1. What is exemestane?
Exemestane is a hormone therapy drug used to treat breast cancer in women who've gone through a natural menopause (when periods stop). It can also be used in premenopausal women having .
You may also hear it called Aromasin, which is its best-known brand name. There are a number of other brands of exemestane, all of which contain the same dose of the drug.
Men with breast cancer may be given exemestane, although another drug called is more commonly used.
2. How exemestane works
Exemestane works by reducing the amount of oestrogen made in the body.
Some breast cancers use oestrogen in the body to help them to grow. These are known as oestrogen receptor positive or ER+ breast cancers.
Exemestane is in a group of drugs called .
3. Who might be offered exemestane?
Exemestane is suitable for women who've been through the menopause and whose breast cancer is oestrogen receptor positive.
Sometimes exemestane is given alongside ovarian suppression to women who haven’t yet been through the menopause.
If your cancer is hormone receptor negative, then exemestane will not be of any benefit.
4. When is exemestane given?
Exemestane is usually given after surgery to reduce the risk of breast cancer coming back or spreading.
If you’re having or , your specialist will tell you when it’s best to start exemestane.
Occasionally, exemestane may be used as the first treatment for breast cancer, for example when surgery isn’t appropriate or needs to be delayed. It’s sometimes given before surgery to shrink a large breast cancer.
Exemestane can also be used to treat breast cancer that has come back (). It can also be given to treat breast cancer that has spread to another part of the body (), when it’s often given alongside another drug.
5. How exemestane is given
Exemestane is taken as a tablet once a day, with or without food. It’s best to take it at the same time every day.
If you miss a dose, you don’t need to take an extra dose the next day. The level of drug in your body will remain high enough from the day before.
Some brands of exemestane contain small amounts of sucrose. If you know you are intolerant to any type of sugar discuss this with your treatment team or pharmacist.
6. How long is exemestane given for?
Life during treatment
The recommended length of time that exemestane is taken for will depend on your individual situation.
People being treated for primary breast cancer will usually take exemestane for five to ten years.
Some people start taking exemestane after a few years of taking the hormone therapy drug tamoxifen.
If you’re taking exemestane to treat breast cancer that has come back or spread to another part of the body, you’ll usually take it for as long as it’s effective and any side effects can be managed.
7. Side effects of exemestane
Like any drug, exemestane can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others.
8. Stopping exemestane
Your treatment team will tell you when to stop taking exemestane. You won’t need to stop taking it gradually.
Some people worry about stopping their treatment, but there’s evidence that exemestane continues to reduce the risk of breast cancer coming back for many years after you stop taking it.
However, not taking the drug for the recommended time may increase the risk of your breast cancer coming back. If you’re thinking about stopping taking exemestane for any reason, talk to your specialist first. Sometimes it may be possible to change to another hormone therapy.
Hormone therapy is a very common treatment for and many people take it for a long time. If exemestane stops working, your specialist may prescribe another hormone therapy drug.
If you have any worries or questions about taking or stopping exemestane, you can call our free helpline on 0808 800 6000 to talk through your concerns.
9. Other important information
Taking exemestane with other drugs
If you’re taking any other prescribed or over-the-counter medicines, check with your treatment team or pharmacist if you can take these with exemestane.
The following medicines should be used cautiously if you take exemestane. Let your doctor know if you are taking medicines such as:
- Rifampicin (an antibiotic)
- Carbamazepine or phenytoin (anticonvulsants used to treat epilepsy)
- St John’s wort – a herbal remedy used as a complementary therapy for mild to moderate depression
Do not take other drugs containing oestrogen, such as hormone replacement therapy (HRT), while you’re taking exemestane as this may interfere with its effectiveness.
Talk to your specialist, pharmacist or GP about any complementary therapies, herbal remedies or supplements you want to use before you start using them.
Sex and contraception
Taking exemestane while pregnant may be harmful to a developing baby. It’s possible to become pregnant while taking exemestane even if your periods have stopped with ovarian suppression.
If you’re sexually active with a chance of becoming pregnant, your specialist is likely to advise you to use a non-hormonal method of contraception while taking exemestane. Non-hormonal methods include condoms, Femidoms or a diaphragm. It may also be possible to use a coil (IUD or intrauterine device). However, you would need to discuss this with your treatment team as not all types are suitable for women with breast cancer.
If you think you may be pregnant, stop exemestane and tell your specialist as soon as possible.
The impact of exemestane on fertility is not currently known. Getting pregnant while taking exemestane is not recommended.
It’s important to discuss any fertility concerns with your treatment team before you begin your treatment.
Breastfeeding is not recommended while having exemestane, or within a week of the last dose. This is because there’s a risk the drugs could be passed on through breast milk.