregular heartbeat
itching or rash
loss of appetite
slow speech
unpleasant breath odor
unusual tiredness or weakness
vomiting of blood
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
general feeling of discomfort or illness
general feeling of tiredness or weakness
increased sweating
trouble sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Exemestane (Aromasin)
Pros
A pill that’s swallowed once a day
A type of hormone therapy that prevents certain types of breast cancers from growing and spreading
Recommended treatment option for breast cancer in people in different stages of menopause
Cons
Can cause menopausal symptoms, such as hot flashes and sweating
Can weaken your bones over time
Requires regular blood tests and follow-ups so your oncologist can check for side effects
Pharmacist tips for Exemestane (Aromasin)
Take exemestane (Aromasin) once a day after a meal. Try to take it at the same time each day. This helps make taking the medication a part of your daily routine.
You might have hot flashes while you take exemestane (Aromasin). Try wearing loose-fitting clothes or using fans to keep cool. Speak with your care team about other options or resources to help you cope with this side effect.
Exemestane (Aromasin) can weaken your bones as you continue treatment. To check your bone health, you might need bone scans done every so often. You also might need to get blood tests to check your vitamin D levels, a vitamin that’s important for your bones. Speak with your oncologist about whether you need to start a vitamin D supplement to help improve your bone health during treatment.
Avoid taking medications that contain estrogen while you’re taking exemestane (Aromasin). Estrogen-containing medications can make exemestane (Aromasin) work less well to treat your cancer.
Tell your cancer care team and pharmacist about all the medications you take, including supplements and over-the-counter products. Before you start any new medications, make sure they know you're taking exemestane (Aromasin). Some medications can lessen the amount of exemestane (Aromasin) in the body. This can affect how well the medication works to treat your breast cancer.
If you can become pregnant, use birth control, such as birth control pills or other effective methods, while you’re taking exemestane (Aromasin) and for at least 1 month after your last dose. It’s important to avoid getting pregnant during treatment because it’s possible for the medication to cause harm to an unborn baby.
Ask your oncologist or pharmacist about the best way to handle and throw away exemestane (Aromasin) safely. Anticancer medications can be very harmful to people who handle or come into contact with them.
More on Exemestane (Aromasin) tips
Frequently asked questions about Exemestane (Aromasin)
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What are the risks and warnings for Exemestane (Aromasin)?
Exemestane (Aromasin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low vitamin D levels
Low vitamin D levels are common in women with early breast cancer. Your oncologist might check your vitamin D levels through lab work before you start taking exemestane (Aromasin) and periodically throughout your treatment. Based on your results, your oncologist might recommend that you take a vitamin D supplement, like cholecalciferol (vitamin D3).
Weakened bones
Risk factors: History of osteoporosis | High risk of osteoporosis
Over time, exemestane (Aromasin) can weaken your bones. This can put you at risk for osteoporosis, and it might be easier for you to break a bone.
During treatment with exemestane (Aromasin), you'll need bone scans done to check the strength of your bones. If these scans show that your bones are getting weaker, your oncologist might recommend another medication to help make your bones stronger. These medications can include calcium, cholecalciferol (vitamin D3), or other medications. Be careful doing anything too active because weakened bones are more likely to break.
Changes in lab results related to kidney or liver health
Exemestane (Aromasin) can sometimes affect your blood tests results related to your kidney and liver health. These changes might be signs of damage. Because you might not notice these lab changes, your oncologist can check for them through blood work while you take exemestane (Aromasin). Call your cancer care team if you have any symptoms of kidney or liver problems, such as urinating less than usual, fluid buildup in your arms and legs, yellowing of your skin and eyes, and pain or swelling in your stomach area.
Low blood cell counts
Exemestane (Aromasin) can cause your white blood cell count to drop. When you have a low white blood cell count, your immune system is weaker and you’re at risk of developing infections. Your body also might have a harder time fighting off the infection. Your oncologist will check your blood cell counts often while you’re taking exemestane (Aromasin). Let your cancer care team know if you develop a fever or start to feel sick.
Harm to unborn baby
Based on animal studies, exemestane (Aromasin) can harm an unborn baby if it’s taken during pregnancy. It can also possibly raise the risk for miscarriage (pregnancy loss).
If you’re able to become pregnant, you’ll need to take a pregnancy test within 7 days before starting [EDITOR|DRUG_DISPLAY_NAME]] to make sure the medication is safe to take. You should also use birth control to prevent becoming pregnant while you’re taking exemestane (Aromasin) and for 1 month after your last dose. Let your oncologist know right away if you become pregnant while you’re taking this medication.
Exemestane (Aromasin) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 25mg | 30 tablets | $16.20 | $0.54 |
Typical dosing for Exemestane (Aromasin)
The typical dose is 25 mg taken by mouth once daily after a meal. This dose might differ if you’re taking certain medications that might interact with exemestane (Aromasin).
Interactions between Exemestane (Aromasin) and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Carbamazepine
- Enzalutamide
- Fosphenytoin
- Mitotane
- Phenytoin
- Primidone
- Rifabutin
- Rifampin
- Rifapentine
- St John's Wort
How much does Exemestane (Aromasin) cost?
What are alternatives to Exemestane (Aromasin)?
Early breast cancer in postmenopausal women who've had 2 to 3 years of treatment with tamoxifen
Advanced breast cancer in postmenopausal women whose cancer has worsened following treatment with tamoxifen
Early stage HR+ breast cancer in postmenopausal women
Advanced or metastatic HR+ breast cancer in postmenopausal women
Advanced breast cancer in postmenopausal women that's getting worse after treatment with tamoxifen
Breast cancer in females who have already gone through menopause:
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References
Best studies we foundAmerican Cancer Society. (2019). Chemotherapy safety.
American Cancer Society. (2024). Hormone therapy for breast cancer.
Breckenridge Pharmaceutical, Inc. (2024). Exemestane tablet, film coated [package insert]. DailyMed.
de Placeido, S., et al. (2018). Adjuvant anastrozole versus exemestane versus letrozole, upfront or after 2 years of tamoxifen, in endocrine-sensitive breast cancer (FATA-GIM3): A randomised, phase 3 trial. The Lancet Oncology.
MedlinePlus. (2023). Low white blood cell count and cancer.
National Cancer Institute. (n.d.). Ovarian suppression.
National Cancer Institute. (2021). Hot flashes and night sweats (PDQ®)–Patient version.
National Comprehensive Cancer Network. (2024). Invasive breast cancer.
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