Kisqali (ribociclib) is a prescription drug that’s used to treat breast cancer. Kisqali comes as a tablet that you swallow.
Kisqali is prescribed for adults to treat HR-positive and HER2-negative breast cancer that has spread to tissues surrounding the breast or to other areas of the body.
Doctors typically prescribe Kisqali along with certain other medications.
To learn more about Kisqali’s uses, see the “What is Kisqali used for?” section below.
Kisqali basics
Kisqali comes as a tablet that you swallow. It contains the active ingredient ribociclib. (An active ingredient is what makes a drug work.)
Kisqali belongs to a group of drugs called kinase inhibitors. It’s a type of targeted therapy.
This medication isn’t available in a generic version.
Kisqali is used to treat advanced or metastatic breast cancer in adults. With advanced breast cancer, the cancer has spread to tissues surrounding the breast. And with metastatic breast cancer, the cancer has spread to other areas of the body.
Breast cancer cells have certain patterns of receptors on their surface. (Receptors are a type of protein. When they’re on the cell surface, they allow substances to attach to and interact with the cell.) Kisqali is used to treat breast cancer cells with the following pattern of receptors:
- Hormone receptor (HR)-positive. Estrogen and progesterone are hormones. HR-positive cancer cells have receptors for one or both of these hormones.
- Human epidermal growth factor receptor 2 (HER2)-negative. HER2 is a receptor found on all breast cells. HER2-negative cancer cells have a typical amount of HER2 receptors. (Cancer cells that are HER2-positive have many HER2 receptors and tend to grow and divide quickly.)
This pattern is called HR-positive and HER2-negative.
Kisqali works by blocking certain proteins in cancer cells. When present in high amounts, these proteins cause the cancer cells to grow and divide more quickly than usual. By blocking these proteins, Kisqali slows the cancer’s growth and helps prevent it from spreading further.
Doctors usually prescribe Kisqali along with hormone therapy. Examples of hormone therapy drugs include fulvestrant (Faslodex) and letrozole (Femara). The specific type of hormone therapy your doctor prescribes depends on several factors. They’ll consider which hormone therapy you’ve taken in the past for your breast cancer, whether your cancer worsened while taking it, your menopause status, and your sex assigned at birth.
Like most drugs, Kisqali may cause mild or serious side effects. The lists below describe some of the more common side effects that Kisqali may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Kisqali. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects that Kisqali can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Kisqali’s prescribing information.
Mild side effects of Kisqali that have been reported include:
- getting mild infections more often than usual
- nausea and vomiting
- tiredness
- diarrhea
- headache
- thinning hair or hair loss
- pain in your back or abdomen (belly)
- cough
- constipation
- rash
- mild allergic reaction*
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
* To learn more about this side effect, see the “Allergic reaction” section below.
Serious side effects
Serious side effects from Kisqali can occur, but they aren’t common. If you have serious side effects from Kisqali, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Kisqali that have been reported include:
- blood disorders, such as low levels of red blood cells or white blood cells
- breathing problems due to interstitial lung disease or pneumonitis (inflammation of the lungs)
- liver problems
- severe allergic reaction†
To learn more about Kisqali’s side effects, see this article.
† To learn more about this side effect, see the “Allergic reaction” section below.
Allergic reactionSome people may have an allergic reaction to Kisqali.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Kisqali. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Whether you have health insurance or not, cost may be a factor when you’re considering Kisqali. What you’ll pay for Kisqali may depend on several things, such as your treatment plan and the pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. Certain saving programs may be available. You can also check out this article to learn more about saving money on prescriptions.
And to learn more about the cost of Kisqali, see this article.
Find answers to some commonly asked questions about Kisqali.
Do I need to take my Kisqali dosage in the morning?
Kisqali’s manufacturer recommends taking Kisqali around the same time each day, preferably in the morning. (You’ll take your dose of Kisqali once daily for 21 days, followed by 7 days off, and then repeat.)
If your schedule doesn’t allow for morning dosing, you can take Kisqali at another time of day. But try to take it around the same time each day.
To help make sure you don’t miss a dose, try setting an alarm or a reminder on your phone.
How does Kisqali compare with Ibrance?
Kisqali and Ibrance (palbociclib) belong to the same group of drugs. And they’re prescribed to treat the same types of breast cancer.
The drugs both come as tablets that you swallow. Kisqali and Ibrance tablets may be taken with or without food. Ibrance is also available as an oral capsule that must be taken with food.
Researchers are comparing the effectiveness of Kisqali versus Ibrance in an ongoing study. But the results aren’t yet known. This study isn’t expected to be completed for several years.
If you have other questions about how Kisqali and Ibrance compare, talk with your doctor. They can help you find the best treatment for you.
Does Kisqali cause long-term side effects?
It’s possible. Long-term side effects include those that may start during treatment and continue for a long time. They also include side effects that may not go away, even after you stop taking the drug.
For example, in animal studies, Kisqali was shown to cause fertility problems in males.* (But animal studies don’t always reflect what will happen in people. It’s not known if Kisqali causes fertility problems in humans.)
Talk with your doctor to learn more about possible side effects of Kisqali and how long they may last.
* In this article, we use the term “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Your doctor will recommend the dosage of Kisqali that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Form and strength
Kisqali is available as an oral tablet in one strength: 200 milligrams (mg).
Recommended dosage
The typical dose of Kisqali is 600 mg, which is three 200-mg tablets taken together. You’ll take this dose once daily for 21 days followed by 7 days off. You’ll repeat this cycle for as long as you and your doctor determine the drug is safe and effective for you.
To learn more about Kisqali’s dosage, see this article.
How to take
Your doctor will explain how you should take Kisqali. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.
Questions about taking Kisqali
Below are some common questions about taking Kisqali.
- Can Kisqali be chewed, crushed, or split? No, you should not chew, crush, or split Kisqali tablets. Swallow them whole. You should not take a Kisqali tablet if it’s broken, cracked, or damaged in any way. If you have trouble swallowing pills, you can ask your doctor or pharmacist for advice.
- Should I take Kisqali with food? You can take Kisqali with food or without it.
- Is there a best time of day to take Kisqali? Kisqali can be taken at any time of day, but the morning is ideal. It’s important to take Kisqali around the same time each day. This helps keep a consistent level of the drug in your body, which helps Kisqali work effectively.
- What if I miss a dose of Kisqali? If you miss a dose of Kisqali, do not take a dose later in the day. Rather, take your next dose at its regularly scheduled time. (To help make sure you don’t miss a dose, try setting an alarm or a reminder on your phone.) If you vomit after taking a dose, do not take any additional doses of Kisqali that day. Take your next dose at the usual time.
- Will I need to use Kisqali long term? Probably. You will take Kisqali for as long as you and your doctor determine the drug is safe and effective for you.
Overdose
Do not take more Kisqali than your doctor prescribes. Taking more than this can lead to harmful effects.
What to do in case you take too much Kisqali
Call your doctor if you think you’ve taken too much Kisqali. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
Below is important information you should consider before taking Kisqali.
Interactions
Taking a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.
Kisqali can interact with several other medications. It can also interact with certain supplements as well as certain foods.
Before taking Kisqali, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
Drug interactions
Below is a list of medications that can interact with Kisqali. This list does not contain all drugs that may interact with Kisqali. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Drug group or drug name | Drug examples |
certain antibiotics | • clarithromycin • rifampin |
certain antifungals | • ketoconazole • itraconazole (Sporanox) |
certain antiviral drugs | • ritonavir (Norvir) • nelfinavir (Viracept) |
certain seizure medications | • phenytoin (Dilantin, Phenytek) • carbamazepine (Tegretol, Epitol, Tegretol XR) |
certain migraine drugs | • ergotamine (Ergomar) • dihydroergotamine (Migranal, Trudhesa) |
certain antiarrhythmic drugs | • amiodarone (Pacerone) • quinidine |
fentanyl | — |
midazolam | — |
ondansetron (Zofran) | — |
Other interactions
Kisqali can also interact with other substances, such as:
- Vitamins or supplements: Kisqali interacts with the herb St. John’s wort (Hypericum perforatum). Your doctor will likely recommend that you avoid taking this herbal supplement during your Kisqali treatment.
- Foods: Kisqali interacts with grapefruit and grapefruit juice. Your doctor will likely recommend that you do not consume grapefruit products during your Kisqali treatment.
- Alcohol: Alcohol is not known to interact with Kisqali. Talk with your doctor to determine whether it’s safe for you to consume alcohol during Kisqali treatment.
Pregnancy and breastfeeding
Kisqali is not safe to use during pregnancy. It isn’t known if Kisqali passes into breast milk. The manufacturer of Kisqali recommends that you not breastfeed during your treatment with Kisqali and for at least 3 weeks after your last dose.
Birth control
If you’re able to become pregnant, you should use birth control throughout your Kisqali treatment and for at least 3 weeks after your last dose.
Warnings
Kisqali can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Kisqali is a good treatment option for you.
Talk with your doctor about your health history before you take Kisqali. Be sure to tell them if any of the following factors apply to you:
- heart problems, such as long QT syndrome, a slow heart rate, or a past heart attack
- liver problems
- an active infection or signs or symptoms of one, such as fever
- problems with certain electrolyte blood levels, including blood levels of calcium, magnesium, phosphorus, or potassium
- previous allergic reaction to Kisqali
- pregnancy
- breastfeeding
Other drugs are available that can treat your condition. If you’d like to explore an alternative to Kisqali, talk with your doctor. They can tell you about other medications that might work well for you.
The following drugs are similar to Kisqali:
- abemaciclib (Verzenio)
- alpelisib (Piqray)
- elacestrant (Orserdu)
- everolimus (Afinitor)
- olaparib (Lynparza)
- palbociclib (Ibrance)
- talazoparib (Talzenna)
In certain situations, doctors may prescribe these drugs along with hormone therapy, such as treatment with fulvestrant (Faslodex) or letrozole (Femara).
If you have questions about taking Kisqali, talk with your doctor or pharmacist. Questions you may want to ask include:
- How does Kisqali compare with other treatments for the type of breast cancer I have?
- Can you recommend ways to lower my risk of side effects while taking Kisqali?
- How can I decrease my prescription cost of Kisqali?
- Do any of my medications interact with Kisqali?
To learn more about Kisqali, see these articles:
- Dosage Details for Kisqali
- Kisqali and Cost: What You Need to Know
- Side Effects of Kisqali: What You Need to Know
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.