Drug absorption after gastric sleeve - especially aromatase inhibitors

Hello, I hope you are well. A gastric sleeve is by no means a "metabolic surgery". Metabolic surgeries are those in which a segment of your intestines is bypassed, which in turn results in malabsorption of nutrients and even drugs. In a gastric sleeve part of your stomach is resected, which only affects tha amount of food you are able to injest. It is possible your doctor felt reluctant to follow through with the procedure due to your comorbid conditions.

This is still a new area, since not much information has been published regarding altered absorption of different medications after a sleeve procedure. The consensus is that certain medications will show a decreased concentration in your system, albeit minimal. The main reason being due to a shift in the gastric pH. 
Regarding aromasin (exemestane), it has even been considered as treatment for gastric cancer alongside gastrectomy (removal of the stomach completely or partially). The initial dose is 25mg a day and can be increased by your attending physician according to the desired maximum plasma drug concentration.David Bizueth, MD OCC Physician