Details of Drug

Drug General Information (ID: D0630)
Drug Name	Exemestane
Drug Type	Small molecule
Drug Synonymous	Aromasil; Aromasin; Aromasine; EXE; Exemestance; Exemestano; Exemestanum; Nikidess; Pfizer brand of exemestane; Curator_000009; Fce 24304; Aromasin (TN); Aromasin, Exemestane; Exemestano [INN-Spanish]; Exemestanum [INN-Latin]; FCE-24304; PNU-155971; Exemestane [USAN:INN:BAN]; Exemestane (JAN/USP/INN); (8R,9S,10R,13S,14S)-10,13-dimethyl-6-methylidene-7,8,9,11,12,14,15,16-octahydrocyclopenta[a]phenanthrene-3,17-dione; 6-Methylenandrosta-1,4-diene-3,17-dione; 6-Methyleneandrosta-1,4-diene-3,17-dione; 6-methylideneandrosta-1,4-diene-3,17-dione Click to Show/Hide
Disease Class	2C60-2C6Y: Breast cancer
Therapeutic Class	Antineoplastics
Structure
Structure	3D Structure		2D Structure
Formula	C20H24O2
InChI	1S/C20H24O2/c1-12-10-14-15-4-5-18(22)20(15,3)9-7-16(14)19(2)8-6-13(21)11-17(12)19/h6,8,11,14-16H,1,4-5,7,9-10H2,2-3H3/t14-,15-,16-,19+,20-/m0/s1
InChIKey	BFYIZQONLCFLEV-DAELLWKTSA-N
Canonical SMILES	CC12CCC3C(C1CCC2=O)CC(=C)C4=CC(=O)C=CC34C
External Link
	Pubchem ID	60198
	CAS Number	107868-30-4
	CHEBI ID	4953
	TTD ID	D0D2VS
	INTEDE ID	DR0675

Drug-Drug Interaction Network
Sunburst Graph		Legend Information AM004 Affected intra/extra-hepatic metabolism AM006 Pharmacodynamic additive effects AM007 Pharmacodynamic antagonistic effects BM017 CYP450 enzyme inhibition BM022 CYP450 enzyme induction BM024 Competitive inhibition of metabolic enzyme BM043 Additive immunosuppressive effects BM044 Additive myelosuppressive effects BM047 Additive thrombogenic effects BM107 Attenuated pharmacological effects (Unspecific)
Relation Graph

Full list of drugs interacting with Exemestane
Affected intra/extra-hepatic metabolism
	CYP450 enzyme inhibition					Drug Num: 4
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0002		Abametapir (topical)	C12H12N2	15664	Moderate		Inter Info	[21]
D0432		Deferasirox	C21H15N3O4	214348	Moderate		Inter Info	[23], [24]
D0699		Fostamatinib	C23H26FN6O9P	11671467	Moderate		Inter Info	[27]
D0899		Lefamulin	C28H45NO5S	25185057	Moderate		Inter Info	[28], [29], [30]
	CYP450 enzyme induction					Drug Num: 51
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0061		Aminoglutethimide	C13H16N2O2	2145	Moderate		Inter Info	[17]
D0178		Bexarotene	C24H28O2	82146	Moderate		Inter Info	[17]
D0194		Bosentan	C27H29N5O6S	104865	Moderate		Inter Info	[17]
D0224		Butabarbital	C10H16N2O3	2479	Moderate		Inter Info	[17]
D0225		Butalbital	C11H16N2O3	2481	Moderate		Inter Info	[17]
D0255		Carbamazepine	C15H12N2O	2554	Moderate		Inter Info	[17]
D0554		Efavirenz	C14H9ClF3NO2	64139	Moderate		Inter Info	[17]
D0071		Amobarbital	C11H18N2O3	2164	Moderate		Inter Info	[17]
D0095		Apalutamide	C21H15F4N5O2S	24872560	Moderate		Inter Info	[17]
D0106		Armodafinil	C15H15NO2S	9690109	Moderate		Inter Info	[17]
D0204		Brigatinib	C29H39ClN7O2P	68165256	Moderate		Inter Info	[22]
D0300		Cenobamate	C10H10ClN5O2	11962412	Moderate		Inter Info	[17]
D0406		Dabrafenib	C23H20F3N5O2S2	44462760	Moderate		Inter Info	[17]
D0453		Dexamethasone	C22H29FO5	5743	Moderate		Inter Info	[17]
D0545		Echinacea	NA	NA	Moderate		Inter Info	[25], [26]
D0555		Elagolix	C32H30F5N3O5	11250647	Moderate		Inter Info	[17]
D0578		Enzalutamide	C21H16F4N4O2S	15951529	Moderate		Inter Info	[17]
D0601		Eslicarbazepine	C15H14N2O2	9881504	Moderate		Inter Info	[17]
D0628		Etravirine	C20H15BrN6O	193962	Moderate		Inter Info	[17]
D0697		Fosphenytoin	C16H15N2O6P	56339	Moderate		Inter Info	[17]
D0872		Ivosidenib	C28H22ClF3N6O3	71657455	Moderate		Inter Info	[17]
D0953		Lorlatinib	C21H19FN6O2	71731823	Moderate		Inter Info	[17]
D0958		Lumacaftor	C24H18F2N2O5	16678941	Moderate		Inter Info	[18], [31], [32]
D1258		Pexidartinib	C20H15ClF3N5	25151352	Moderate		Inter Info	[17]
D1265		Phenobarbital	C12H12N2O3	4763	Moderate		Inter Info	[17]
D1400		Rifampicin	C43H58N4O12	135398735	Moderate		Inter Info	[18], [31], [32]
D1401		Rifapentine	C47H64N4O12	135403821	Moderate		Inter Info	[17]
D1433		Rufinamide	C10H8F2N4O	129228	Moderate		Inter Info	[34], [35]
D1493		Somapacitan	C54H95N13O20S2	129894493	Moderate		Inter Info	[18], [31], [32]
D1495		Somatrem	C43H72N14O14	5487805	Moderate		Inter Info	[17]
D1502		St. John's Wort	NA	NA	Moderate		Inter Info	[36], [37]
D1518		Sulfinpyrazone	C23H20N2O3S	5342	Moderate		Inter Info	[17]
D1538		Tazemetostat	C34H44N4O4	66558664	Moderate		Inter Info	[17]
D1546		Telotristat ethyl	C27H26ClF3N6O3	25181577	Moderate		Inter Info	[34], [38]
D1687		Vemurafenib	C23H18ClF2N3O3S	42611257	Moderate		Inter Info	[17]
D0639		Felbamate	C11H14N2O4	3331	Moderate		Inter Info	[17]
D0741		Griseofulvin	C17H17ClO6	441140	Moderate		Inter Info	[17]
D1040		Methylphenobarbital	C13H14N2O3	8271	Moderate		Inter Info	[18], [31], [32]
D1078		Mitotane	C14H10Cl4	4211	Moderate		Inter Info	[17]
D1081		Modafinil	C15H15NO2S	4236	Moderate		Inter Info	[17]
D1099		Nafcillin	C21H22N2O5S	8982	Moderate		Inter Info	[17]
D1128		Nevirapine	C15H14N4O	4463	Moderate		Inter Info	[17]
D1198		Oxcarbazepine	C15H12N2O2	34312	Moderate		Inter Info	[17]
D1248		Pentobarbital	C11H18N2O3	4737	Moderate		Inter Info	[17]
D1274		Phenylbutazone	C19H20N2O2	4781	Moderate		Inter Info	[17]
D1283		Phenytoin	C15H12N2O2	1775	Moderate		Inter Info	[17]
D1340		Primidone	C12H14N2O2	4909	Moderate		Inter Info	[17]
D1399		Rifabutin	C46H62N4O11	135398743	Moderate		Inter Info	[17]
D1453		Secobarbital	C12H18N2O3	5193	Moderate		Inter Info	[17]
D1494		Somatotropin	NA	NA	Moderate		Inter Info	[18], [31], [32]
D1652		Troglitazone	C24H27NO5S	5591	Moderate		Inter Info	[17]
	Competitive inhibition of metabolic enzyme					Drug Num: 3
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1549		Temsirolimus	C56H87NO16	6918289	Moderate		Inter Info	[39], [40]
D1476		Sirolimus	C51H79NO13	5284616	Moderate		Inter Info	[39], [40]
D1526		Tacrolimus	C44H69NO12	445643	Moderate		Inter Info	[39], [40]
Pharmacodynamic additive effects
	Additive immunosuppressive effects					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1174		Omacetaxine mepesuccinate	C29H39NO9	285033	Moderate		Inter Info	[33]
	Additive thrombogenic effects					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1569		Thalidomide	C13H10N2O4	5426	Major		Inter Info	[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16]
Pharmacodynamic antagonistic effects
	Attenuated pharmacological effects (Unspecific)					Drug Num: 14
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0387		Conjugated estrogens	C18H21NaO5S	45357473	Moderate		Inter Info	[18], [19], [20]
D0388		Conjugated estrogens (topical)	C18H21NaO5S	45357473	Moderate		Inter Info	[18], [19], [20]
D0484		Dienestrol (topical)	C18H18O2	667476	Moderate		Inter Info	[18], [19], [20]
D0487		Diethylstilbestrol	C18H20O2	448537	Moderate		Inter Info	[18], [19], [20]
D0606		Estradiol	C18H24O2	5757	Moderate		Inter Info	[18], [19], [20]
D0607		Estradiol (topical)	C18H24O2	5757	Moderate		Inter Info	[18], [19], [20]
D0609		Estrone	C18H22O2	5870	Moderate		Inter Info	[18], [19], [20]
D0619		Ethinylestradiol	C20H24O2	5991	Moderate		Inter Info	[18], [19], [20]
D0605		Esterified estrogens	NA	NA	Moderate		Inter Info	[18], [19], [20]
D0608		Estramustine	C23H31Cl2NO3	259331	Moderate		Inter Info	[18], [19], [20]
D0610		Estrone sulfate	C18H22O5S	3001028	Moderate		Inter Info	[18], [19], [20]
D0611		Estrone sulfate (topical)	C18H22O5S	3001028	Moderate		Inter Info	[18], [19], [20]
D1011		Mestranol	C21H26O2	6291	Moderate		Inter Info	[18], [19], [20]
D1370		Quinestrol	C25H32O2	9046	Moderate		Inter Info	[18], [19], [20]

References
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2	Bennett CL, Schumock GT, Desai AA, et al "Thalidomide-associated deep vein thrombosis and pulmonary embolism." Am J Med 113 (2002): 603-6. [PMID: 12459408]
3	Cavo M, Zamagni E, Cellini C, et al. "Deep-vein thrombosis in patients with multiple myeloma receiving first-line thalidomide-dexamethasone therapy." Blood 100 (2002): 2272-3. [PMID: 12229885]
4	Escudier B, Lassau N, Leborgne S, Angevin E, Laplanche A "Thalidomide and venous thrombosis." Ann Intern Med 136 (2002): 711. [PMID: 11992318]
5	Figg WD, Arlen P, Gulley J, et al. "A randomized phase II trial of docetaxel (taxotere) plus thalidomide in androgen-independent prostate cancer." Semin Oncol 28(4 Suppl 15) (2001): 62-6. [PMID: 11685731]
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7	Lee CK, Barlogie B, Munshi N, et al "DTPACE: an effective, novel combination chemotherapy with thalidomide for previously treated patients with myeloma." J Clin Oncol 21 (2003): 2732-9. [PMID: 12860952]
8	Osman K, Comenzo R, Rajkumar SV "Deep venous thrombosis and thalidomide therapy for multiple myeloma." N Engl J Med 344 (2001): 1951-2. [PMID: 11419443]
9	Product Information. Thalomid (thalidomide). Celgene Corporation, Warren, NJ.
10	Rajkumar SV, Hayman S, Gertz MA, et al. "Combination therapy with thalidomide plus dexamethasone for newly diagnosed myeloma." J Clin Oncol 20 (2002): 4319-23. [PMID: 12409330]
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14	Zangari M, Barlogie B, Anaissie E, et al "Deep vein thrombosis in patients with mutiple myeloma treated with thalidomide and chemotherapy: effects of prophylactic and therapeutic anticoagulation." Br J Haematol 126 (2004): 715-21. [PMID: 15327525]
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16	Desai AA, Vogelzang NJ, Rini BI, Ansari R, Krauss S, Stadler WM "A high rate of venous thromboembolism in a multi-institutional Phase II trial of weekly intravenous gemcitabine with continuous infusion fluorouracil and daily thalidomide in patients with metastatic renal cell carcinoma." Cancer 95 (2002): 1629-36. [PMID: 12365009]
17	Product Information. Aromasin (exemestane) Pharmacia & Upjohn, Kalamazoo, MI.
18	Product Information. Aromasin (exemestane) Pharmacia &amp Upjohn, Kalamazoo, MI.
19	Product Information. Femara (letrozole). Novartis Pharmaceuticals, East Hanover, NJ.
20	Product Information. Arimidex (anastrozole). Zeneca Pharmaceuticals, Wilmington, DE.
21	Product Information. Xeglyze (abametapir topical). Dr. Reddy's Laboratories Inc, Upper Saddle River, NJ.
22	Product Information. Alunbrig (brigatinib). Ariad Pharmaceuticals Inc, Cambridge, MA.
23	Product Information. Exjade (deferasirox). Novartis Pharmaceuticals, East Hanover, NJ.
24	Skerjanec A, Wang J, Maren K, Rojkjaer L "Investigation of the pharmacokinetic interactions of deferasirox, a once-daily oral iron chelator, with midazolam, rifampin, and repaglinide in healthy volunteers." J Clin Pharmacol 50 (2010): 205-13. [PMID: 19940232]
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27	Product Information. Tavalisse (fostamatinib). Rigel Pharmaceuticals, South San Francisco, CA.
28	Product Information. Fycompa (perampanel). Eisai Inc, Teaneck, NJ.
29	Product Information. Xenleta (lefamulin). Nabriva Therapeutics US, Inc., King of Prussia, PA.
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31	Product Information. Diabinese (chlorpropamide). Pfizer US Pharmaceuticals, New York, NY.
32	Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72. [PMID: 6781341]
33	Product Information. Synribo (omacetaxine). Teva Pharmaceuticals USA, North Wales, PA.
34	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
35	Product Information. Banzel (rufinamide). Eisai Inc, Teaneck, NJ.
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38	Product Information. Xermelo (telotristat ethyl). Lexicon Pharmaceuticals, Inc., The Woodlands, TX.
39	Product Information. Prograf (tacrolimus). Fujisawa, Deerfield, IL.
40	Product Information. Rapamune (sirolimus) Wyeth-Ayerst Laboratories, Philadelphia, PA.

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