exemestane (Rx)

Postmenopausal ER-Positive Breast Cancer

25 mg PO qDay; continue until tumor progression
Breast Cancer Adjuvant Treatment

Switch to exemestane dosage after 2-3 years of tamoxifen treatment
25 mg PO qDay; continue until tumor progression
Take after meals
Breast Cancer Prevention (Off-label)

2013 ASCO guidelines suggest exemestane as an alternative to tamoxifen or raloxifene to prevent invasive breast cancer in high risk women
25 mg PO qDay for 5 years
Dosage Modifications

Coadministration with potent CYP3A4 inducers: 50 mg PO qDay
Dosing Considerations

High risk of breast cancer is defined as at least 1 breast biopsy showing lobular carcinoma in situ (LCIS) or atypical hyperplasia, 1 or more first-degree relatives with breast cancer, or a 5-year predicted risk of breast cancer >1.66% (based on the modified Gail model)