Aromasin (Exemestane) — Patient Information for Australia

Aromasin is a prescription medicine commonly used to treat certain types of breast cancer. The active ingredient is exemestane, which belongs to a group of medicines called aromatase inhibitors. Aromasin works by lowering oestrogen levels in the body, which can help slow the growth of hormone-sensitive breast cancer.

This page is written to help you understand how Aromasin works, how it’s typically taken, what interactions to watch for, and key safety points. If anything is unclear, speak with your clinician or pharmacist.

Quick Facts

• Medicine: Aromasin
• Active ingredient: Exemestane
• Medicine class: Aromatase inhibitor
• Common form: Oral tablets
• Common dosing schedule: Once daily (often after food)
• Primary use: Hormone receptor–positive breast cancer in postmenopausal women

How Aromasin Works (Mechanism of Action)

Exemestane reduces the production of oestrogen by inhibiting an enzyme called aromatase. Aromatase is responsible for converting androgens into oestrogens, particularly in tissues such as adipose (fat) tissue.

Many breast cancers depend on oestrogen to grow. By lowering oestrogen levels, Aromasin helps reduce stimulation of oestrogen-receptor–positive cancer cells.

Important note: Aromasin is designed to work in the setting of low natural oestrogen production typically seen after menopause. It may not work effectively in premenopausal women without additional ovarian suppression.

Pharmacokinetics (Absorption, Distribution, Metabolism, Excretion)

Understanding how the body handles exemestane can help explain why timing with meals matters.

Absorption

Exemestane is absorbed from the gut after oral dosing. Absorption may be improved when taken after food. This is one reason many patients are advised to take Aromasin after a meal.

Distribution

After absorption, exemestane circulates in the body and is distributed into tissues where aromatase is present.

Metabolism

Exemestane is primarily metabolised in the body by enzymes, producing metabolites that are cleared through normal elimination pathways.

Excretion

Metabolites are removed mainly through urine and faeces. The overall effect is that exemestane is cleared within a reasonable time after dosing, allowing for once-daily use.

What Aromasin Is Used For (Indications)

Aromasin is used for the treatment of hormone receptor–positive breast cancer in appropriate patients. Common clinical uses include:

• Early breast cancer: After initial treatment, Aromasin may be used as part of endocrine therapy to help reduce recurrence risk.
• Advanced/metastatic breast cancer: In postmenopausal women when the disease has progressed following prior endocrine therapy.
• Switch therapy: Some patients may be switched to exemestane from other hormone therapies under clinical guidance.

Your exact treatment plan depends on tumour characteristics, previous treatments, menopausal status, and overall health. Always follow the schedule your clinician recommends.

Typical Dosing and Timing

Aromasin is usually taken as an oral tablet once daily. Many patients are advised to take it after a meal (often after dinner) for best tolerability and absorption.

Common dosing (general information)

The most commonly used adult dose is 25 mg once daily. Your doctor may adjust your regimen based on your individual situation.

How to take it

• Take at the same time each day to help you remember.
• Take after food (for example, after your evening meal), unless your clinician advises otherwise.
• Swallow the tablet whole with water.
• Do not double up if you miss a dose.

If you miss a dose

If you miss a dose, take it when you remember if it’s close to the usual time. If it’s nearly time for the next dose, skip the missed tablet and continue your normal schedule. (If you’re unsure, ask a pharmacist.)

Food Interactions (Meals and Absorption)

Food can influence how well medicines are absorbed. For Aromasin, taking it after a meal is commonly recommended. This may help improve drug absorption and reduce the chance of stomach upset for some people.

• Best practice: Take your dose after food, such as after dinner.
• Consistency matters: Try to take it in a similar way each day.

There are no specific “no foods” restrictions, but it’s wise to follow any dietary advice given alongside your cancer treatment.

Alcohol and Medicine Interactions

Alcohol can affect your overall health and may worsen side effects such as dizziness, fatigue, nausea, or mood changes. Aromasin does not have a well-known direct alcohol interaction that is universally described as unsafe, but the main concern is tolerability and safety.

Practical guidance

• Limit alcohol if you experience side effects or if your clinician advises moderation.
• Avoid heavy drinking, particularly if you have liver disease or ongoing treatment-related fatigue.
• If you take other medicines, alcohol may interact indirectly (for example, increasing sedation with some drugs).

Important medicine interactions (general)

Some medicines may affect drug metabolism, potentially changing exemestane levels. Always tell your pharmacist about:

• Hormonal therapies and other endocrine medicines
• Certain antibiotics or antifungals (some can alter drug metabolism)
• Anticonvulsants (antiepileptic medicines)
• Herbal products, especially St John’s wort
• Any medicines you take occasionally (including over-the-counter options)

For the safest advice, ask your pharmacist to check your specific combination of medicines.

Safety Profile and Side Effects

Like all medicines, Aromasin can cause side effects. Not everyone will experience them, and many are manageable with supportive care. Report serious or persistent symptoms promptly.

Common side effects

• Hot flushes
• Joint pain or stiffness (arthralgia)
• Fatigue
• Headache
• Swelling (sometimes in legs/feet)
• Nausea or indigestion
• Sleep changes
• Reduced bone mineral density (may increase fracture risk over time)

Serious (seek medical advice urgently)

Get medical help urgently if you experience:

• Signs of severe allergic reaction (e.g., swelling of face/lips, rash, difficulty breathing)
• Symptoms of blood clot such as one-sided leg swelling or sudden shortness of breath (as advised by your clinician)
• Unexplained severe pain or persistent symptoms that worsen rapidly

Bone health considerations

Aromatase inhibitors can reduce oestrogen levels, which can affect bone density. Your clinician may:

• Arrange bone density scans (DEXA scans)
• Recommend calcium and vitamin D if appropriate
• Consider other medications for bone protection in higher-risk patients

Cardiovascular and metabolic health

Changes in cholesterol and cardiovascular risk can occur in some people undergoing endocrine therapy. Your clinician may monitor blood pressure, cholesterol, and overall risk factors.

Monitoring during treatment

Monitoring may include:

• Clinical review of symptoms
• Bone health assessment
• Blood tests as needed based on your overall health and other treatments

Practical Use Tips

• Set a daily reminder (phone alarm) to maintain consistent dosing.
• Take after dinner (or your largest meal) to support absorption and reduce nausea.
• Manage joint symptoms early: gentle stretching, regular movement, and discussing supportive options with your clinician can help.
• Support bone health: weight-bearing exercise (if safe for you), adequate calcium/vitamin D intake (as advised), and bone monitoring.
• Track side effects: note severity and timing; this can help your healthcare team tailor supportive care.

Alternative Options (What Your Clinician May Consider)

Depending on your diagnosis and prior therapy, alternatives to Aromasin may include other endocrine medicines. Examples include:

• Other aromatase inhibitors (e.g., letrozole, anastrozole)
• Selective oestrogen receptor modulators (e.g., tamoxifen in selected settings)
• Fulvestrant (a different type of hormone therapy used in some patients)
• Ovarian suppression therapies where appropriate for certain premenopausal patients

If you experience bothersome side effects or have concerns about effectiveness, discuss switching strategies with your clinician rather than stopping treatment on your own.

Market and Legal Context for Australia (Availability and Support)

Aromasin (exemestane) is available in Australia through regulated channels. Like many cancer medicines, it may be supplied via:

• Pharmacy dispensing under Australian healthcare rules
• Hospital/oncology pathways depending on treatment setting
• Possible subsidy schemes depending on eligibility and listing status (for example, PBS or other programs, where applicable)

Availability, brand packaging, and specific supply options can vary. Your local pharmacy or oncology team can advise on the most appropriate and timely supply route.

Recent Guidance and Treatment Updates

Endocrine therapy practices evolve as new clinical evidence and safety data become available. In general, current care in Australia typically includes:

• Choosing endocrine therapy based on tumour receptor status and menopausal status
• Regular assessment of bone health while on aromatase inhibitors
• Managing symptoms such as hot flushes and joint pain with supportive interventions
• Reviewing medicine interactions and overall cardiovascular risk

Always follow advice from your oncology team, as individual recommendations can differ based on your cancer stage, history, and co-existing conditions.

Delivery and Availability (Online Pharmacy)

Online pharmacies in Australia typically provide convenient ordering and home delivery. Availability may depend on stock levels and your location. When ordering Aromasin, consider:

• Packaging and strength: confirm the product strength and the form you need.
• Delivery timeframe: estimate based on standard dispatch times.
• Cold chain: Aromasin tablets do not usually require refrigeration, but always store as directed on the pack.
• Order completeness: ensure correct quantity and dosing instructions for your regimen.

If you need urgent supply (for example, because you’re nearing your next dose), contact the pharmacy to check dispatch and courier options.

Storage

• Store in the original packaging to protect from moisture.
• Keep out of reach of children.
• Store at room temperature (unless the pack directs otherwise).
• Check the expiry date and do not use after expiry.

Frequently Asked Questions (FAQ)

1) Who is Aromasin suitable for?

Aromasin is used for hormone receptor–positive breast cancer in appropriate patients, most commonly in postmenopausal women. Suitability depends on your cancer type, prior treatments, and menopausal status.

2) When should I take Aromasin?

A common schedule is once daily after a meal. Many people find taking it after dinner helps with absorption and comfort. Follow your clinician’s instructions.

3) Can I take Aromasin with food?

Yes. In many cases, taking it after food is recommended. If you eat late or your meal schedule changes, try to keep the routine consistent.

4) What if I forget to take a dose?

If you remember later, take it if it’s close to the time you usually take it. If it’s almost time for your next dose, skip the missed one and continue as normal. Ask a pharmacist if you’re unsure.

5) What side effects are most common?

Common side effects include hot flushes, joint pain, fatigue, headaches, nausea, and possible changes to bone density. Many side effects can be managed with supportive care.

6) Does Aromasin cause bone thinning?

It can. Aromasin lowers oestrogen levels, which may reduce bone mineral density. Your clinician may recommend bone density monitoring and preventive measures such as calcium/vitamin D or other bone-protecting treatments if needed.

7) Are there interactions with other medicines?

Yes, some medicines can affect how exemestane is metabolised or increase the risk of side effects. Always provide your pharmacist with a complete list of medicines, supplements, and herbal products—especially any recent changes.

8) Can I drink alcohol while taking Aromasin?

Moderate alcohol is not universally contraindicated, but it can worsen side effects like fatigue, dizziness, or nausea. Consider limiting alcohol and discuss your situation with your pharmacist, especially if you take other medicines.

9) How long will I need to take it?

Duration depends on your cancer stage, risk profile, and response. Aromasin is often taken for a defined period as part of endocrine therapy. Do not stop early without medical advice.

10) What should I do if side effects are bothering me?

Speak with your clinician or pharmacist. Options may include supportive strategies (exercise, symptom management), reviewing other medicines, and—if necessary—considering adjustments to your endocrine therapy plan.

Summary Table (At a Glance)

If you have any questions about Aromasin—such as how to take it with your other medications, what to do after a missed dose, or how to reduce side effects—speak with your pharmacist. They can help ensure your treatment is as safe and effective as possible.