What is Ibrance?

Ibrance is used to treat HR-positive, HER2-negative breast cancer that has spread to other parts of the body. Ibrance is used in combination with an aromatase inhibitor as the first hormonal-based therapy, or fulvestrant in those with breast cancer progression following hormonal therapy.

Ibrance’s mechanism of action involves blocking proteins involved in cell division called cyclin-dependent kinases (CDK), specifically CDK 4 and 6, preventing the cancer from dividing and multiplying uncontrollably. HR+ breast cancer cells rely heavily on CDK 4/6 for growth. Ibrance belongs to the drug class CDK 4/6 inhibitors.

Ibrance is a targeted treatment, it is not chemotherapy .

Ibrance gained FDA approval on February 3, 2015. An Ibrance generic is available under the name palbociclib .

Ibrance uses

Ibrance is used to treat HR-positive, HER2-negative advanced or metastatic breast cancer in postmenopausal women or men. Ibrance should always be used in combination with:

• an aromatase inhibitor (such as anastrozole, exemestane, or letrozole) as initial endocrine-based therapy in postmenopausal women or men; or
• fulvestrant in patients with disease progression following endocrine therapy.

Ibrance side effects

The most common side effects of Ibrance are:

• infections
• tiredness
• nausea
• sore mouth
• abnormalities in liver blood tests
• diarrhea
• hair thinning or hair loss
• vomiting
• rash
• loss of appetite
• low red blood cell counts and low platelet counts. Call your healthcare provider right away if you develop any of these symptoms of low blood cell  during treatment dizziness, shortness of breath, weakness, bleeding or bruising more easily, or nosebleeds

These Ibrance side effects are the most common ones that occur when used with either letrozole or fulvestrant.

Hair loss is not considered a common side effect of Ibrance. Ibrance is more likely to cause hair thinning .

Ibrance may cause fertility problems in males. This may affect your ability to father a child. Talk to your healthcare provider about family planning options before starting Ibrance if this is a concern for you.

Serious side effects and warnings

Ibrance may cause the following serious side effects.

Low white blood cell counts (neutropenia). Low white blood cell counts are very common when taking Ibrance and may cause serious infections that can lead to death. Your healthcare provider should check your white blood cell counts before and during treatment.

If you develop low white blood cell counts during treatment with Ibrance, your healthcare provider may stop your treatment, decrease your dose, or tell you to wait to begin your treatment cycle. 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.

Lung problems (pneumonitis). Ibrance may cause severe or life-threatening inflammation of the lungs during treatment that can lead to death. Tell your healthcare provider right away if you have any new or worsening symptoms, including:

• chest pain
• cough with or without mucus
• trouble breathing or shortness of breath.

Your healthcare provider may interrupt or stop treatment with Ibrance completely if your symptoms are severe.

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

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects of Ibrance. Call your doctor for medical advice about side effects. You may report side effects to the FDA .

Before taking

Before taking Ibrance, tell your healthcare provider about all of your medical conditions, including if you:

• have a fever, chills, or any other signs or symptoms of infection
• have liver or kidney problems
• have any other medical conditions
• are pregnant, or plan to become pregnant
• are breastfeeding or plan to breastfeed.

Pregnancy

Ibrance can harm your unborn baby. Females who can become pregnant should use effective birth control during treatment and for at least 3 weeks after the last dose of Ibrance. Your healthcare provider may ask you to take a pregnancy test before you start treatment with Ibrance.

Males with female partners who can become pregnant should use effective birth control during treatment with Ibrance for at least 3 months after the last dose of Ibrance. 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.

Breastfeeding

It is not known if Ibrance passes into your breast milk. Do not breastfeed during treatment with Ibrance and for 3 weeks after the last dose.

How should I take Ibrance?

Take Ibrance exactly as your healthcare provider tells you.

• Take Ibrance with or without food.
• Ibrance should be taken at about the same time each day.
• Swallow Ibrance capsules or tablets whole. Do not chew or crush the capsules or tablets and do not try to open the capsules before swallowing them.
• Do not take any Ibrance capsules or tablets that are broken, cracked, or that look damaged.

Avoid grapefruit and grapefruit products during treatment with Ibrance. Grapefruit may increase the amount of Ibrance in your blood.

Do not change your dose or stop taking Ibrance unless your healthcare provider tells you.

Ibrance dosage

The recommended initial Ibrance dosage for breast cancer is Ibrance 125 mg 1 time daily with or without food for 21 days followed by 7 days without treatment.

• Your healthcare provider may adjust your dose based on how well you tolerate Ibrance.
• Ibrance is taken in combination with an aromatase inhibitor or fulvestrant.  

What happens if I miss a dose?

If you miss a dose of Ibrance or vomit after taking a dose of Ibrance, do not take another dose on that day. Take your next dose at your regular time.

What happens if I take too much Ibrance?

If you take too much Ibrance, call your healthcare provider right away or go to the nearest hospital emergency room.

What other drugs will affect Ibrance?

Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Ibrance and other medicines may affect each other causing side effects. Especially tell your healthcare provider if you take:

• CYP3A Inhibitors, such as clarithromycin, diltiazem, erythromycin, fluconazole, ketoconazole, or verapamil. These should not be taken at the same time as Ibrance. If a strong CYP3A inhibitor cannot be avoided, your healthcare provider should reduce the dose of Ibrance
• CYP3A Inducers, such as glucocorticoids, rifampin, carbamazepine, phenobarbital, and phenytoin. Avoid using these at the same time as Ibrance
• CYP3A substrates, such as cyclosporin, tricyclic antidepressants, and some chemotherapy agents. The dose of sensitive CYP3A4 substrates with narrow therapeutic indices may need to be reduced when given concurrently with Ibrance.

Avoid grapefruit and grapefruit products.

Know the medicines you take. Keep a list of them to show your healthcare provider or pharmacist when you get a new medicine. This is not a full list of interactions with Ibrance.

What is Kisqali?

Kisqali is a  prescription medicine that may be used to treat hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer in adults:

• in combination with an aromatase inhibitor for stage II and III early breast cancer with a high risk of coming back
• that has gotten worse or has spread to other parts of the body (advanced or metastatic breast cancer). Kisqali is used in combination with:
  • an aromatase inhibitor as the first endocrine-based therapy, or
  • fulvestrant as the first endocrine-based therapy or following disease progression on endocrine therapy.

Kisqali’s mechanism of action involves blocking cyclin-dependent kinases 4 and 6 (CDK4/6), which are key regulators of the cell cycle. By blocking these enzymes, Kisqali slows or stops the growth of cancer cells. Kisqali is not chemotherapy, it is a targeted treatment. Kisqali is usually used in combination with hormone therapies, such as an aromatase inhibitor or fulvestrant (Faslodex).

• Aromatase inhibitors used in combination with Kisqali include letrozole (Femara), anastrozole (Arimidex), and exemestane (Aromasin).
• Kisqali is available co-packaged with Femara as the Kisqali Femara Co-Pack.

Kisqali first gained FDA approval on March 13, 2017. Kisqali belongs to the drug class kinase inhibitors.

Kisqali side effects

The most common side effects of Kisqali in people with early breast cancer include:

• Changes in laboratory test results, such as decreased white blood cell counts, decreased red blood cell counts, increased liver function tests, decreased platelet counts, or increased kidney function tests
• infections
• nausea
• headache
• tiredness.

Other common side effects of Kisqali reported in people with advanced or metastatic breast cancer include:

• diarrhea
• vomiting
• constipation
• hair loss.

Serious side effects and warnings

Kisqali may cause the following serious side effects.

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

Severe skin reactions. Tell your healthcare provider or get medical help right away if you get severe rash or rash that keeps getting worse, reddened skin, flu-like symptoms, skin pain or burning, blistering of the lips, eyes, or mouth, blisters on the skin or skin peeling, with or without fever.

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 during treatment with 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.

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. Call your doctor for medical advice about side effects. You may report side effects to the FDA .

Before taking

Before taking Kisqali, tell your healthcare provider about all of your medical conditions, including 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 high blood pressure that is not controlled
• have decreased thyroid gland function (hypothyroidism)
• have problems with the amount of potassium, calcium, phosphorus, or magnesium in your blood
• have a fever, chills, or any other signs or symptoms of infection
• have liver problems
• have kidney problems
• are pregnant, or plan to become pregnant
• are breastfeeding or plan to breastfeed.

Pregnancy

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.

Breastfeeding

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.

Fertility in males

Kisqali may cause fertility problems in males, which may affect your ability to father a child. Talk to your healthcare provider if this is a problem for you.

How should I take Kisqali?

Take Kisqali exactly as your healthcare provider tells you. Do not change your dose or stop taking Kisqali without talking to your healthcare provider.

• Kisqali is usually taken 1 time a day for 21 days followed by 7 days of treatment.
  • This is called a cycle of treatment.
• Kisqali may be taken with or without food.
• Kisqali is usually taken in combination with an aromatase inhibitor or fulvestrant.
• Swallow Kisqali tablets whole. Do not chew, crush, or split Kisqali tablets before swallowing them.
• Take Kisqali each day at about the same time, preferably in the morning.
• Do not take any Kisqali tablets that are broken, cracked, or that look damaged.

Kisqali dosing

Kisqali Dosing for Early Breast Cancer

Kisqali dosing for Early Breast Cancer: Kisqali 400 mg orally (two 200 mg tablets) taken once daily with or without food for 21 consecutive days followed by 7 days off treatment.

Kisqali dosing for Advanced or Metastatic Breast Cancer: Recommended starting dose: Kisqali 600 mg orally (three 200 mg tablets) taken once daily with or without food for 21 consecutive days followed by 7 days without treatment.

Dose interruption, reduction, and/or discontinuation may be required based on individual safety and tolerability.

What happens if I miss a dose of Kisqali?

 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.

What other drugs will affect Kisqali?

Tell your healthcare provider about all 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. Especially tell your healthcare provider if you take:

• CYP3A Inhibitors: Avoid concomitant use of Kisqali with strong CYP3A inhibitors, such as clarithromycin, erythromycin, diltiazem, itraconazole, ketoconazole, ritonavir, verapamil, goldenseal, and grapefruit. If strong inhibitors cannot be avoided, reduce the dose of  Kisqali.
• CYP3A4 inducers, such as phenobarbital, phenytoin, rifampicin, St. John’s Wort, and glucocorticoids. Avoid concomitant use.
• CYP3A Substrates, such as midazolam, felodipine, buspirone, lovastatin, eletriptan, sildenafil, simvastatin, triazolam, dexamethasone, antipyrine, quinine: The dose of CYP3A substrates may need to be reduced when given concurrently with Kisqali.
• Drugs known to prolong the QT interval, such as haloperidol, ziprasidone, quetiapine, thioridazine, olanzapine, risperidone, droperidol, amiodarone, sotalol, dofetilide, procainamide, quinidine, flecainide, macrolides, fluoroquinolones. Avoid concomitant use of drugs known to prolong QT interval with Kisqali.

What is abemaciclib?

Abemaciclib is used to treat HR-positive and HER2-negative breast cancer in adults. It is a targeted treatment, not a chemotherapy drug . 

Abemaciclib (brand name Verzenio) first gained FDA approval on September 28, 2017. There is no generic Verzenio.

Uses and FDA approvals

Abemaciclib is a prescription medicine approved to treat various types of hormone receptor-positive (HR+), human epidermal growth factor receptor 2 negative (HER2–) breast cancer, such as:

• Early breast cancer that is HR+, HER2– node-positive and has a high risk of coming back in combination with endocrine therapy (tamoxifen or an aromatase inhibitor) 
• HR+, HER2– breast cancer that has worsened or spread (metastasized) in combination with an aromatase inhibitor (such as anastrozole, exemestane, or letrozole) as the first endocrine-based therapy
• HR+, HER2– breast cancer that has worsened or metastasized, and progressed despite endocrine therapy in combination with Fulvestrant.

Clinical trials have also reported abemaciclib is effective when used alone to treat HR+, HER2– breast cancer that has worsened, metastasized, or progressed despite endocrine treatment and chemotherapy.

Abemaciclib side effects

Most common side effects

Common side effects that patients may experience while taking abemaciclib are:

Digestive system effects

• Nausea and vomiting
• Abdominal pain
• Decreased appetite

Blood-related side effects

• Anemia (low red blood cell count)
• Leukopenia (low white blood cell count)
• Thrombocytopenia (low platelet count)

Other frequent side effects

• Increased risk of infections
• Fatigue and tiredness
• Headaches
• Alopecia (hair thinning or hair loss).

Important note for male patients

Male patients should be aware that clinical trials have shown that abemaciclib may affect their fertility and their ability to father a child. If you have concerns about fertility, talk to your healthcare provider before starting treatment.

Serious side effects and warnings

Abemaciclib may cause the following serious side effects:

Diarrhea

Diarrhea is common with abemaciclib and may sometimes be severe. It may cause dehydration or increase your risk of an infection. Diarrhea is more likely to happen in the first month of taking abemaciclib. Tell your healthcare provider as soon as possible if you have any loose stools and start taking an antidiarrheal medicine (such as loperamide). Drink fluids to prevent dehydration.

Low white blood cell counts (neutropenia)

Low white blood cell counts may cause serious infections that can lead to death. Your healthcare provider should check your white blood cell counts before and during treatment with abemaciclib. Tell your healthcare provider right away if you have signs and symptoms of low white blood cell counts or develop symptoms of an infection.

Lung problems

Abemaciclib may cause severe or life-threatening inflammation of the lungs that could be fatal. Tell your healthcare provider right away if you have any new or worsening lung symptoms, including:

• trouble breathing or shortness of breath
• cough with or without mucus
• chest pain.

Liver problems

Abemaciclib can cause serious liver problems. Tell your healthcare provider right away if you have any of the following signs and symptoms of liver problems:

• feeling very tired
• pain on the upper right side of your stomach area (abdomen)
• loss of appetite
• bleeding or bruising more easily than normal.

Your healthcare provider will do blood tests to monitor your liver for elevations in liver enzymes during treatment with abemaciclib, such as alkaline phosphatase or alanine aminotransferase (ALT).

Blood clots in your veins, or the arteries of your lungs

Abemaciclib may cause serious blood clots that may be fatal. Tell your healthcare provider right away if you get any of the following signs and symptoms of a blood clot:

• pain or swelling in your arms or legs
• shortness of breath
• chest pain
• tachycardia (a fast heartbeat).

Allergic reactions

Get emergency medical help if you have signs of an allergic reaction to abemaciclib such as hives; difficulty breathing; or swelling of your face, lips, tongue, or throat.

These are not all the possible side effects of abemaciclib. For more information, ask your healthcare provider or pharmacist. Call your healthcare provider for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

How does abemaciclib work?

Abemaciclib’s mechanism of action involves blocking proteins involved in cell division called cyclin-dependent kinases (CDK), specifically CDK 4 and 6. Blocking these prevents cancer cells from dividing and multiplying uncontrollably because HR+ breast cancer cells rely heavily on CDK 4/6 for growth.

Abemaciclib belongs to the drug class called CDK 4/6 inhibitors.

How much does abemaciclib cost?

The cost of abemaciclib depends on your insurance plan and if you are eligible for the Verzenio (abemaciclib) savings card. Some people with commercial insurance who meet other criteria pay as little as $0 a month. Abemaciclib is only available through a specialty pharmacy that can help you work out if you are eligible for the savings card. For more information, call 1-844-ABEMACICLIB (1-844-837-9364).

If you do not have insurance or your insurance does not cover abemaciclib, you may pay close to the list price for it. See Verzenio (abemaciclib) Prices, Coupons, Copay Cards & Patient Assistance for more information.

Before taking this medicine

Do not take abemaciclib if you are allergic to abemaciclib, Verzenio, or any of the inactive ingredients in the Verzenio tablets.

Before taking abemaciclib, tell your healthcare provider about all your medical conditions including if you:

• have a fever, chills, or other signs of infection
• have lung or breathing problems
• have a history of blood clots in your veins
• have liver or kidney problems
• take any medications, such as ketoconazole, clarithromycin, itraconazole, lopinavir/ritonavir, posaconazole, and voriconazole because these may affect abemaciclib concentrations
• are pregnant or intending to become pregnant
• are breastfeeding or intend to breastfeed.

Pregnancy

Abemaciclib may harm an unborn baby. For females who can become pregnant, your healthcare provider will do a pregnancy test before you start treatment with abemaciclib. You should use effective birth control (contraception) during treatment with abemaciclib and for 3 weeks after the last dose of abemaciclib. Tell your healthcare provider right away if you become pregnant or think you are pregnant during treatment with abemaciclib.

Breastfeeding

You should not breastfeed while using this medicine and for at least 3 weeks after your last dose.

Male fertility

It may be harder for males to get a woman pregnant if they are taking abemaciclib.

How should I take abemaciclib?

Take abemaciclib exactly as prescribed by your doctor. Follow all directions on your Verzenio (abemaciclib) Package Insert and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

• Abemaciclib is usually taken 2 times a day.
• Take with or without food, at the same time each day.
• Swallow whole and do not crush, chew, or break it. Do not take a cracked, broken, or damaged tablet.
• If you vomit shortly after taking abemaciclib, do not take another dose. Take your next dose as scheduled.

Call your doctor if you get loose stools (diarrhea) while taking abemaciclib and start taking anti-diarrhea medicine such as loperamide (Imodium A-D). Drink extra fluids to prevent dehydration.

Your blood will need to be tested often and your cancer treatments may be delayed based on the results.

Abemaciclib is taken until your breast cancer gets worse despite treatment or side effects become intolerable .

Abemaciclib dosing information

Usual Adult Dose of Abemaciclib for Breast Cancer:

• Abemaciclib 150 mg 2 times a day when used with fulvestrant, tamoxifen, or an aromatase inhibitor.
• Abemaciclib 200 mg 2 times a day when used alone.

What happens if I miss a dose?

Take abemaciclib as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

If you vomit shortly after taking abemaciclib, do not take another dose. Take your next dose as scheduled.

What should I avoid while taking abemaciclib?

Avoid taking ketoconazole during treatment with abemaciclib. Tell your healthcare provider if you take a medicine that contains ketoconazole.

Avoid grapefruit and products that contain grapefruit during treatment with abemaciclib. Grapefruit may increase levels of this medicine in your blood.

What other drugs will affect abemaciclib?

Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective.

Tell your doctor about all your other medicines, especially ketoconazole. You should not take ketoconazole while you are being treated with abemaciclib.

• Ketoconazole is a strong CYP3A4 inhibitor and coadministration of abemaciclib with strong CYP3A4 inhibitors should be avoided because they can increase abemaciclib concentrations.
• Other medications that are strong CYP3A4 inhibitors include clarithromycin, itraconazole, lopinavir/ritonavir, posaconazole, and voriconazole. Grapefruit or grapefruit juice should also be avoided.

The dose of abemaciclib should be reduced if co-administered with moderate CYP3A4 inhibitors, such as
verapamil or diltiazem.

This list is not complete, see the Verzenio (abemaciclib) Prescribing Information for a full list. Other drugs may affect abemaciclib, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Does abemaciclib interact with my other drugs?

Enter medications to view a detailed interaction report using our Drug Interaction Checker.Drug nameAdd a drug to check interactionsAdd

Ingredients

Abemaciclib is only available under the brand name Verzenio. There is no abemaciclib generic.

Active ingredient: abemaciclib

Inactive ingredients: microcrystalline cellulose 102, microcrystalline cellulose 101, lactose monohydrate, croscarmellose sodium, sodium stearyl fumarate, and silicon dioxide.

Color mixture ingredients: polyvinyl alcohol, titanium dioxide, polyethylene glycol, talc, iron oxide yellow, iron oxide red.

Abemaciclib is available as 50 mg, 100 mg, 150 mg, and 200 mg tablets.

Abemaciclib storage

Store abemaciclib at room temperature between 68°F to 77°F (20°C to 25°C).

Keep out of the reach of children.

Who makes abemaciclib?

Abemaciclib is manufactured by Eli Lilly and Company (commonly known as Lilly), headquartered in Indianapolis, Indiana. Besides abemaciclib, Lilly produces several other notable medications including:

• Cymbalta (duloxetine) for depression and anxiety
• Humalog and Lyumjev for diabetes
• Taltz for psoriasis and psoriatic arthritis
• Olumiant for rheumatoid arthritis
• Jardiance (in partnership with Boehringer Ingelheim) for diabetes
• Mounjaro (tirzepatide) for type 2 diabetes and weight management
• Zepbound (tirzepatide) for weight management.