Ibrance Dosage/Direction for Use

Treatment with IBRANCE should be initiated and supervised by a physician experienced in the use of anticancer medicinal products.
Posology: The recommended dose is 125 mg of palbociclib once daily for 21 consecutive days followed by 7 days off treatment (Schedule 3/1) to comprise a complete cycle of 28 days. The treatment with IBRANCE should be continued as long as the patient is deriving clinical benefit from therapy or until unacceptable toxicity occurs.
When coadministered with palbociclib, the aromatase inhibitor should be administered according to the dose schedule reported in the Summary of Product Characteristics. Treatment of pre/perimenopausal women with the combination of palbociclib plus an aromatase inhibitor should always be combined with an LHRH agonist (see Precautions).
When coadministered with palbociclib, the recommended dose of fulvestrant is 500 mg administered intramuscularly on Days 1, 15, 29, and once monthly thereafter. Please refer to the Summary of Product Characteristics of fulvestrant. Prior to the start of treatment with the combination of palbociclib plus fulvestrant, and throughout its duration, pre/perimenopausal women should be treated with LHRH agonists according to local clinical practice.
Patients should be encouraged to take their dose at approximately the same time each day. If the patient vomits or misses a dose, an additional dose should not be taken that day. The next prescribed dose should be taken at the usual time.
Dose adjustments: Dose modification of IBRANCE is recommended based on individual safety and tolerability.
Management of some adverse reactions may require temporary dose interruptions/delays, and/or dose reductions, or permanent discontinuation as per dose reduction schedules provided in Tables 5, 6, and 7 (see Precautions and Adverse Reactions). (See Table 5.)

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Complete blood count should be monitored prior to the start of IBRANCE therapy and at the beginning of each cycle, as well as on Day 15 of the first 2 cycles, and as clinically indicated.
For patients who experience a maximum of Grade 1 or 2 neutropenia in the first 6 cycles, complete blood counts for subsequent cycles should be monitored every 3 months, prior to the beginning of a cycle and as clinically indicated.
Absolute neutrophil counts (ANC) of ≥1000/mm³ and platelet counts of ≥50,000/mm³ are recommended to receive IBRANCE. (See Tables 6 and 7.)

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IBRANCE should be permanently discontinued in patients with severe interstitial lung disease (ILD)/pneumonitis (see Precautions).
Special populations: Elderly: No dose adjustment of IBRANCE is necessary in patients ≥65 years of age (see Pharmacology: Pharmacokinetics under Actions).
Hepatic impairment: No dose adjustment of IBRANCE is required for patients with mild or moderate hepatic impairment (Child-Pugh classes A and B). For patients with severe hepatic impairment (Child-Pugh class C), the recommended dose of IBRANCE is 75 mg once daily on Schedule 3/1 (see Precautions and Pharmacology: Pharmacokinetics under Actions).
Renal impairment: No dose adjustment of IBRANCE is required for patients with mild, moderate or severe renal impairment (creatinine clearance [CrCl] ≥15 mL/min). Insufficient data are available in patients requiring haemodialysis to provide any dose adjustment recommendation in this patient population (see Precautions and Pharmacology: Pharmacokinetics under Actions).
Paediatric population: The safety and efficacy of IBRANCE in children and adolescents <18 years of age have not been established. No data are available.
Method of administration: IBRANCE is for oral use. It should be taken with food, preferably a meal to ensure consistent palbociclib exposure (see Pharmacology: Pharmacokinetics under Actions). Palbociclib should not be taken with grapefruit or grapefruit juice (see Interactions).
IBRANCE capsules should be swallowed whole (should not be chewed, crushed, or opened prior to swallowing). No capsule should be ingested if it is broken, cracked, or otherwise not intact.