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Adults: The recommended dose of letrozole is 2.5 mg once daily. In the adjuvant and extended adjuvant setting, treatment with letrozole should continue for 5 years or until disease relapse/recurrence occurs, whichever comes first. In patients with metastatic disease, treatment with letrozole should continue until tumor progression is evident.
Special populations: Hepatic impairment: No dose adjustment of letrozole is required for patients with mild to moderate hepatic insufficiency (Child-Pugh score A or B). Insufficient data are available for patients with severe hepatic impairment, but patients with severe hepatic impairment (Child-Pugh score C) should be kept under close supervision (see Precautions and PHARMACOLOGY: Pharmacokinetics under Actions).
Renal impairment: No dosage adjustment of letrozole is required for patients with renal insufficiency with creatinine clearance (CLcr) ≥10 mL/min. Insufficient data are available in cases of renal insufficiency with CLcr <10 mL/min (see Precautions and PHARMACOLOGY: Pharmacokinetics under Actions).
Pediatrics: Letrozole is not recommended for use in children and adolescents. The safety and efficacy of letrozole 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.
Geriatrics: No dose adjustment is required for elderly patients.
Method of administration: Letrozole should be taken orally and can be taken with or without food because food has no effect on the extent of absorption.
The missed dose should be taken as soon as the patient remembers. However, if it is almost time for the next dose, 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 under Actions).
