Side Effects Requiring Immediate Medical Attention
Along with its needed effects, ribociclib may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking ribociclib:
More common
- bloating or swelling of the face, arms, hands, lower legs, or feet
- bloody or cloudy urine
- difficult, burning, or painful urination
- fever
- lower back or side pain
- pale skin
- tingling of the hands or feet
- trouble breathing
- ulcers, sores, or white spots in the mouth
- unusual bleeding or bruising
- unusual weight gain or loss
Less common
- numbness and tingling around the mouth, fingertips, or feet
- pain or tenderness in the upper stomach
- pale stools
- red skin lesions, often with a purple center
- swollen glands
What Is Kisqali And How Is It Used
Kisqali is a prescription medicine used in combination with:
- an aromatase inhibitor to treat pre/perimenopausal or postmenopausal women with hormone receptor -positive, human epidermal growth factor receptor 2 -negative breast cancer that has spread to other parts of the body , as the first endocrine based therapy or
- fulvestrant to treat postmenopausal women with HR-positive, HER2-negative metastatic breast cancer as the first endocrine based therapy or with disease progression following endocrine therapy.
What Other Drugs Interact With Ribociclib
If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.
- Ribociclib has severe interactions with the following drugs:
This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.
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Can I Apply Cold Caps To My Scalp To Decrease Hair Loss
Talk to your provider about this option. Small studies have shown that products marketed as “cold caps” can reduce or prevent hair loss from chemotherapy in some patients. These work by decreasing the blood flow to the scalp, preventing the chemotherapy from affecting the hair follicles . Some providers are concerned that this may also prevent the chemotherapy from reaching cancer cells that may be in the scalp area.
Are There Lab Tests To Check For Side Effects From Taking Kisqali
For some of the side effects Kisqali may cause, your doctor can order certain lab tests. As an example, your doctor will likely order tests to check your liver health regularly while youre taking this drug. This helps monitor for liver damage, a possible serious side effect of Kisqali.
There are other lab tests your doctor will likely have you get while youre taking Kisqali. Talk with your doctor to find out more about the tests theyll order for you during your Kisqali treatment.
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Dealing With The Emotional Impact Of Hair Loss
Women from many cultures and backgrounds find that hair loss affects the way they view their bodies and femininity. If your hair means a lot to you, losing it can be painful. Even if youve never felt that your hair was an important part of who you are, losing it can still be distressing.
Hair loss also makes the issue of having cancer more public. For many people, it can bring up feelings of vulnerability and unwanted exposure.
If emotions about hair loss are interfering with your daily life, it can help talk to a professional. Ask your healthcare team to recommend a licensed professional counselor or therapist who specializes in helping women with breast cancer. In-person support groups or online communities may also bring you comfort. It can be reassuring to meet others who know what its like, and to know youre not alone.
Visit these pages to learn more about supportive resources:
Ribociclib And Hormone Therapy
In the UK ribociclib is always given alongside a hormone therapy drug.
You may have ribociclib with:
- An aromatase inhibitor if you have not already had hormone therapy for locally advanced or secondary breast cancer
- Fulvestrant if you have had hormone therapy for locally advanced or secondary breast cancer
Some people who had hormone therapy for primary breast cancer, and who now have locally advanced or secondary breast cancer, may be offered ribociclib with an aromatase inhibitor or fulvestrant. This will depend on their circumstances.
Taking ribociclib with an aromatase inhibitor
You take three ribociclib tablets a day for 21 days, followed by a seven-day break. This is known as a cycle.
The cycle is then repeated.
You take an aromatase inhibitor drug once a day continually throughout the cycle.
Taking ribociclib with fulvestrant
You take three ribociclib tablets a day for 21 days, followed by a seven-day break. This is known as a cycle.
The cycle is then repeated.
Fulvestrant is given in two injections, one into the muscle of each buttock. They are usually given every 14 days for the first three doses, then every 28 days for as long as you are taking ribociclib.
If you have not been through the menopause
Aromatase inhibitors and fulvestrant are suitable for women who have been through the menopause .
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How Should I Take Ribociclib
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Ribociclib is given in a 28-day treatment cycle. You will take the medicine for the first 21 days of each cycle, followed by 7 days off. Your doctor will determine how long to treat you with ribociclib.
Swallow the tablet whole and do not crush, chew, or break it.
Take the medicine at the same time each morning, with or without food.
If you vomit after taking the medicine, wait until the next day to take your next dose.
Do not use a broken or damaged pill.
You may need frequent medical tests to be sure ribociclib is not causing harmful effects. Your cancer treatments may be delayed based on the results.
Store ribociclib in the original container at room temperature, away from moisture and heat.
How To Prevent And Manage Hair Loss
If youre receiving treatment for breast cancer that can cause hair loss, its important to know you have options. Below, you can learn about ways to prevent and manage hair loss as a side effect of breast cancer treatments.
If chemotherapy medicines that will cause hair loss are part of your breast cancer treatment plan, there are steps you can take to prepare, possibly lessen hair loss, and protect your hair as it grows back. Learn more about Managing Hair Loss From Chemotherapy, including tips for hair loss on your head, eyebrows, and eyelashes.
Cold caps and scalp cooling systems are tightly fitting hat-like devices filled with a cold gel or liquid coolant. Cold caps and scalp cooling systems have helped many people keep some or quite a bit of their hair during chemotherapy. Learn more about Cold Caps and Scalp Cooling Systems
Many people find that wearing a wig is a good solution for them if they experience hair loss from breast cancer treatment. A wig can provide a sense of normalcy, consistency, and privacy during cancer treatment. Experimenting with different wig styles and colors can also be quite fun! Not sure if a wig is right for you or where to begin looking for one? Read more about wigs to learn about where to buy a wig or get one for free, how to choose one that suits you, how to care for a wig, and more.
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Drug Forms And Administration
Kisqali comes as tablets that you take by mouth. Its taken once a day for 21 days, followed by 7 days of not taking the drug. This 28-day cycle is repeated for as long as your doctor recommends.
Afinitor comes as tablets that you take by mouth. For breast cancer, its taken once a day for as long as your doctor recommends.
What Are The Possible Side Effects Of Ribociclib Kisqali Kisqali
Get emergency medical help if you have signs of an allergic reaction:hives difficult breathing swelling of your face, lips, tongue, or throat.
- fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness
- low white blood cell counts—fever, mouth sores, skin sores, sore throat, cough, trouble breathing
- signs of inflammation in the lungs–new or worsening cough, painful or difficult breathing, wheezing, feeling short of breath even while resting or
- liver problems–loss of appetite, upper stomach pain, tiredness, easy bruising or bleeding, dark urine, jaundice .
Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.
Common side effects may include:
- low white blood cells, infections
- cough
- hair loss.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
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Tucatinib Neratinib And Lapatinib
The tyrosine-kinase inhibitors FDA-approved for metastatic breast cancer treatment are:
- Tucatinib
- Neratinib
- Lapatinib
Tyrosine-kinase inhibitors are a class of drugs that target enzymes important for cell functions . These drugs can block tyrosine-kinase enzymes at many points along the cancer growth pathway.
A tyrosine-kinase inhibitor in combination with trastuzumab and chemotherapy can be used to treat HER2-positive metastatic breast cancer. This combination may give women with HER2-positive metastatic breast cancer more time before the cancer spreads compared to treatment with trastuzumab and chemotherapy alone .
Adding the tyrosine-kinase inhibitor tucatinib to treatment with trastuzumab and chemotherapy may also increase overall survival in women with HER2-positive metastatic breast cancer who were treated with trastuzumab in the past .
Neratinib is also used to treat HER2-positive early breast cancer.
Tucatinib, neratinib and lapatinib are pills.
Learn about neratinib and treatment of early breast cancer.
Tucatinib, neratinib and lapatinib and brain metastases
Many drug therapies cannot pass through the blood to the brain . So, they cant treat breast cancer that has spread to the brain.
However, tucatinib, neratinib and lapatinib can pass through the blood-brain barrier and may be used to treat some metastatic breast cancers that have spread to the brain.
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What Other Drugs Will Affect Ribociclib Kisqali Kisqali
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Ribociclib can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.
Many drugs can affect ribociclib. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.
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Using Cdk4/6 Inhibitors As A First
Some oncologists still often reserve CDK4/6 inhibitors as a second-line treatment for their patients with advanced breast cancer, waiting until the disease has started to progress on hormone-blocking therapies. But Dr. Burris said he hopes this thinking will now change.
We shouldnt be saving these therapies, Dr. Burris said. Regardless of which you pick, oncologists should be offering patients these drugs as a first-line treatment.
There doesnt appear to be a consensus on whether the updated findings from MONALEESA-2 mean ribociclib should be the preferred initial treatment.
Dr. Burris pointed to similar overall survival improvements seen with ribociclib in two other large clinical trials involving people with advanced breast cancer: MONALEESA-3 and MONALEESA-7, in younger, premenopausal patients.
Because of his long involvement in clinical trials of ribociclib and the consistency of the survival data from these trials, Dr. Burris said that he tends to favor it for many of his patients.
Other oncologists are likely to take the MONALEESA-2 results as confirmation that any of the CDK4/6 inhibitors are a good choice, Dr. McShane said.
Overall survival data from large clinical trials of palbociclib and abemaciclib as a first-line treatment in postmenopausal women with HR-positive, HER2-negative advanced breast cancer are expected to be available soon, Dr. McShane said, and she expects that they will also show an improved overall survival with the CDK4/6 inhibitor.
What Else Contributes To Hair Loss
There are a number of non-cancer-related medications that are also associated with hair loss. These might accentuate the effects of chemotherapy drugs if used alongside them.
Some of these include:
- Non-steroidal anti-inflammatory medications
- Antidepressants like tricyclic antidepressants and Wellbutrin
In addition to medications, illness, surgery, or dietary changes may lead to hair loss.
Thyroid disease may cause hair loss and may occur as a result of cancer treatment .
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Is Kisqali Right For You
Kisqali can work in combination with an aromatase inhibitor in premenopausal, perimenopausal, and postmenopausal women diagnosed with advanced-stage or metastatic, hormone-receptor-positive, HER2-negative breast cancer that hasnt been treated with hormonal therapy yet.
Premenopausal and perimenopausal women treated with Kisqali also should be treated with a luteinizing hormone-releasing hormone agonist, such as Zoladex, to suppress ovarian function.
Kisqali also can work in combination with Faslodex in postmenopausal women diagnosed with advanced-stage or metastatic, hormone-receptor-positive, HER2-negative breast cancer that hasnt been treated with hormonal therapy yet, or that has grown while be treated with a different hormonal therapy.
Advanced-stage breast cancer is cancer that has come back or spread beyond the breast to the chest wall below the breast. Metastatic breast cancer is advanced-stage cancer that has spread to parts of the body away from the breast, such as the bones or liver.
Both Faslodex, an estrogen receptor downregulator , and the aromatase inhibitors are types of hormonal therapy medicines used to treat hormone-receptor-positive breast cancer.
Faslodex and the aromatase inhibitors Arimidex, Aromasin, and Femara, are commonly used to treat postmenopausal women. The aromatase inhibitors can be used to treat premenopausal women if ovarian function is suppressed.
Hormonal therapy medicines treat hormone-receptor-positive breast cancers in two ways:
Other Medicines Foods And Drinks
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Peanut and soya allergy
Do not take ribociclib if you are allergic to peanuts or soya because it contains soya bean oil.
Grapefruit and grapefruit juice
You should not eat grapefruit or drink grapefruit juice when you are taking this drug because it may increase the side effects.
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How Do I Store And/or Throw Out This Drug
- Store in the original container at room temperature.
- Store in a dry place. Do not store in a bathroom.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
What Other Drugs Will Affect Ribociclib
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Ribociclib can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.
Many drugs can affect ribociclib. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.
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What Are Common Side Effects Of Chemo And Radiation
Chemo and radiation cause similar side effects. Chemos side effects depend on the type of drug used, the dosage, and a childs overall health. These effects are more likely to affect the whole body.
Radiations side effects, on the other hand, tend to affect the area being treated. But they do still depend on the dose of radiation given, the location on the body, and whether the radiation was internal or external.
Here are some of the side effects associated with these cancer treatments, and how to manage them:
Fatigue
Tiredness is the most common side effect of both chemotherapy and radiation. Even the most active kids are likely to find themselves exhausted and perhaps even a little foggy-headed during treatment and possibly for a while afterward. This is normal. Encourage your child to scale back on activities and to rest as much as possible. When treatment is over, your childs energy should return.
Flu-like Symptoms
Some cancer medicines appear to trigger the bodys normal inflammatory response, producing flu- or cold-like symptoms, such as a runny nose, chills, and cough. Drinking plenty of fluids can help clear excess mucus. Also ask your doctor which, if any, over-the-counter medicines might help.
Pain
Mouth, Gum, and Throat Sores
Gastrointestinal Problems
If your childs appetite wanes, try offering several small servings of something rather than three large meals. Also concentrate on keeping your child hydrated with water, juices, and broths.
Skin Changes