Aromasin

By Anton J. Bilchik, MD
Medically Reviewed by Brad Tice, PharmD, MBA, FAPhA
Last Update: January 16, 2025

What is Aromasin?

aromasin tablet 25mg Aromasin is a prescription medication designed to treat certain types of breast cancer in postmenopausal women. Its active ingredient, exemestane, is an aromatase inhibitor that lowers estrogen levels in the body. By reducing estrogen, the tablet helps slow or stop the growth of hormone receptor-positive breast cancer, a type of cancer that relies on estrogen to grow. It is often prescribed after treatments like tamoxifen or as part of a comprehensive plan to prevent the cancer from coming back.

This aromatase inhibitor is typically taken as a once-daily tablet and is highly effective in reducing the risk of breast cancer recurrence. Studies show that women taking this estrogen-lowering medication after tamoxifen experience up to a 65% reduction in recurrence rates. It is also effective in improving long-term survival and helping patients stay cancer-free. The tablet’s targeted action makes it a trusted choice for postmenopausal women looking to enhance their treatment outcomes and achieve lasting results.

FAQ

What is Aromasin good for?

This medication helps treat and manage certain types of breast cancer in postmenopausal women. Its active ingredient, exemestane, lowers estrogen levels, which slows or stops the growth of hormone-sensitive cancer cells. Here’s what Aromasin is good for:

Treating hormone receptor-positive breast cancer: Used to reduce estrogen levels and control cancer growth in postmenopausal women.
Preventing cancer recurrence: Lowers the risk of breast cancer returning after surgery or other treatments like tamoxifen.
Managing advanced breast cancer: Helps slow the progression of cancer that has spread to other parts of the body.
Reducing cancer progression after tamoxifen: Often prescribed as a follow-up treatment to improve long-term outcomes.

Hormone therapy for breast cancer plays a crucial role in improving survival rates and providing effective management for hormone-sensitive breast cancer. It is typically part of a long-term treatment plan to ensure lasting benefits.

What steroid is in this tablet?

The active ingredient in Aromasin is exemestane, a type of steroidal aromatase inhibitor. It works by permanently blocking the enzyme responsible for producing estrogen, helping to lower estrogen levels in the body and slow the growth of hormone-sensitive breast cancer cells. By reducing estrogen levels, it helps to slow or stop the growth of hormone receptor-positive breast cancer cells.

Although this drug is classified as a steroid due to its chemical structure, it is not the same as anabolic steroids used for muscle building. Instead, it is specifically designed to target hormonal pathways related to cancer treatment. This steroidal action makes this product highly effective in reducing estrogen and managing hormone-sensitive breast cancer.

What does Aromasin do to the body?

It affects the body by targeting estrogen levels, which helps manage certain types of breast cancer. Here’s how it works:

Blocks the aromatase enzyme: Stops the conversion of other hormones into estrogen.
Lowers estrogen levels: Reduces the amount of estrogen in the body, essential for hormone-sensitive breast cancer growth.
Slows cancer cell growth: Prevents cancer cells from multiplying by removing their main fuel (estrogen).
Reduces cancer recurrence: Helps prevent the cancer from returning after initial treatment.

These steps make this medication an effective treatment for hormone receptor-positive breast cancer in postmenopausal women.

Does this drug cause bone loss?

Yes, Aromasin can lead to bone loss in postmenopausal women undergoing treatment for hormone receptor-positive breast cancer. By lowering estrogen levels—a hormone essential for maintaining bone density—postmenopausal cancer therapy may increase the risk of osteoporosis and fractures. Clinical studies have observed a reduction in bone mineral density (BMD) among patients taking this steroidal aromatase inhibitor. For instance, a study reported a 6.1% decrease in BMD at the wrist over two years in women treated with this anti-estrogen medication, compared to a 1.8% decrease in those receiving a placebo.

To mitigate this side effect, healthcare providers often recommend regular BMD monitoring, adequate intake of calcium and vitamin D, and engaging in weight-bearing exercises. In some cases, additional medications may be prescribed to protect bone health during advanced breast cancer therapy. It’s important for patients to discuss bone health management strategies with their healthcare team while undergoing treatment with this anti-estrogen medication.

What does Aromasin do for men?

Exemestane medication is sometimes prescribed for men to manage conditions related to high estrogen levels. It works by reducing the enzyme aromatase, which converts testosterone into estrogen. This is particularly beneficial for men with gynecomastia (enlarged breast tissue), helping to shrink breast size and reduce tenderness caused by excess estrogen. Aromasin is also used in certain cases of hormone imbalances, such as those seen in obesity or specific medical conditions, to restore a more balanced testosterone-to-estrogen ratio.

In addition, the tablet is sometimes used as an off-label therapy for men undergoing testosterone replacement therapy (TRT). TRT can sometimes lead to increased estrogen levels, resulting in side effects like water retention, mood swings, or decreased testosterone effectiveness. The pill helps counter these effects by controlling estrogen levels, making TRT more effective and minimizing side effects. However, these tablets should be used under medical supervision to avoid excessively lowering estrogen, which is important for bone and cardiovascular health in men.

What is the benefit of this tablet?

Aromasin provides several key benefits for managing hormone receptor-positive breast cancer in postmenopausal women. Here’s how it helps:

Reduces estrogen levels: Lowers the hormone that fuels the growth of certain breast cancers.
Prevents cancer recurrence: Lowers the risk of cancer returning after treatment by up to 65%.
Slows cancer progression: Helps stop the growth of cancer cells in advanced or metastatic stages.
Improves survival rates: Enhances long-term outcomes for women with hormone-sensitive breast cancer.
Convenient to use: Taken as a once-daily tablet, making it easy to include in daily routines.

These benefits make this estrogen synthesis blocker a critical part of treatment for hormone-sensitive breast cancer.

Is Aromasin the same as Arimidex?

Aromasin (exemestane) and Arimidex (anastrozole) are both aromatase inhibitors used to treat hormone receptor-positive breast cancer in postmenopausal women. While they share similarities, they differ in how they work and their specific characteristics. Below is a comparison to help you understand the key differences:

Feature	Aromasin (Exemestane)	Arimidex (Anastrozole)
Type of inhibitor	Steroidal aromatase inhibitor	Non-steroidal aromatase inhibitor
Mechanism of action	Permanently blocks aromatase enzyme	Temporarily inhibits aromatase enzyme
Usage	Often used after tamoxifen	Commonly used as first-line therapy
Effectiveness	Comparable to Arimidex in reducing recurrence	Proven highly effective for early-stage breast cancer
Side effects	May cause more bone density loss	May lead to higher joint stiffness
Recommended duration	Typically 2–5 years	Typically 5 years

If you are starting hormone therapy for early-stage breast cancer, your doctor may recommend Arimidex as a first-line treatment. However, Aromasin is often preferred for patients who have already taken tamoxifen or as part of a sequential treatment plan. Both medications are effective, and the choice often depends on your specific medical history, tolerance for side effects, and treatment goals. Your healthcare provider will guide you in selecting the best option for your needs.

How fast does Aromasin lower estrogen?

Exemestane medication is effective in rapidly reducing estrogen levels in postmenopausal women with hormone receptor-positive breast cancer. After starting treatment, significant suppression of estrogen production occurs within 2 to 3 days. Studies have shown that a daily dose of 25 mg can lead to a reduction in estrogen levels by up to 98%.

This swift decrease in estrogen is crucial for inhibiting the growth of estrogen-dependent breast cancer cells. By effectively lowering estrogen levels, Aromasin helps to slow or stop the progression of the disease, making it a vital component of breast cancer treatment in postmenopausal women.

Do the side effects go away?

Yes, many side effects of exemestane (Aromasin) tend to go away as your body adjusts to the medication. Common side effects like hot flashes, joint pain, and fatigue often lessen within the first few months of treatment. However, some individuals may continue to experience these effects throughout the duration of therapy.

In certain cases, side effects may persist or become bothersome, potentially leading to discontinuation of the medication. For example, studies have shown that approximately 10% of participants stopped taking this medication each year due to side effects.

It’s important to note that individual experiences with side effects can vary. If you have concerns about side effects while taking these pills, discussing them with your healthcare provider can help determine the best course of action.

Does this tablet make you lose weight?

Exemestane (Aromasin) is not commonly associated with weight loss, but it can occur in some cases. Studies show that approximately 13.9% of patients reported losing 10% or more of their body weight when this medication was combined with other treatments like everolimus. This weight change is usually linked to the body’s response to hormonal adjustments and treatment side effects.

Weight changes may vary depending on individual factors such as age, health, and concurrent therapies. While weight loss is not a primary concern for most taking this drug, any significant changes should be monitored. Staying active and maintaining a balanced diet can help manage potential fluctuations during treatment. For tailored advice, regular consultations with your doctor are important to ensure a healthy treatment experience.

How much does Aromasin increase testosterone?

This tablet is primarily used to treat breast cancer by reducing estrogen levels. In men, it can lead to an increase in testosterone levels. Studies have shown that a daily dose of 25 mg can result in a 60% increase in serum testosterone levels.

However, at the standard therapeutic dose of 25 mg per day, significant increases in testosterone are not typically observed. Notably, increases in testosterone levels have been observed at daily doses of 200 mg or more.

It’s important to note that while the oral aromatase inhibitor can influence hormone levels, it is not approved for use as a testosterone booster. Using it for this purpose should only be done under medical supervision to avoid potential side effects and ensure safety.

What are the interactions?

Aromasin (exemestane) can interact with other medications, which may affect its effectiveness or increase the risk of side effects. It’s important to be aware of these interactions to ensure safe use. Below are some common interactions and examples of drugs involved:

Estrogen-containing medications: Drugs like oral contraceptives or hormone replacement therapy (e.g., estradiol, conjugated estrogens) can reduce the aromatase inhibitor’s effectiveness by counteracting its estrogen-lowering action.
CYP3A4 inducers: Medications like rifampin, phenytoin, or carbamazepine can speed up the breakdown of the oral aromatase inhibitor in the body, lowering its effectiveness.
CYP3A4 inhibitors: Drugs such as ketoconazole or erythromycin can increase exemestane levels, potentially leading to more side effects.
Blood thinners: Anticoagulants like warfarin may interact, increasing the risk of bleeding.
Herbal supplements: St. John’s Wort can interfere with anti-estrogen medication’s metabolism and reduce its efficacy.

Always inform your doctor about any medications, supplements, or herbal products you are using to avoid harmful interactions and ensure your treatment is as effective as possible.

How long can you stay on Aromasin 25mg?

The standard duration for taking 25 mg of exemestane is 2 to 5 years, depending on your treatment plan and individual medical needs. For postmenopausal women with early-stage hormone receptor-positive breast cancer, Aromasin is often prescribed for 5 years to reduce the risk of cancer recurrence. In some cases, it may be taken for 2 to 3 years after initial treatment with tamoxifen, completing a total of 5 years of hormone therapy.

In advanced or metastatic breast cancer, the treatment may be continued as long as it effectively controls the disease. Regular follow-ups with your doctor are essential to monitor your progress and adjust the duration if necessary. Prolonged use of this postmenopausal cancer therapy should be closely supervised to manage potential side effects, such as bone loss or joint pain, ensuring you receive the maximum benefit from your treatment.

When is the best time to take the tablet?

The best time to take Aromasin 25 mg is after a meal, preferably at the same time each day. Taking it with food helps improve absorption and ensures the medication works effectively. For example, you can take it with breakfast, lunch, or dinner, depending on what fits best into your daily routine.

Consistency is key for optimal results. Set a reminder or link the tablet to a regular mealtime to help you remember. Avoid taking it on an empty stomach, as this may reduce its effectiveness. If you accidentally miss a dose, take it as soon as you remember unless it’s almost time for your next dose. Do not double up to make up for a missed tablet. Always follow your doctor’s instructions for the best results.

What to avoid when taking this medication?

While taking exemestane (Aromasin), there are certain things you should avoid to ensure the medication works effectively and to reduce the risk of side effects. Here’s a detailed list:

Estrogen-containing medications: Avoid hormone replacement therapy, oral contraceptives, or any other products containing estrogen, as they can counteract the effects of the breast cancer treatment tablet.
Grapefruit and grapefruit juice: These can interfere with how your body processes the medication, potentially increasing side effects.
Smoking and excessive alcohol: Both can weaken bone health, which is already at risk due to the drug’s impact on estrogen levels.
High-calcium supplements without doctor approval: While calcium is beneficial for bone health, excessive intake without guidance can lead to other complications.
Skipping doses: Missing doses can reduce the effectiveness of the treatment, so it’s important to take the medication as prescribed.

Always inform your doctor about any other medications, supplements, or foods you’re consuming to avoid harmful interactions. Staying mindful of these factors will help you get the most out of your treatment.

About the Author

dr Anton Bilchik

Dr. Anton J. Bilchik, MD, is a highly respected Professor of Surgery and Chief of Medicine at the John Wayne Cancer Institute, leading advancements in cancer treatment and research since 2012. Renowned for his expertise in minimally invasive surgery and surgical oncology, he has authored over 200 research publications and continuously secured National Institutes of Health (NIH) grants since 2001. He also serves as Medical Director of the California Oncology Research Institute and a Professor at UCLA’s David Geffen School of Medicine. Dr. Bilchik’s career includes pivotal roles such as Director of Gastrointestinal Surgical Oncology at the John Wayne Cancer Institute. A graduate of the University of the Witwatersrand, Dr. Bilchik completed advanced training at Yale University and UCLA, specializing in surgical oncology and gastrointestinal research. His groundbreaking contributions, blending cutting-edge science with compassionate care, have earned him numerous professional honors and awards, including the Anti-Defamation League’s Humanitarian Award in 2012.

Disclaimer: This page offers general health information and is not a substitute for medical advice, diagnosis, or treatment from a qualified healthcare provider. If you have specific health concerns, consult a licensed medical professional. Never delay seeking medical assistance based on the content provided here.