Kisqali
Kisqali (ribociclib) is a medication used to treat certain types of breast cancer, specifically hormone receptor–positive, human epidermal growth factor 2-negative (HR+, HER2-) breast cancer. It belongs to a drug class called CDK4/6 inhibitors, which help slow or stop cancer cells from growing. You typically take a tablet by mouth once a day for 21 days, then take 7 days off, repeating this 28-day cycle. It’s often taken together with other hormone treatments, like aromatase inhibitors or fulvestrant. Common side effects include feeling tired, nausea, and low white blood cell counts, which can make it easier to get infections.
What is Kisqali (ribociclib)?
What is Kisqali (ribociclib) used for?
- Early breast cancer (HR+, HER2-), used with an aromatase inhibitor in adults at high risk of the cancer coming back
- Advanced or metastatic breast cancer (HR+, HER2-), used with
- An aromatase inhibitor as the first hormone-based treatment OR
- Fulvestrant either as the first treatment or after the cancer has stopped responding to hormone-based treatment
How Kisqali (ribociclib) works
Kisqali (ribociclib) is a cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitor. It works by blocking two proteins — CDK4 and CDK6 — that help cells divide and grow. By stopping these proteins, the medication helps slow down or stop the growth of cancer cells.
Drug facts
More on Kisqali (ribociclib) essentials
Side effects of Kisqali (ribociclib)
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
Early breast cancer
- Lower white blood cell counts (up to 97%)
- Lower red blood cell counts (47%)
- Higher liver enzymes (up to 45%)
- Infections (37%)
- Higher creatinine levels (33%)
- Lower platelets (28%)
- Headache (23%)
- Nausea (23%)
- Tiredness (22%)
Advanced or metastatic breast cancer
- Lower white blood cell counts (up to 95%)
- Lower red blood cell counts (68%)
- Higher liver enzymes (up to 55%)
- Nausea (47%)
- Infections (47%)
- Higher creatinine levels (42%)
- Tiredness (35%)
- Low red blood cell count
- Lower appetite
- Dizziness
- Trouble sleeping
- Trouble breathing
- Swollen or sore mouth
- Stomach pain
- Fever
- Pain or swelling in arms or legs
- Liver problems
- Lower platelets (34%)
- Diarrhea (33%)
- Vomiting (29%)
- Headache (27%)
- Constipation (25%)
- Hair loss (25%)
- Cough (24%)
- Rash (24%)
- Back pain (24%)
- Lower blood sugar (20%)
Note: Side effects listed above were reported in studies where people took Kisqali (ribociclib) with another hormone medication.
Less Common Side Effects
Early breast cancer
- Stomach pain
- Feeling weak
- Fever
- Hair loss
- Cough
- Rash
- Dizziness
- Vomiting
- Swelling in the arms and legs
- Itchiness
- Shortness of breath
- Mouth sores
Advanced or metastatic breast cancer
- Mouth sores
- Stomach pain
- Fever
- Swelling in the arms and legs
- Itchiness
- Trouble sleeping
- Reduced appetite
- Shortness of breath
- Urinary tract infection (UTI)
- Dizziness
Kisqali (ribociclib) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Lung problems: cough, trouble breathing, shortness of breath, chest pain
- Severe skin reactions: severe rash, skin peeling, skin burning, blisters, flu-like symptoms, fever
- Heart rhythm problems: dizziness, fainting, fast or irregular heartbeat
- Liver problems: yellowing of the skin or eyes, stomach pain, dark urine, tiredness, reduced appetite, bleeding or bruising more easily
- Serious infections: fever, chills, sore throat, tiredness, no energy, nasal congestion
More on Kisqali (ribociclib) side effects
The following Kisqali (ribociclib) 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
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Infection—fever, chills, cough, or sore throat
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
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Pros and cons of Kisqali (ribociclib)
Pros
- Taken by mouth once a day
- A first-choice treatment option for HR+, HER2- breast cancer
- Can be taken with or without food
Cons
- Common side effects include nausea, tiredness, and headache
- Requires regular blood tests to monitor for side effects
- Interacts with many medications
Pharmacist tips for Kisqali (ribociclib)
- Take Kisqali (ribociclib) with or without food at the same time every day, preferably in the morning. Swallow the tablet whole. Don’t cut, chew, or crush it.
- You should take Kisqali (ribociclib) with another treatment like an aromatase inhibitor or fulvestrant. If you’re not taking one, ask your oncologist if you should be.
- If you miss a dose of Kisqali (ribociclib) or throw up after taking it, skip that dose. Take your next dose at the usual time the next day. Don’t take extra to make up for the missed dose.
- Avoid grapefruit and grapefruit juice while taking Kisqali (ribociclib). These can increase the amount of medication in your body and raise the risk of side effects.
- Some medications and supplements can interact with Kisqali (ribociclib). Make sure your oncologist and pharmacist know about everything you take, including vitamins and over-the-counter medication.
- Kisqali (ribociclib) can cause a heart rhythm problem called QT prolongation. Call your oncologist right away if you feel dizzy, faint, or notice a fast or irregular heartbeat.
- Kisqali (ribociclib) can lower your white blood cell count. Contact your oncology care team right away if you get a fever or signs of infection, like chills or sore throat.
- Kisqali (ribociclib) might not be safe in pregnancy. Tell your oncologist if you’re pregnant or planning to become pregnant, and use birth control while taking it and for 3 weeks after your last dose.
- Don’t breastfeed while taking Kisqali (ribociclib), and wait at least 3 weeks after your last dose before starting again. The medication might pass into breast milk and could harm your baby.
- Store Kisqali (ribociclib) at room temperature after getting your prescription. Keep it stored properly and use it within 2 months.
More on Kisqali (ribociclib) tips
Common questions about Kisqali
No, Kisqali isn’t chemotherapy. It’s a type of targeted therapy called a CDK4/6 inhibitor. It works by slowing down or stopping the growth of cancer cells without harming all fast-growing cells in your body the way chemotherapy does.
It might be recommended to take Kisqali in the morning so it’s easier to check for side effects, like dangerous changes to your heart rhythm. These side effects can include dizziness, fainting, or feeling like your heart is skipping beats. Taking it in the morning can also help you stay on a regular schedule and avoid missing a dose. What matters most is taking it at the same time every day. If you’re thinking about switching to a different time, talk to your oncologist first.
It’s different for everyone, but Kisqali can start working within a few weeks to a few months. In clinical studies, some people saw results in as little as 8 weeks, while for others it took a few months. Your oncologist will check how well the medication is working using body scans and lab tests. Be sure to take it as prescribed and follow up regularly with your care team.
No, Kisqali isn’t immunotherapy. Immunotherapy helps your immune system recognize and fight cancer cells. Kisqali works differently — it directly blocks proteins that cancer cells need to grow and divide, without involving the immune system.
Kisqali was first approved by the FDA in March 2017 to treat advanced or metastatic breast cancer that’s HR+, HER2–. In September 2024, the FDA also approved Kisqali for early breast cancer in adults at high risk of the cancer coming back.
In clinical studies, people who took Kisqali with hormone therapy lived more than a year longer on average than those who took hormone therapy alone. Speak to your oncologist if you have questions about how well this medication might work for you.
Both Kisqali and Kisqali Femara Co-pack contain ribociclib. The difference is that the Co-pack also includes letrozole, which is an aromatase inhibitor. Since you need to take an aromatase inhibitor or fulvestrant with Kisqali, the Co-pack might be more convenient with just one prescription. But your oncologist might recommend a different aromatase inhibitor, like anastrozole or exemestane, depending on your needs. Talk to your oncologist if you have questions comparing these two medications.
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Risks and warnings for Kisqali (ribociclib)
Kisqali (ribociclib) 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.
Lung problems
Rarely, Kisqali (ribociclib) can cause serious lung problems, like lung inflammation or interstitial lung disease. Let your cancer care team know right away if you have new or worsening breathing issues, such as coughing or shortness of breath. Your oncologist might tell you to stop taking the medication while they figure out what’s causing the symptoms. If the symptoms are serious or keep coming back, you might need to stop the medication for good.
Severe skin reactions
Rare but serious skin reactions can happen with Kisqali (ribociclib), including conditions like Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS), which can affect your whole body. If you notice a severe rash, peeling skin, or any unusual skin changes, stop taking the medication and contact your cancer care team right away. Your oncologist might pause treatment while they find out what’s causing the reaction, and they might refer you to a dermatologist.
Heart rhythm problem (QT prolongation)
- Risk factors: History of abnormal heart rhythm | Heart problems | Low electrolytes | Taking tamoxifen or other medications that affect heart rhythm
Taking Kisqali (ribociclib) can cause a heart rhythm problem called QT prolongation, which can be dangerous. Your risk is higher if you also take medications like tamoxifen or other medications that interact with Kisqali (ribociclib). Make sure to tell your oncologist about all the medications and supplements you’re taking.
To help keep you safe, your oncologist will do electrocardiograms (ECGs) before and during your treatment to help check your heart rhythm. They’ll also do blood tests to make sure that your electrolyte levels — potassium, magnesium, calcium, and phosphorus — aren’t too low, since that can raise your risk for heart problems. Contact your cancer care team right away if you feel dizzy, faint, or notice a heartbeat that’s faster or slower than usual.
Liver problems
Kisqali (ribociclib) can sometimes cause liver problems, including liver injury and higher liver enzyme levels. You’ll need regular blood tests done while taking this medication to make sure that your liver is healthy. If your liver enzymes get too high, your oncologist might pause treatment, lower your dose, or stop the medication depending on how serious it is. Let your cancer care team know right away if you notice symptoms of liver problems, like yellowing of the skin or eyes, dark urine, or stomach pain.
Low white blood cell counts
Kisqali (ribociclib) can cause your white blood cell count to drop. When these cells are low, you might have a harder time fighting off infections. Your oncologist will check your blood counts regularly while you’re taking this medication. Let your cancer care team know if you get a fever, chills, or start to feel sick. They might pause treatment, lower your dose, or stop the medication altogether.
Harm to unborn baby
Kisqali (ribociclib) might cause harm to an unborn baby if taken during pregnancy. Animal studies showed that the medication caused problems in developing babies when given during pregnancy. If you’re pregnant or planning to become pregnant, tell your cancer care team right away. If you can get pregnant, use effective birth control while taking this medication and for at least 3 weeks after your last dose.
Kisqali (ribociclib) dosage
Carton| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 21 tablets of 200mg/day | 1 carton | $0.00 | $0.00 |
| 42 tablets of 400mg/day | 1 carton | $0.00 | $0.00 |
| 63 tablets of 600mg/day | 1 carton | $0.00 | $0.00 |
Typical dosage for Kisqali (ribociclib)
- Early breast cancer: The typical dose is 400 mg (two 200 mg tablets) by mouth once a day for 21 days in a row, followed by 7 days off. Then, the cycle repeats every 28 days.
- Advanced or metastatic breast cancer: The typical dose is 600 mg (three 200 mg tablets) by mouth once a day 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 certain side effects, kidney or liver problems, or take other medications that interact with Kisqali (ribociclib).
How much does Kisqali (ribociclib) cost?
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