Watch Closely (1)lumefantrine will lower the level or impact of exemestane by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Watch. For clients acquiring exemestane which has a potent CYP3A4 inducer the suggested dose of exemestane is 50 mg day by day after a food.dexamethasone will lower the level or impact of exemestane by inf