FEMARA Film-coated tablet Ref.[50800] Active ingredients: Letrozole

Source: Health Products Regulatory Authority (IE)  Revision Year: 2021  Publisher: Novartis Ireland Limited, Vista Building,, Elm Park, Merrion Road, Ballsbridge, Dublin 4, Ireland

4.1. Therapeutic indications

  • Adjuvant treatment of postmenopausal women with hormone receptor positive invasive early breast cancer.
  • Extended adjuvant treatment of hormone-dependent-invasive breast cancer in postmenopausal women who have received prior standard adjuvant tamoxifen therapy for 5 years.
  • First-line treatment in postmenopausal women with hormone-dependent advanced breast cancer.
  • Advanced breast cancer after relapse or disease progression, in women with natural or artificially induced postmenopausal endocrine status, who have previously been treated with anti-oestrogens.
  • Neo-adjuvant treatment of postmenopausal women with hormone receptor positive, HER-2 negative breast cancer where chemotherapy is not suitable and immediate surgery not indicated.

Efficacy has not been demonstrated in patients with hormone receptor negative breast cancer.

4.2. Posology and method of administration

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 sections 4.4 and 5.1).

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 sections 4.4 and 5.2).

Hepatic impairment

No dose adjustment of Femara is required for patients with mild to moderate hepatic insufficiency (ChildPugh 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 sections 4.4 and 5.2).

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 section 5.2).

4.9. Overdose

Isolated cases of overdose with Femara have been reported.

No specific treatment for overdose is known; treatment should be symptomatic and supportive.

6.3. Shelf life

5 years.

6.4. Special precautions for storage

Do not store above 30°C.

Store in the original package in order to protect from moisture.

6.5. Nature and contents of container

PVC/PE/PVDC/aluminium blisters.

Packs of 10 (1x10), 14 (1x14), 28 (2x14), 30 (3x10), 100 (10 × 10) tablets.

Not all pack sizes may be marketed.

6.6. Special precautions for disposal and other handling

No special requirements for disposal.

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