Kisqali (ribociclib)

Kisqali is a prescription medicine used in combination with:

• an aromatase inhibitor to treat pre/perimenopausal or postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer that has spread to other parts of the body (metastatic), 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.

Kisqali may cause serious side effects, including:

• Lung problems. Kisqali may cause severe or life-threatening inflammation of the lungs during treatment that may lead to death. Tell your healthcare provider right away if you have any new or worsening symptoms, including:
• trouble breathing or shortness of breath
• cough with or without mucus
• chest pain
• Heart rhythm problems (QT prolongation). Kisqali can cause a heart problem known as QT prolongation. This condition can cause an abnormal heartbeat and may lead to death. Your healthcare provider should check your heart and do blood tests before and during treatment with Kisqali. Tell your healthcare provider right away if you have a change in your heartbeat (a fast or irregular heartbeat), or if you feel dizzy or faint.
• Liver problems. Kisqali can cause serious liver problems. Your healthcare provider should do blood tests to check your liver before and during treatment with Kisqali. Tell your healthcare provider right away if you get any of the following signs and symptoms of liver problems:
• yellowing of your skin or the whites of your eyes (jaundice)
• dark or brown (tea-colored) urine
• feeling very tired
• loss of appetite
• pain on the upper right side of your stomach area (abdomen)
• bleeding or bruising more easily than normal
• Low white blood cell counts (neutropenia). Low white blood cell counts are very common when taking Kisqali and may result in infections that may be severe. Your healthcare provider should check your white blood cell counts before and during treatment with Kisqali. Tell your healthcare provider right away if you have signs and symptoms of low white blood cell counts or infections such as fever and chills.

Your healthcare provider may tell you to decrease your dose, temporarily stop or completely stop taking Kisqali if you develop certain serious side effects during treatment with Kisqali.

The most common side effects of Kisqali include:

• neutropenia
• diarrhea
• headache
• nausea
• leukopenia
• constipation
• infections
• vomiting
• rash
• fatigue
• hair loss
• cough

Kisqali may cause fertility problems if you are male and take Kisqali. This may affect your ability to father a child. Talk to your healthcare provider if this is a concern for you.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all of the possible side effects of Kisqali. For more information, ask your healthcare provider or pharmacist.

• Take Kisqali exactly as your healthcare provider tells you.
• Do not change your dose or stop taking Kisqali unless your healthcare provider tells you.
• Take Kisqali each day at about the same time, preferably in the morning.
• You may take Kisqali with or without food.
• Swallow Kisqali tablets whole. Do not chew, crush, or split Kisqali tablets before swallowing them.
• Do not take any Kisqali tablets that are broken, cracked, or that look damaged. If you miss a dose of Kisqali or vomit after taking a dose of Kisqali, do not take another dose on that day. Take your next dose at your regular time.
• If you take too much Kisqali, call your healthcare provider right away or go to the nearest hospital emergency room.
• Inform your healthcare provider if you are pre-or perimenopausal.

What should I avoid while taking Kisqali?

Avoid eating grapefruit and drinking grapefruit juice during treatment with Kisqali since these may increase the amount of Kisqali in your blood.

It is not known if Kisqali is safe and effective in children.

What should I tell my healthcare provider before taking Kisqali?

Before you take Kisqali, tell your healthcare provider if you:

• have any heart problems, including heart failure, irregular heartbeats, and QT prolongation
• have ever had a heart attack
• have a slow heartbeat (bradycardia)
• have problems with the amount of potassium, calcium, phosphorus, or magnesium in your blood
• have fever, chills, or any other signs or symptoms of infection
• have liver problems
• have any other medical conditions
• are pregnant, or plan to become pregnant. Kisqali can harm your unborn baby.
  • If you are able to become pregnant, your healthcare provider should do a pregnancy test before you start treatment with Kisqali.
  • Females who are able to become pregnant and who take Kisqali should use effective birth control during treatment and for at least 3 weeks after the last dose of Kisqali.
  • Talk to your healthcare provider about birth control methods that may be right for you during this time.
  • If you become pregnant or think you are pregnant, tell your healthcare provider right away.
• are breastfeeding or plan to breastfeed. It is not known if Kisqali passes into your breast milk. Do not breastfeed during treatment with Kisqali and for at least 3 weeks after the last dose of Kisqali.

Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Kisqali and other medicines may affect each other causing side effects. Know the medicines you take. Keep a list of them to show your healthcare provider or pharmacist when you get a new medicine.