Steroidal aromatase inhibitor
Exemestane
Brand names: Aromasin
Adult dose
Dose: 25 mg PO OD with food
Route: PO
Frequency: OD
Clinical pearls
- Postmenopausal ER+ early/advanced breast cancer
- Co-prescribe vitamin D and calcium; consider DEXA at baseline + 2-yearly
Contraindications
- Premenopausal women
- Pregnancy/breastfeeding
Side effects
- Hot flushes
- Arthralgia
- Osteoporosis/fractures
- Fatigue
- Hepatic dysfunction
Interactions
- CYP3A4 inducers (rifampicin, phenytoin) reduce levels
- Oestrogen-containing products (antagonism)
Monitoring
- Bone density
- Lipids
- LFTs
Reference: BNF; NICE TA112; SmPC; https://bnf.nice.org.uk/drugs/exemestane/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Acute Myeloid Leukaemia Presentation · BSH; NICE — NG146
- Tumour Lysis Syndrome · Cairo-Bishop; BSH; NICE — Best Practice
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022