All About Kisqali

What is Kisqali used for?

Kisqali is used in adults to treat HR-positive and HER2-negative breast cancer. 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.)

For this type of breast cancer, Kisqali can specifically be prescribed for:

• Early (stage 2 or stage 3) breast cancer: Kisqali is used for people with a high risk of early breast cancer (stage 2 or stage 3) coming back after treatment.
• Advanced or metastatic breast cancer: Advanced means the cancer has spread to tissues surrounding the breast. And metastatic means the cancer has spread to other areas of the body.

Doctors usually prescribe Kisqali along with hormone therapy, specifically fulvestrant (Faslodex) or an aromatase inhibitor such as letrozole (Femara). The specific type of hormone therapy your doctor prescribes depends on several factors. They’ll consider the stage of your cancer, which hormone therapy you’ve taken in the past, whether your cancer worsened while taking it, your menopause status, and your sex assigned at birth.

What are Kisqali’s side effects?

Like most drugs, Kisqali may cause mild or serious side effects. The following lists 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
• cough
• constipation
• rash
• mild allergic reaction (see the “allergic reaction” section for details)

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.

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
• heart rhythm problem called QT prolongation
• severe skin reactions, such as drug reaction with eosinophilia and systemic symptoms,
• Stevens-Johnson syndrome, and toxic epidermal necrolysis
• breathing problems due to interstitial lung disease or pneumonitis (inflammation of the lungs)
• liver problems
• severe allergic reaction (see the allergic reaction section for details)

Allergic reaction

Some people may have an allergic reaction to Kisqali.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

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 difficulty 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.

What does Kisqali cost?

Whether you have health insurance or not, price 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.

Kisqali’s manufacturer offers a patient support program, which includes a copay program and other resources.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also check out this article to learn more about saving money on prescriptions.

What are some frequently asked questions about Kisqali?

Find answers to some commonly asked questions about Kisqali.

Why 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. The manufacturer does not provide a reason for this recommendation, however.

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. Be sure to follow your doctor’s dosing instructions.

To help make sure you don’t miss a dose, try setting an alarm or a reminder on your phone.

What’s Kisqali’s mechanism of action?

Kisqali works by blocking proteins called CDK4 and CDK6 that help cancer cells grow and divide. This is the drug’s mechanism of action (how it works). By blocking these proteins, Kisqali slows the cancer’s growth and helps prevent it from spreading further.

How does Kisqali compare with Ibrance?

Kisqali and Ibrance (palbociclib) belong to the same group of drugs. They’re both used for HR-positive and HER2-negative breast cancer that’s advanced or metastatic. Kisqali is also approved for early breast cancer (stage 2 or stage 3) that is HR-positive and HER2-negative.

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 caused damage to male reproductive organs and lowered sperm production. It’s not known if this happens in people. But, there is a risk that any damage might not fully go away, even after stopping the medication. If you’re male and you may want to have children in the future, talk with your doctor about freezing sperm before starting Kisqali. This is a common step some people take to preserve fertility (the ability to conceive a child with a partner) before beginning cancer treatment.

Talk with your doctor to learn more about possible side effects of Kisqali and how long they may last.

Note: In this article, we use the term “male” to refer to someone’s sex assigned at birth.

What is Kisqali’s dosage?

Your doctor will recommend the dosage of Kisqali that’s right for you.

Form and strength

Kisqali comes as an oral tablet in one strength: 200 milligrams (mg).

Note: Your doctor may prescribe the Kisqali Femara Co-Pack if you take Femara (letrozole) with Kisqali. The co-pack contains enough Kisqali and Femara tablets for one cycle.

Recommended dosages

Here are commonly used Kisqali dosages, but always take the dosage your doctor prescribes.

Dosage for early breast cancer

For stage 2 or stage 3 breast cancer, the typical Kisqali dose is 400 mg, which is two 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 as long as you and your doctor determine the drug is safe and effective for you.

Dosage for advanced or metastatic breast cancer

The typical dose of Kisqali for advanced or metastatic breast cancer 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.

Dosage in people with kidney problems

If you have severe kidney problems, your doctor may lower your Kisqali dose to 200 mg per day, to help prevent side effects.

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

Here 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 difficulty 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 suitable. 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.

What should be considered before taking Kisqali?

Consider the following important information 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

Here 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.

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 or risk factors for 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
• kidney problems
• previous allergic reaction to Kisqali
• pregnancy
• breastfeeding