• Hormone receptor-positive (HR+) early breast cancer
    • In postmenopausal women after 2–3 years of tamoxifen → complete 5 years total of adjuvant therapy
  • Advanced or metastatic HR+ breast cancer in postmenopausal women
    • After progression on tamoxifen or other antiestrogens

Dose: 25 mg orally once daily, after a meal,Continue treatment until disease progression or unacceptable toxicity

  • In early breast cancer: typically 24–36 months, following tamoxifen
     For advanced breast cancer: until progression
  • Tablets: 25 mg
  • Take after food (improves absorption)
  • Take at the same time each day
  • Do not crush or chew tablet
  • Used only in postmenopausal women
  • Ensure menopausal status is confirmed before use
  • Class: Irreversible steroidal aromatase inhibitor (aka “suicide inhibitor”)
  • Mechanism of Action:
    • Blocks conversion of androgens to estrogens in peripheral tissues
    • ↓ Estrogen levels → starves estrogen-dependent tumor cells
  • Pharmacokinetics:
    • Oral bioavailability: ↑ with food
    • Metabolized by liver (CYP3A4, aldoketoreductases)
    • Half-life: ~24 hours
    • Excretion: Urine and feces
  • Hot flashes
  • Fatigue
  • Sweating
  • Nausea
  • Dizziness
  • Headache
  • Arthralgia/myalgia
  • Insomnia
  • Premenopausal women
  • Pregnancy or lactation
  • Hypersensitivity to exemestane or components
  • CYP3A4 inducers (e.g., rifampin, phenytoin, carbamazepine): may ↓ exemestane levels
  • Estrogen-containing therapies (e.g., HRT) antagonize effect—should be avoided
  • Does not inhibit CYP enzymes significantly, so minimal interactions

                                   Drug Status

Availability
Pregnancy
Breastfeeding
Schedule
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Aromasin 25mg Tablet 30’s Pfizer Labs Pfizer Labs