Medical Oncologist
Medicines
Missed a dose of exemestane? What to do
Forgetting a tablet now and then happens to almost everyone on long-term hormone therapy. This page explains exactly what to do if you miss a dose of exemestane, take an extra one or are sick afterwards, why a single miss is unlikely to matter, and practical ways to build a routine that keeps you on track for years.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
On this page
- What should you do if you miss a dose of exemestane?
- Four common mix-ups and what to do
- When you remember, and what to do
- The vocabulary, in plain language
- What we know and do not know about missed doses
- Simple ways to remember your tablet
- Fasting, festivals, shift work and illness
- Myths about missed doses
- Common questions about missed doses of exemestane
The short answer
What should you do if you miss a dose of exemestane?
If you forget your exemestane tablet, the usual advice is simple. If you remember later the same day, take it then, ideally after a meal or snack. If you only remember the next day, when your next tablet is nearly due, skip the forgotten one and take your normal dose at the usual time. Never take two tablets together to make up for a missed one. Missing a single dose now and then is very unlikely to affect how well exemestane protects you. Exemestane switches off the aromatase enzyme permanently, and the body needs time to make new enzyme, so oestrogen levels do not jump back up overnight. What matters far more is the pattern over months and years. Studies of hormone therapy show that many women miss doses often or stop early, and that regularly missing tablets is linked with less benefit. If you find you forget frequently, that is a common problem with practical fixes, such as linking the tablet to a daily meal, using a phone alarm or a weekly pill box. If you accidentally take an extra tablet, one additional dose is unlikely to cause harm, but let your pharmacist or oncology team know and carry on as normal the next day. If you have missed several days, run out of tablets or stopped because of side effects, restart as soon as you can and tell your team, so they can help with whatever got in the way.
Same day: take it
If you remember later that day, take your tablet after some food and carry on as usual.
Next day: skip it
Leave out the forgotten tablet and take only your normal dose at the normal time.
Never double up
Taking two tablets at once does not add protection and may increase side effects.
This page gives general information only. Follow any specific instructions from your own team.Different situations
Four common mix-ups and what to do
Most have a simple fix and none is a reason to panic.
You forgot one tablet
Take it later the same day if you remember, or skip it if the next dose is nearly due. Then carry on as normal.
You took two by mistake
One extra tablet is unlikely to cause harm. Do not skip the next day to balance it out; just take your usual dose.
Seek advice if a child or someone else swallows your tablets.You were sick after taking it
Do not take another tablet. Take your next dose at the usual time, and tell your team if vomiting keeps happening.
You missed several days
Restart your normal daily dose as soon as you can, without taking extra to catch up.
Tell your team if
- You stopped because of side effects
- You ran out or could not afford a new pack
- You have missed more than a week
Quick guide
When you remember, and what to do
When you realise
What to do
A few hours after your usual time
Take it now, after a meal or snack
Late the same evening
Usually still fine to take it, then return to your normal time tomorrow
The next day, near your usual time
Skip the missed tablet and take just one as normal
You cannot remember whether you took it
Do not take another; carry on tomorrow and consider a pill box
After several missed days
Restart one tablet a day and let your team know
Words you may hear
The vocabulary, in plain language
- Adherence
- How closely you take a medicine as prescribed, including timing and not missing doses.
- Double dose
- Taking two tablets together to make up for a missed one, which is not advised.
- Irreversible inhibitor
- A medicine, like exemestane, that disables its target enzyme permanently rather than briefly.
- Pill organiser
- A box with a section for each day, making it easy to see whether you have taken today's tablet.
- Half-life
- The time it takes for the level of a medicine in the blood to fall by half.
- Persistence
- Continuing a medicine for the whole planned course rather than stopping early.
Talk to our team
Have a question about your situation?
Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
Call 1800 202 8726
Helpline open 24/7
Being straight with you
What we know and do not know about missed doses
Advice on missed doses is based on how the medicine behaves in the body, not on trials that tested forgetting.
Occasional misses
There is no evidence that forgetting a tablet once in a while changes long-term outcomes, and experts agree it is unlikely.
Frequent misses
Research on hormone therapy links poor adherence and stopping early with a higher chance of the cancer coming back. Exactly how many missed doses matter is not known.
What this page cannot tell you
It cannot tell you whether your own pattern of missed doses has affected your treatment. Your oncologist can talk this through honestly with you.
Building the habit
Simple ways to remember your tablet
Exemestane may be part of your life for years, so a routine that runs on autopilot is worth setting up.
Tie it to a meal
Because exemestane is best taken after food, many women keep the pack next to where they eat breakfast or dinner and take it straight after.
Use reminders
A daily phone alarm, a medicine reminder app or a weekly pill organiser helps. A family member can also check in, especially during busy or stressful periods.
Plan ahead for refills and travel
Set a reminder to buy a new pack a week before you run out. When travelling, carry enough tablets for the whole trip plus a few spare, in your hand luggage.
Changes in routine
Fasting, festivals, shift work and illness
Life does not always follow a fixed timetable. A little planning keeps your treatment on track.
Religious fasting
During fasts such as Ramadan or Navratri, you can usually take exemestane after the pre-dawn or evening meal, keeping to roughly the same time each day. Check with your team if you plan a long fast.
Shift work or time zones
Taking the tablet after your main meal each day is more important than an exact clock time. Move the timing gradually if needed.
When you are unwell
For minor illnesses, keep taking exemestane. If you cannot eat, take it with a small snack. Seek advice if you are admitted to hospital.
Commonly believed
Myths about missed doses
Missing one tablet ruins my treatment.
A single missed dose is very unlikely to matter. Simply carry on with your next dose.
I should take two tomorrow to catch up.
Doubling up does not add benefit. Take one tablet as normal.
Weekend breaks help with side effects.
Regular breaks are not a proven way to ease side effects and may reduce protection. Ask your team for other help.
If I have missed a lot, there is no point restarting.
Restarting still gives you benefit from here on. Tell your team and pick up again.
Questions we are asked
Common questions about missed doses of exemestane
Can I take exemestane at night if I forgot in the morning?
Yes. If you usually take it after breakfast and remember in the evening, take it after your evening meal. You can then return to your usual morning time the next day, or switch to evenings if that suits your routine better. Consistency matters more than the exact hour.
What if I took my tablet on an empty stomach?
That is not a missed dose, and you do not need to take another. Exemestane is absorbed a little better after food, which is why it is recommended after a meal, but an occasional dose without food is not a concern. Simply take the next one after eating.
Should I tell my doctor about a single missed dose?
There is no need to call about one forgotten tablet. Mention it at your next review if it worries you. Do tell your team if you are missing doses regularly, because they can help you find a routine or tackle side effects that make the tablets hard to take.
I ran out of tablets for a few days. Is that serious?
A short gap is unlikely to cause lasting harm, but restart as soon as you have new tablets. Do not take extra to make up the missed days. Set a refill reminder so it does not happen again, and tell your team if cost or supply was the reason.
What if a child swallows my exemestane tablets?
Get medical advice straight away, even if the child seems well. Take the pack with you so doctors know exactly what was swallowed and how much. Keep all medicines out of sight and reach of children, in their original packaging.
I stopped exemestane because of side effects. Can I restart?
Usually yes, but talk to your team first. They may suggest ways to manage the side effect, such as exercise or pain relief for joint aches, or a switch to a different hormone tablet. Restarting treatment still offers protection, so it is worth the conversation.
Does a missed dose change how long I take exemestane?
No. Occasional missed doses do not extend your planned course. If you have had a long gap of weeks or months, your oncologist may discuss whether to add that time on at the end. Ask at your next appointment.
Can I keep a spare strip in my handbag?
Yes, as long as the tablets stay in their original strip, away from heat and damp. A spare strip helps if you are away from home unexpectedly. Check the expiry date now and then, and replace the spare when you open a new pack.
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Sources
- Macmillan Cancer Support — Exemestane
- MedlinePlus — Exemestane
- Cancer Research UK — Exemestane (Aromasin)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.