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When given with YULAREB, refer to the Full Prescribing Information for the recommended dose of the aromatase inhibitor being used.
When given with YULAREB, the recommended dose of fulvestrant is 500 mg administered on Days 1, 15, and 29; and once monthly thereafter. Refer to the Full Prescribing Information for fulvestrant.
Pre/perimenopausal women treated with the combination of YULAREB plus fulvestrant should be treated with a gonadotropin-releasing hormone agonist according to current clinical practice standards.
Continue treatment until disease progression or unacceptable toxicity. YULAREB may be taken with or without food [see Pharmacology: Pharmacokinetics under Actions].
Instruct patients to take their doses of YULAREB at approximately the same times every day.
If the patient vomits or misses a dose of YULAREB, instruct the patient to take the next dose at its scheduled time. Instruct patients to swallow YULAREB tablets whole and not to chew, crush, or split tablets before swallowing. Instruct patients not to ingest YULAREB tablets if broken, cracked, or otherwise not intact.
Dose Modification: Dose Modifications for Adverse Reactions: The recommended YULAREB dose modifications for adverse reactions are provided in Tables 3-8. Discontinue YULAREB for patients unable to tolerate 50 mg twice daily. (See Tables 3, 4, 5, 6, 7 and 8.)
Click on icon to see table/diagram/image
Click on icon to see table/diagram/image
Click on icon to see table/diagram/image
Click on icon to see table/diagram/image
Click on icon to see table/diagram/image
Click on icon to see table/diagram/imageRefer to the Full Prescribing Information for coadministered aromatase inhibitor or fulvestrant for dose modifications and other relevant safety information.
Dose Modification for Use with Strong and Moderate CYP3A Inhibitors: Avoid concomitant use of the strong CYP3A inhibitor ketoconazole.
With concomitant use of strong CYP3A inhibitors other than ketoconazole, in patients with recommended starting doses of 150 mg twice daily, reduce the YULAREB dose to 100 mg twice daily. In patients who have had a dose reduction to 100 mg twice daily due to adverse reactions, further reduce the YULAREB dose to 50 mg twice daily. If a patient taking YULAREB discontinues a CYP3A inhibitor, increase the YULAREB dose (after 3-5 half-lives of the inhibitor) to the dose that was used before starting the strong inhibitor [see Effect of Other Drugs on YULAREB under Interactions and Pharmacology: Pharmacokinetics under Actions].
With concomitant use of moderate CYP3A inhibitors, monitor for adverse reactions and consider reducing the YULAREB dose in 50 mg decrements as demonstrated in Table 3, if necessary.
Dose Modification for Patients with Severe Hepatic Impairment: For patients with severe hepatic impairment (Child Pugh-C), reduce the YULAREB dosing frequency to once daily [see Hepatic Impairment under Precautions and Pharmacology: Pharmacokinetics under Actions].
Refer to the Full Prescribing Information for coadministered aromatase inhibitor or fulvestrant for dose modification requirements for severe hepatic impairment.
