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Exemestane is an irreversible, steroidal aromatase inactivator, structurally related to the natural substrate androstenedione. It acts as a false substrate for the aromatase enzyme, and is processed to an intermediate that binds irreversibly to the active site of the enzyme causing its inactivation, an effect also known as "suicide inhibition." By being structurally similar to enzyme targets, Exemestane permanently binds to the enzymes, preventing them from converting androgen into estrogen.
Exemestane is taken in tablet form once a day. Patients can experience side effects like nausea, anxiety, shortness of breath, abdominal pain, bone pain, and chest pain. Side effects vary widely between patients and patients should report the side effects they experience to their doctors, as some may be indicators of dangerous complications. Shortness of breath and chest pain in particular are causes for concern in patients taking exemestane.
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