Femara Dosage/Direction for Use

Posology: Adult and elderly patients: The recommended dose of Femara is 2.5 mg once daily. No dose adjustment is required for elderly patients.
In patients with advanced or metastatic breast cancer, treatment with Femara should continue until tumour progression is evident.
In the adjuvant and extended adjuvant setting, treatment with Femara should continue for 5 years or until tumour relapse occurs, whichever is first.
In the adjuvant setting a sequential treatment schedule (letrozole 2 years followed by tamoxifen 3 years) could also be considered (see Precautions and Pharmacology: Pharmacodynamics under Actions).
In the neoadjuvant setting, treatment with Femara could be continued for 4 to 8 months in order to establish optimal tumour reduction. If the response is not adequate, treatment with Femara should be discontinued and surgery scheduled and/or further treatment options discussed with the patient.
Paediatric population: Femara is not recommended for use in children and adolescents. The safety and efficacy of Femara in children and adolescents aged up to 17 years have not been established. Limited data are available and no recommendation on a posology can be made.
Renal impairment: No dosage adjustment of Femara is required for patients with renal insufficiency with creatinine clearance ≥10 ml/min. Insufficient data are available in cases of renal insufficiency with creatinine clearance lower than 10 ml/min (see Precautions and Pharmacology: Pharmacokinetics under Actions).
Hepatic impairment: No dose adjustment of Femara is required for patients with mild to moderate hepatic insufficiency (Child-Pugh A or B). Insufficient data are available for patients with severe hepatic impairment. Patients with severe hepatic impairment (Child-Pugh C) require close supervision (see Precautions and Pharmacology: Pharmacokinetics under Actions).
Method of administration: Femara should be taken orally and can be taken with or without food.
A missed dose should be taken as soon as the patient remembers. However, if it is almost time for the next dose (within 2 or 3 hours), the missed dose should be skipped, and the patient should go back to her regular dosage schedule. Doses should not be doubled because with daily doses over the 2.5 mg recommended dose, over-proportionality in systemic exposure was observed (see Pharmacology: Pharmacokinetics under Actions).