The goal of this paper is to understand how exponential-time approximation algorithms can be obtained from existing polynomial-time approximation algorithms, existing parameterized exact algorithms, and existing parameterized approximation algorithms. More formally, we consider a monotone subset minimization problem over a universe of size $n$ (e.g., Vertex Cover or Feedback Vertex Set). We have access to an algorithm that finds an $α$-approximate solution in time $c^k \cdot n^{O(1)}$ if a solution of size $k$ exists (and more generally, an extension algorithm that can approximate in a similar way if a set can be extended to a solution with $k$ further elements). Our goal is to obtain a $d^n \cdot n^{O(1)}$ time $β$-approximation algorithm for the problem with $d$ as small as possible. That is, for every fixed $α,c,β\geq 1$, we would like to determine the smallest possible $d$ that can be achieved in a model where our problem-specific knowledge is limited to checking the feasibility of a solution and invoking the $α$-approximate extension algorithm. Our results completely resolve this question: (1) For every fixed $α,c,β\geq 1$, a simple algorithm (``approximate monotone local search'') achieves the optimum value of $d$. (2) Given $α,c,β\geq 1$, we can efficiently compute the optimum $d$ up to any precision $\varepsilon > 0$. Earlier work presented algorithms (but no lower bounds) for the special case $α= β= 1$ [Fomin et al., J. ACM 2019] and for the special case $α= β> 1$ [Esmer et al., ESA 2022]. Our work generalizes these results and in particular confirms that the earlier algorithms are optimal in these special cases.