Skip to Content

Everolimus Dosage

Medically reviewed on February 12, 2018.

Applies to the following strengths: 0.5 mg; 0.75 mg; 0.25 mg; 5 mg; 10 mg; 2.5 mg; 7.5 mg; 2 mg; 3 mg

Usual Adult Dose for Breast Cancer

10 mg orally once a day
Duration of therapy: Continue until disease progression or unacceptable toxicity occurs.

Comments:
-Not all trade name products are approved for the same indications. Refer to the manufacturer product information for indications.
-Dose should be taken at the same time each day.
-Dose should be taken consistently with or without food.
-Tablets should be swallowed whole with a glass of water and not chewed, broken, or crushed.
-Do not combine Afinitor(R) tablets and Afinitor Disperz(R) to achieve the desired total dose; use one or the other.

Uses:
1) Advanced Hormone Receptor-Positive, HER2-Negative Breast Cancer (Advanced HR+ BC): For postmenopausal women with advanced hormone receptor-positive, HER2-negative breast cancer (advanced HR+ BC) in combination with exemestane, after failure of treatment with letrozole or anastrozole
2) Advanced Neuroendocrine Tumors (NET):
-For progressive neuroendocrine tumors of pancreatic origin (PNET) with unresectable, locally advanced or metastatic disease
-For progressive, well-differentiated, non-functional neuroendocrine tumors (NET) of GI or lung origin with unresectable, locally advanced or metastatic disease
3) Advanced Renal Cell Carcinoma (RCC): For advanced renal cell carcinoma (RCC) after failure of treatment with sunitinib or sorafenib
4) For Renal Angiomyolipoma with Tuberous Sclerosis Complex (TSC): For renal angiomyolipoma and TSC, not requiring immediate surgery

Usual Adult Dose for Renal Cell Carcinoma

10 mg orally once a day
Duration of therapy: Continue until disease progression or unacceptable toxicity occurs.

Comments:
-Not all trade name products are approved for the same indications. Refer to the manufacturer product information for indications.
-Dose should be taken at the same time each day.
-Dose should be taken consistently with or without food.
-Tablets should be swallowed whole with a glass of water and not chewed, broken, or crushed.
-Do not combine Afinitor(R) tablets and Afinitor Disperz(R) to achieve the desired total dose; use one or the other.

Uses:
1) Advanced Hormone Receptor-Positive, HER2-Negative Breast Cancer (Advanced HR+ BC): For postmenopausal women with advanced hormone receptor-positive, HER2-negative breast cancer (advanced HR+ BC) in combination with exemestane, after failure of treatment with letrozole or anastrozole
2) Advanced Neuroendocrine Tumors (NET):
-For progressive neuroendocrine tumors of pancreatic origin (PNET) with unresectable, locally advanced or metastatic disease
-For progressive, well-differentiated, non-functional neuroendocrine tumors (NET) of GI or lung origin with unresectable, locally advanced or metastatic disease
3) Advanced Renal Cell Carcinoma (RCC): For advanced renal cell carcinoma (RCC) after failure of treatment with sunitinib or sorafenib
4) For Renal Angiomyolipoma with Tuberous Sclerosis Complex (TSC): For renal angiomyolipoma and TSC, not requiring immediate surgery

Usual Adult Dose for Pancreatic Cancer

10 mg orally once a day
Duration of therapy: Continue until disease progression or unacceptable toxicity occurs.

Comments:
-Not all trade name products are approved for the same indications. Refer to the manufacturer product information for indications.
-Dose should be taken at the same time each day.
-Dose should be taken consistently with or without food.
-Tablets should be swallowed whole with a glass of water and not chewed, broken, or crushed.
-Do not combine Afinitor(R) tablets and Afinitor Disperz(R) to achieve the desired total dose; use one or the other.

Uses:
1) Advanced Hormone Receptor-Positive, HER2-Negative Breast Cancer (Advanced HR+ BC): For postmenopausal women with advanced hormone receptor-positive, HER2-negative breast cancer (advanced HR+ BC) in combination with exemestane, after failure of treatment with letrozole or anastrozole
2) Advanced Neuroendocrine Tumors (NET):
-For progressive neuroendocrine tumors of pancreatic origin (PNET) with unresectable, locally advanced or metastatic disease
-For progressive, well-differentiated, non-functional neuroendocrine tumors (NET) of GI or lung origin with unresectable, locally advanced or metastatic disease
3) Advanced Renal Cell Carcinoma (RCC): For advanced renal cell carcinoma (RCC) after failure of treatment with sunitinib or sorafenib
4) For Renal Angiomyolipoma with Tuberous Sclerosis Complex (TSC): For renal angiomyolipoma and TSC, not requiring immediate surgery

Usual Adult Dose for Renal Angiomyolipoma

10 mg orally once a day
Duration of therapy: Continue until disease progression or unacceptable toxicity occurs.

Comments:
-Not all trade name products are approved for the same indications. Refer to the manufacturer product information for indications.
-Dose should be taken at the same time each day.
-Dose should be taken consistently with or without food.
-Tablets should be swallowed whole with a glass of water and not chewed, broken, or crushed.
-Do not combine Afinitor(R) tablets and Afinitor Disperz(R) to achieve the desired total dose; use one or the other.

Uses:
1) Advanced Hormone Receptor-Positive, HER2-Negative Breast Cancer (Advanced HR+ BC): For postmenopausal women with advanced hormone receptor-positive, HER2-negative breast cancer (advanced HR+ BC) in combination with exemestane, after failure of treatment with letrozole or anastrozole
2) Advanced Neuroendocrine Tumors (NET):
-For progressive neuroendocrine tumors of pancreatic origin (PNET) with unresectable, locally advanced or metastatic disease
-For progressive, well-differentiated, non-functional neuroendocrine tumors (NET) of GI or lung origin with unresectable, locally advanced or metastatic disease
3) Advanced Renal Cell Carcinoma (RCC): For advanced renal cell carcinoma (RCC) after failure of treatment with sunitinib or sorafenib
4) For Renal Angiomyolipoma with Tuberous Sclerosis Complex (TSC): For renal angiomyolipoma and TSC, not requiring immediate surgery

Usual Adult Dose for Neuroendocrine Carcinoma

10 mg orally once a day
Duration of therapy: Continue until disease progression or unacceptable toxicity occurs.

Comments:
-Not all trade name products are approved for the same indications. Refer to the manufacturer product information for indications.
-Dose should be taken at the same time each day.
-Dose should be taken consistently with or without food.
-Tablets should be swallowed whole with a glass of water and not chewed, broken, or crushed.
-Do not combine Afinitor(R) tablets and Afinitor Disperz(R) to achieve the desired total dose; use one or the other.

Uses:
1) Advanced Hormone Receptor-Positive, HER2-Negative Breast Cancer (Advanced HR+ BC): For postmenopausal women with advanced hormone receptor-positive, HER2-negative breast cancer (advanced HR+ BC) in combination with exemestane, after failure of treatment with letrozole or anastrozole
2) Advanced Neuroendocrine Tumors (NET):
-For progressive neuroendocrine tumors of pancreatic origin (PNET) with unresectable, locally advanced or metastatic disease
-For progressive, well-differentiated, non-functional neuroendocrine tumors (NET) of GI or lung origin with unresectable, locally advanced or metastatic disease
3) Advanced Renal Cell Carcinoma (RCC): For advanced renal cell carcinoma (RCC) after failure of treatment with sunitinib or sorafenib
4) For Renal Angiomyolipoma with Tuberous Sclerosis Complex (TSC): For renal angiomyolipoma and TSC, not requiring immediate surgery

Usual Adult Dose for Brain/Intracranial Tumor

4.5 mg/m2 orally once a day
Duration of therapy: Continue until disease progression or unacceptable toxicity occurs. The optimal duration of therapy is unknown.

Comments:
-Not all trade name products are approved for the same indications. Refer to the manufacturer product information for indications.
-Dose should be taken at the same time each day.
-Dose should be taken consistently with or without food.
-Afinitor(R) tablets should be swallowed whole with a glass of water and not chewed, broken, or crushed.
-Do not combine Afinitor(R) tablets and Afinitor Disperz(R) to achieve the desired total dose; use one or the other.
-Use therapeutic drug monitoring to guide subsequent dosing.
-Adjust dose at 2 week intervals as needed to achieve and maintain trough concentrations of 5 to 15 ng/mL.

Use: Subependymal Giant Cell Astrocytoma (SEGA) with Tuberous Sclerosis Complex (TSC): For tuberous sclerosis complex (TSC) for the treatment of SEGA that requires therapeutic intervention but cannot be curatively resected

Usual Adult Dose for Organ Transplant - Rejection Prophylaxis

KIDNEY transplant: 0.75 mg orally twice a day
Comments:
-Not all trade name products are approved for the same indications. Refer to the manufacturer product information for indications.
-This drug should be administered in combination with reduced dose cyclosporine as soon as possible after transplantation.
-Oral prednisone should be initiated once oral medication is tolerated. Doses may be further individualized based on the clinical status of the patient and function of the graft.

LIVER transplant: 1 mg orally twice a day
Comments:
-Not all trade name products are approved for the same indications. Refer to the manufacturer product information for indications.
-Start therapy at least 30 days after transplant.
-Use this drug in combination with reduced dose tacrolimus.
-Steroid doses may be individualized based on the clinical status of the patient and function of the graft.

Uses:
-Prophylaxis of organ rejection in patients at low-moderate immunologic risk receiving a kidney transplant and in combination with basiliximab induction and concurrently with reduced doses of cyclosporine and with corticosteroids
-Prophylaxis of allograft rejection in adult patients receiving a liver transplant to be administered no earlier than 30 days post-transplant concurrently with reduced doses of tacrolimus and with corticosteroids

Usual Pediatric Dose for Brain/Intracranial Tumor

One year and older:
4.5 mg/m2 orally once a day
Duration of therapy: Continue until disease progression or unacceptable toxicity occurs. The optimal duration of therapy is unknown.

Comments:
-Not all trade name products are approved for the same indications. Refer to the manufacturer product information for indications.
-Dose should be taken at the same time each day.
-Dose should be taken consistently with or without food.
-Afinitor (R) tablets should be swallowed whole with a glass of water and not chewed, broken, or crushed.
-Do not combine Afinitor (R) tablets and Afinitor Disperz (R) to achieve the desired total dose; use one or the other.
-Use therapeutic drug monitoring to guide subsequent dosing.
-Adjust dose at 2 week intervals as needed to achieve and maintain trough concentrations of 5 to 15 ng/mL.

Use: Subependymal Giant Cell Astrocytoma (SEGA) with Tuberous Sclerosis Complex (TSC): For tuberous sclerosis complex (TSC) for the treatment of SEGA that requires therapeutic intervention but cannot be curatively resected in pediatric patients 1 year and older

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

----DOSE MODIFICATIONS IN ADVANCED HORMONE RECEPTOR-POSITIVE, HER2-NEGATIVE BREAST CANCER, ADVANCED NET, ADVANCED RCC, AND RENAL ANGIOMYOLIPOMA WITH TSC----
-Mild hepatic impairment (Child-Pugh class A): The recommended dose is 7.5 mg a day. The dose may be reduced to 5 mg a day if not well tolerated.
-Moderate hepatic impairment (Child-Pugh class B): The recommended dose is 5 mg a day. The dose may be decreased to 2.5 mg a day if not well tolerated.
-Severe hepatic impairment (Child-Pugh class C): If the desired benefit outweighs the risk, a dose of 2.5 mg a day may be used but must not be exceeded.
-Dose adjustments should occur if a patient's hepatic status changes during therapy.

----DOSE MODIFICATIONS IN SEGA WITH TSC----
-Mild hepatic impairment (Child-Pugh class A): No dose adjustment recommended.
-Moderate hepatic impairment (Child-Pugh class B): No dose adjustment recommended.
-Severe hepatic impairment (Child-Pugh class C): Reduce the starting dose by approximately 50%.
-Assess everolimus trough concentrations approximately 2 weeks after commencing therapy, a change in dose, or any change in hepatic function.

DOSE MODIFICATIONS FOR ORGAN TRANSPLANT-REJECTION PROPHYLAXIS:
-Mild hepatic impairment (Child-Pugh class A): The initial daily dose should be reduced by one-third of the normally recommended initial dose.
-Moderate hepatic impairment (Child-Pugh class B) or severe hepatic impairment (Child-Pugh class C): Initial daily dose should be reduced to one-half of the normally recommended initial dose; further dose adjustment and/or dose titration should be made if the patient whole blood trough concentration of this drug is not within the target trough concentration range of 3 to 8 ng/mL

Dose Adjustments

DOSE MODIFICATIONS IN ADVANCED HORMONE RECEPTOR-POSITIVE, HER2-NEGATIVE BREAST CANCER, ADVANCED NET, ADVANCED RCC, AND RENAL ANGIOMYOLIPOMA WITH TSC:
----NON-INFECTIOUS PNEUMONITIS----
-Grade 1: No dose adjustment recommended; monitor closely
-Grade 2: Consider interrupting therapy; rule out infection; consider treatment with corticosteroids until symptoms improve to Grade 1 or less; reinitiate therapy at a lower dose; discontinue therapy if failure to recover within 4 weeks
-Grade 3: Interrupt therapy until symptoms resolve to Grade 1 or less; rule out infection; consider treatment with corticosteroids; consider reinitiating therapy at a lower dose; if toxicity recurs at Grade 3, consider discontinuing therapy
-Grade 4: Discontinue therapy; rule out infection; consider treatment with corticosteroids
----STOMATITIS----
-Grade 1: No dose adjustment recommended; manage with nonalcoholic or salt water (0.9%) mouthwash several times a day
-Grade 2: Interrupt therapy until recovery to Grade 1 or less; reinitiate therapy at the same dose; if stomatitis recurs at Grade 2, interrupt therapy until recovery to Grade 1 or less; reinitiate therapy at a lower dose; manage with topical analgesic mouth treatments (e.g., benzocaine, butyl aminobenzoate, tetracaine hydrochloride, menthol, phenol) with or without topical corticosteroids (i.e., triamcinolone oral paste)
-Grade 3: Interrupt therapy until recovery to Grade 1 or less; reinitiate therapy at a lower dose; manage with topical analgesic mouth treatments (e.g., benzocaine,
butyl aminobenzoate, tetracaine hydrochloride, menthol, phenol) with or without topical corticosteroids (i.e., triamcinolone oral paste)
-Grade 4: Discontinue therapy and treat medically
----OTHER NONHEMATOLOGIC TOXICITIES (EXCLUDING METABOLIC EVENTS)----
-Grade 1: If toxicity is tolerable, no dose adjustment is recommended; initiate medical therapy and monitor
-Grade 2: If toxicity is tolerable, no dose adjustment is recommended; initiate medical therapy and monitor; if toxicity becomes intolerable, interrupt therapy until recovery to Grade 1 or less; reinitiate therapy at the same dose; if toxicity recurs at Grade 2, interrupt therapy until recovery to Grade 1 or less; reinitiate therapy at a lower dose
Grade 3: Interrupt therapy until recovery to Grade 1 or less; initiate medical therapy and monitor; consider reinitiating therapy at a lower dose; if toxicity recurs at Grade 3, consider discontinuing therapy
Grade 4: Discontinue therapy and treat medically
----METABOLIC EVENTS (e.g., HYPERGLYCEMIA, DYSLIPIDEMIA)----
-Grade 1: No dose adjustment recommended; initiate medical therapy and monitor
-Grade 2: No dose adjustment recommended; initiate medical therapy and monitor
-Grade 3: Interrupt therapy temporarily; reinitiate therapy at a lower dose; treat medically and monitor
-Grade 4: Discontinue therapy; treat medically and monitor
----THROMBOCYTOPENIA----
-Grade 1: No dose adjustment recommended
-Grade 2: Interrupt therapy until recovery to Grade 1 or less; reinitiate therapy at the same dose
-Grade 3 or 4: Interrupt therapy until recovery to Grade 1 or less; reinitiate therapy at a lower dose
----NEUTROPENIA----
-Grade 1 or 2: No dose adjustment recommended
-Grade 3: Interrupt therapy until recovery to Grade 2 or less; reinitiate therapy at the same dose
-Grade 4: Interrupt therapy until recovery to Grade 2 or less; reinitiate therapy at a lower dose
----FEBRILE NEUTROPENIA----
-Grade 3: Interrupt therapy until recovery to Grade 2 or less and no fever; reinitiate therapy at a lower dose
-Grade 4: Discontinue therapy
----CYP450 3A4/P-GLYCOPROTEIN (PGP) INHIBITORS----
-Strong CYP450 3A4/PgP inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, atazanavir, nefazodone, saquinavir, telithromycin, ritonavir, indinavir, nelfinavir, voriconazole): Avoid use
-Moderate CYP450 3A4/PgP inhibitors (e.g., amprenavir, fosamprenavir, aprepitant, erythromycin, fluconazole, verapamil, diltiazem): Use with caution; if patients require coadministration of a moderate CYP450 3A4/PgP inhibitor, reduce the Afinitor (R) dose to 2.5 mg daily; an Afinitor (R) dose increase from 2.5 mg to 5 mg may be considered based on patient tolerance; if the moderate inhibitor is discontinued, a washout period of approximately 2 to 3 days should be allowed before the Afinitor (R) dose is increased; if the moderate inhibitor is discontinued, the Afinitor (R) dose should be returned to the dose used prior to initiation of the moderate CYP450 3A4/PgP inhibitor
-Grapefruit, grapefruit juice, and other foods that are known to inhibit CYP450 and PgP activity may increase everolimus exposures and should be avoided during therapy
----STRONG CYP450 3A4/PGP INDUCERS----
Avoid the use of concomitant strong CYP450 3A4/PgP inducers (e.g., phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, phenobarbital); if patients require coadministration of a strong CYP450 3A4/PgP inducer, consider doubling the daily dose of Afinitor (R) using increments of 5 mg or less; if the strong inducer is discontinued, consider a washout period of 3 to 5 days, before the Afinitor (R) dose is returned to the dose used prior to initiation of the strong CYP450 3A4/PgP inducer
-St. John's Wort (Hypericum perforatum) may decrease everolimus exposure unpredictably and should be avoided.

THERAPEUTIC DRUG MONITORING IN SEGA WITH TSC:
-Monitor everolimus whole blood trough levels routinely in all patients.
-Assess trough concentrations approximately 2 weeks after initiation of therapy, a change in dose, a change in coadministration of CYP450 3A4/P-gp inducers and/or inhibitors, a change in hepatic function, or a change in dosage form from Afinitor(R) to Afinitor Disperz(R).
-Once a stable dose is attained, monitor trough levels every 3 to 6 months in patients with changing body surface area or every 6 to 12 months in patients with a stable body surface area.
----Titrate the dose to attain trough concentrations of 5 to 15 ng/mL----
-For trough concentrations less than 5 ng/mL, increase the daily dose by 2.5 mg (Afinitor (R) tablets) or 2 mg (Afinitor (R) Disperz)
-For trough concentrations greater than 15 ng/mL, reduce the daily dose by 2.5 mg (Afinitor (R) tablets) or 2 mg (Afinitor (R) Disperz)
-If dose reduction is required for patients taking the lowest available strength, administer every other day

DOSE MODIFICATIONS IN SEGA WITH TSC:
----ADVERSE REACTIONS----
-Temporarily interrupt or permanently discontinue therapy for severe or intolerable adverse reactions
-If dose reduction is required when reinitiating therapy, reduce the dose by approximately 50%
-If dose reduction is required for patients receiving the lowest available strength, administer every other day
----CYP450 3A4/P-GLYCOPROTEIN (PGP) INHIBITORS----
-Strong CYP450 3A4/PgP inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, atazanavir, nefazodone, saquinavir, telithromycin, ritonavir, indinavir, nelfinavir, voriconazole): Avoid use
-Moderate CYP450 3A4/PgP inhibitors (e.g., amprenavir, fosamprenavir, aprepitant, erythromycin, fluconazole, verapamil, diltiazem): Reduce the Afinitor (R) or Afinitor (R) Disperz dose by approximately 50%; administer every other day if dose reduction is required for patients receiving the lowest available strength and maintain trough concentrations of 5 to 15 ng/mL.
-Assess everolimus trough concentrations approximately 2 weeks after dose reduction.
-Resume the dose that was used prior to initiating the CYP450 3A4/PgP inhibitor 2 to 3 days after discontinuation of a moderate inhibitor; assess the everolimus trough concentration approximately 2 weeks later.
-Do not ingest foods or nutritional supplements (e.g., grapefruit, grapefruit juice) that are known to inhibit CYP450 or PgP activity.
----STRONG CYP450 3A4/PGP INDUCERS----
Avoid the use of concomitant strong CYP450 3A4/PgP inducers (e.g., phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, phenobarbital) if alternative therapy is available; for patients who require treatment with a strong CYP450 3A4/PgP inducer:
-Double the dose of Afinitor (R) Tablets or Afinitor (R) Disperz and assess tolerability.
-Assess the everolimus trough concentration approximately 2 weeks after doubling the dose and adjust the dose if necessary to maintain a trough concentration of 5 to 15 ng/mL.
-Return the dose to that used prior to initiating the strong CYP450 3A4/PgP inducer if the strong inducer is discontinued, and assess the everolimus trough concentrations approximately 2 weeks later.
-Do not ingest foods or nutritional supplements (e.g., St. John's Wort (Hypericum perforatum)) that are known to induce CYP450 activity.

DOSE MODIFICATIONS IN KIDNEY OR LIVER TRANSPLANT:
Patients may require dose adjustments based on everolimus blood concentrations achieved, tolerability, individual response, change in concomitant medications and the clinical situation. Dose adjustments should be based on trough concentrations taken 4 or 5 days after a previous dosing change. Dose adjustment is required if the trough concentration is below 3 ng/mL. The total daily dose should be doubled using the available tablet strengths (0.25 mg, 0.5 mg or 0.75 mg). Dose adjustment is also required if the trough concentration is greater than 8 ng/mL on 2 consecutive measures; the dose should be decreased by 0.25 mg twice daily.

Precautions

US BOXED WARNINGS:
Zortress (R):
-MANAGEMENT OF IMMUNOSUPPRESSION: Only physicians experienced in immunosuppressive therapy and management of transplant patients should use Zortress(R).
-INFECTION AND MALIGNANCIES: Increased susceptibility to infection and the possible development of malignancies may result from immunosuppression.
-KIDNEY GRAFT THROMBOSIS: An increased risk of kidney arterial and venous thrombosis, resulting in graft loss, was reported, mostly within the first 30 days post-transplantation.
-ZORTRESS AND CALCINEURIN INHIBITOR-INDUCED NEPHROTOXICITY: Reduced doses of cyclosporine are required for use in combination with Zortress(R) in order to reduce nephrotoxicity.
-HEART TRANSPLANTATION: Increased mortality in a heart transplant clinical trial. Use in heart transplantation is not recommended.

CONTRAINDICATIONS:
-Hypersensitivity to the active component or any of the ingredients

Afinitor (R): Safety and efficacy have not been established in patients younger than 1 year.
Zortress (R): Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Take consistently with or without food.
-Maintain consistency in time of administration.
-Tablets should be taken with a full glass of water.
-Tablets should not be broken or crushed.
-Do not combine the 2 dosage forms (Afinitor(R) tablets and Afinitor Disperz(R)) to achieve the desired total dose for patients with SEGA with TSC.
-If a dose is missed, continue normal dosing schedule. Do not take 2 doses to make up for the missed dose.
-Zortress(R) should be taken 12 hours apart with or without food and at the same times each day.

General:
-Grapefruit, grapefruit juice, and other foods that are known to inhibit CYP450 and PgP activity may increase everolimus exposures and should be avoided during therapy.
-St. John's Wort (Hypericum perforatum) may decrease everolimus exposure unpredictably and should be avoided.
-AFINITOR (R) is available in 2 dosage forms: tablets (Afinitor) and tablets for oral suspension (Afinitor Disperz); Afinitor tablets may be used for all approved indications; Afinitor Disperz is approved for the treatment of patients with subependymal giant cell astrocytoma (SEGA) and tuberous sclerosis complex (TSC).

Storage requirements:
-Store in original container away from light and moisture.

Reconstitution/preparation techniques:
Afinitor Disperz(R):
-Wear gloves to avoid possible contact with the drug when preparing suspensions for another person.
-Administer as a suspension only within 60 minutes of preparation. If not used within 60 minutes, discard suspension.
-Prepare suspension in water only.

For additional information, refer to manufacturer product information.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Hide