Ribociclib (Kisqali®)

About This Drug

Ribociclib is used to treat cancer. It is given orally.

Possible Side Effects

  • Nausea and throwing up (vomiting).
  • Tiredness
  • Constipation (not able to move bowels)
  • Loose bowel movements (diarrhea)
  • Hair loss. Hair loss is often temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face, armpits, pubic area, chest, and/or legs. You may also notice your hair getting thin.
  • Headache
  • Back pain
  • A decrease in the number of your white blood cells. This may raise your risk of infections.

Note: Each of the side effects above was reported in 20% or greater of patients treated with ribociclib. Not all possible side effects are included above.

Warnings and Precautions

  • EKG changes. This may cause your heart to beat in a way that is not normal. Your doctor may order an EKG to check this.
  • Changes in your liver function. Your liver function will be checked as needed.

Important Information

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.

How to Take Your Medication

  • Swallow the medicine whole with or without food. Take your medicine at approximately the same time every day, preferably in the morning.
  • Missed Dose: If you vomit or miss a dose, take your next dose at the regular time. Do not take 2 doses at the same time.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • Do not take your medicine if tablets look cracked, broken or look damaged.
  • This drug is excreted in the urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • As your doctor or nurse about medicines that are available to help stop or lessen constipation, diarrhea and/or nausea/vomiting.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • Talk to your doctor or nurse about precautions you can take to avoid infections.

Food and Drug Interactions

  • Do not eat grapefruit and/or pomegranate, or drink grapefruit/pomegranate juice while taking this medicine. They may raise levels of ribociclib in your body. This could make side effects worse.
  • Avoid the use of St. John’s Wort while taking ribociclib as this may lower the levels of the drug in your body, which can make it less effective.
  • Check with your doctor before starting any other herbal medication, as there may be serious drug interactions.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are a lot of known drug interactions with ribociclib. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms: 

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Wheezing or trouble breathing
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911
  • Loose bowel movements (diarrhea) 4 more times or loose bowel movements with lack of strength or a feeling of being dizzy
  • Nausea that stops you from you from eating or drinking
  • Throwing up more than 3 times a day
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • No bowel movement in 3 days or when you feel uncomfortable
  • Bad abdominal pain, especially in upper right area
  • Nausea that is not relieved by prescribed medicines
  • Lasting loss of appetite or rapid weight loss of 5 pounds in a week
  • Headache that does not go away
  • Feeling that your heart is beating too slow or too fast
  • Fatigue that interferes with your daily activities
  • If you think you are pregnant

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 3 weeks after treatment. Let your doctor know right away if you think you may be pregnant .
  • Breast feeding warning: Women should not breast feed during treatment and for 3 weeks after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Infertility warning: In men, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm banking.

Revised May 2017

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