11 Ibrance Side Effects and How to Manage Them
Ibrance, or palbociclib, is an oral breast cancer medication. Side effects range from mild to severe. Here are 11 side effects to know.
Ibrance
Used for Breast Cancer
Used for Breast Cancer
Ibrance (palbociclib) is a capsule or tablet you take by mouth to treat certain types of breast cancer, specifically hormone receptor-positive, human epidermal growth factor 2-negative (HR+, HER2‑) advanced or metastatic breast cancer. It works by blocking specific proteins called CDK4/6 to help slow down the growth of cancer cells. You usually take it once a day for 21 days, and then don’t take it for 7 days, repeating this cycle every 28 days. Ibrance (palbociclib) is also used with other medications like an aromatase inhibitor, fulvestrant, or inavolisib. Side effects include low white blood cell counts, infections, nausea, and tiredness.
What is Ibrance (palbociclib)?
What is Ibrance (palbociclib) used for?
- Advanced or metastatic breast cancer (HR+, HER2-), used with
- An aromatase inhibitor as the first hormone-based treatment OR
- Fulvestrant after the cancer has stopped responding to hormone-based treatment
- Advanced or metastatic breast cancer (HR+, HER2-) with a PIK3CA mutation, used with inavolisib and fulvestrant after the cancer has come back following hormone therapy
How Ibrance (palbociclib) works
Ibrance (palbociclib) is a cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitor. CDK 4/6 are proteins that help control how cells grow. In cancer, these proteins can become too active, causing cells to grow and divide too quickly. Ibrance (palbociclib)] blocks these proteins to help slow down the growth of cancer cells.
When does Ibrance (palbociclib) start working?Time passed since treatment started:
Drug facts
| Common Brands | Ibrance |
|---|---|
| Drug Class | Cyclin-dependent kinase (CDK) inhibitor |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
More on Ibrance (palbociclib) essentials
Side effects of Ibrance (palbociclib)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Ibrance (palbociclib) with letrozole:
- Low white blood cell count (up to 80%)
- Infections (60%)
- Tiredness (37%)
- Nausea (35%)
- Hair loss (33%)
- Mouth sores (30%)
- Diarrhea (26%)
- Anemia (24%)
Ibrance (palbociclib) with fulvestrant:
- Low white blood cell count (up to 83%)
- Infections (47%)
- Tiredness (41%)
- Nausea (34%)
- Anemia (30%)
- Mouth sores (28%)
- Diarrhea (24%)
- Low platelet count (23%)
Ibrance (palbociclib) with inavolisib and fulvestrant:
- Mouth sores (51%)
- Diarrhea (48%)
- Tiredness (38%)
- Nausea (28%)
- Rash (26%)
- Reduced appetite (24%)
- COVID-19 infection (23%)
- Headache (22%)
Less Common Side Effects
Ibrance (palbociclib) with letrozole:
- Low platelet count
- Reduced appetite
- Changes in taste
- Vomiting
- Rash
- Dry skin
- Weakness
- Fever
Ibrance (palbociclib) with fulvestrant:
- Reduced appetite
- Vomiting
- Hair loss
- Rash
- Fever
Ibrance (palbociclib) with inavolisib and fulvestrant:
- Vomiting
- Hair loss
- Dry skin
- Urinary tract infection
- Weight loss
Ibrance (palbociclib) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious infections: fever, chills, dizziness, trouble breathing, weakness, easy bruising or bleeding
- Lung problems: cough, trouble breathing, shortness of breath, chest pain
More on Ibrance (palbociclib) side effects
The following Ibrance (palbociclib) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dry cough, shortness of breath or trouble breathing
- Infection—fever, chills, cough, or sore throat
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Pros and cons of Ibrance (palbociclib)
Pros
- Oral pill taken at home
- Recommended treatment option for advanced or metastatic breast cancer (HR+, HER2-)
- Helps you live longer without the cancer getting worse compared to hormone therapy alone
Cons
- Raises your risk for infections, some of which can be serious
- Requires regular blood tests to check white blood cell count
- Not safe to take while pregnant or breastfeeding
Pharmacist tips for Ibrance (palbociclib)
- If you're taking the capsule form of Ibrance (palbociclib), take it with food at the same time every day. This helps your body absorb the medication better. Swallow the capsules whole — don’t chew, crush, or open them.
- If you’re taking the tablet form, you can take it with or without food at the same time each day. Swallow the tablets whole — don’t chew, crush, or split them.
- If you miss a dose of Ibrance (palbociclib) or vomit after taking it, don’t take an extra dose that day. Just take your next dose at your regular time.
- You should take Ibrance (palbociclib) at the same time as another cancer medication like an aromatase inhibitor, fulvestrant, or inavolisib. These medications work together to treat your cancer. Ask your oncologist if you’re not sure whether you're taking one.
- Avoid grapefruit and grapefruit juice while taking Ibrance (palbociclib). They can raise the amount of the medication in your body and lead to more side effects.
- Tell your oncologist and pharmacist about all medications and supplements you take while using Ibrance (palbociclib). Some medications can interact and cause more side effects or make the treatment not work as well.
- Let your oncologist know right away if you have signs of low blood counts or infection while taking Ibrance (palbociclib). This includes fever, chills, dizziness, trouble breathing, weakness, or easy bruising or bleeding. These could be signs of a serious problem.
- Tell your oncologist if you have new or worse breathing problems while taking Ibrance (palbociclib). Trouble breathing or shortness of breath might need medical attention.
- Ibrance (palbociclib) isn’t safe to take during pregnancy since it can harm an unborn baby. Use birth control while taking it and for 3 weeks after your last dose. Let your oncologist know right away if you become pregnant.
- Men with partners who can get pregnant should use birth control while taking Ibrance (palbociclib) and for at least 3 months after the last dose. If your partner becomes pregnant during this time, let your oncologist know right away
- Don’t breastfeed while taking Ibrance (palbociclib). It’s not known if it passes into breast milk, but it could be harmful to a baby. Avoid breastfeeding during treatment and for 3 weeks after your last dose.
- Ibrance (palbociclib) might lower your ability to have children, especially for men. Talk to your oncologist if you have concerns about fertility.
Risks and warnings for Ibrance (palbociclib)
Ibrance (palbociclib) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low white blood cell counts
Ibrance (palbociclib) often causes your white blood cell count to drop. When this happens, you might have a higher risk of getting an infection. Your oncologist will check your blood counts regularly during treatment. Let your care team know if you get a fever or start to feel sick. If your white blood cell count gets too low, your oncologist might pause your treatment, lower the dose, or delay your next cycle.
Lung problems
Rarely, Ibrance (palbociclib) can cause serious lung problems, like lung inflammation or interstitial lung disease. Tell your care team right away if you have new or worsening breathing problems like coughing or shortness of breath. They might have you stop taking the medication while they figure out what’s causing the problem.
Harm to unborn baby
Based on animal studies, Ibrance (palbociclib) might harm an unborn baby. If you can get pregnant, use birth control while taking it and for at least 3 weeks after your last dose. Men with partners who can get pregnant should use birth control during treatment and for at least 3 months after the last dose. Let your oncologist know right away if you or your partner becomes pregnant.
Ibrance (palbociclib) dosage
Typical dosage for Ibrance (palbociclib)
The typical dose is 125 mg by mouth for 21 days in a row, followed by 7 days off. Then, the cycle repeats every 28 days.
The dose might be different if you have liver problems or take other medications that interact with Ibrance (palbociclib).
What are alternatives to Ibrance (palbociclib)?
There are a number of medications that your doctor can prescribe in place of Ibrance (palbociclib). Compare a few possible alternatives below.
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