Are you a healthcare professional? Join GoodRx for HCPs

Kisqali

ribociclib

Used for Breast Cancer

Kisqali (ribociclib) is an oral medication used to treat certain types of advanced or metastatic breast cancer. It’s considered a first-choice treatment option and might even help you live longer compared with hormone therapy alone. Kisqali (ribociclib) is typically used in combination with other medications that block or lower the amount of estrogen in your body.

Reviewed by:

Lauren Morton, PharmD, BCPS

Daisy Chau, PharmD

Last reviewed on October 10, 2022

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Alternatives Latest news Images Prices Medicare

What is Kisqali (ribociclib)?

What is Kisqali (ribociclib) used for?

HR+/HER2- advanced or metastatic breast cancer

How Kisqali (ribociclib) works

Kisqali (ribociclib) is a specific type of kinase inhibitor, called a cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitor. CDK 4/6 are proteins that control cell growth in both normal and cancer cells. These proteins can become overactive in cancer cells and cause the cancer to uncontrollably divide and grow. By blocking CDK 4/6, Kisqali (ribociclib) slows the growth of cancer cells.

Drug Facts

Common BrandsKisqali, Kisqali Femara Co-pack

Drug ClassKinase inhibitor

Controlled Substance ClassificationNot a controlled medication

Generic StatusNo lower-cost generic available

AvailabilityPrescription only

What are the 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

Low white blood cell counts (up to 78%)
Nausea (up to 52%)
Infection (up to 42%)
Tiredness (up to 37%)
Diarrhea (up to 35%)
Joint pain (up to 33%)
Hair loss (up to 33%)
Vomiting (up to 29%)
Constipation (up to 25%)
Rash (up to 23%)
Cough (up to 22%)
Headache (up to 22%)
Itchy skin (up to 20%)
Back pain (up to 20%)

Other Side Effects

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

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

Source: DailyMed

The following 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):

Pros and cons of Kisqali (ribociclib)

Pros

Taken by mouth once a day

A first-choice treatment option for a certain type of breast cancer

Can be taken with or without food

Cons

Common side effects include hair loss, tiredness, diarrhea, and nausea

Must be taken with other medications

Only available as a brand medication, so it might be expensive

Pharmacist tips for Kisqali (ribociclib)

Take Kisqali (ribociclib) with or without food at the same time every day. Swallow the tablet whole so that the medication works properly. Don’t cut, chew, or crush the tablet.

If you miss a dose of Kisqali (ribociclib), or vomit after taking a dose, don’t take another dose that day. Take your next dose at the normally scheduled time.

Avoid grapefruit and grapefruit juice while taking Kisqali (ribociclib). These foods or drinks can raise the levels of the medication in your body and raise your risk for more side effects.

Certain medications can interact with Kisqali (ribociclib), so it’s important to tell your provider and pharmacist about all the medications you take, including supplements and over-the-counter medications. Your provider can guide you to safer alternatives or recommend how to best take your medications.

You should be taking Kisqali (ribociclib) at the same time as a medication that blocks or lowers the amount of estrogen in your body (like an aromatase inhibitor or fulvestrant (Faslodex). Check with your provider if you aren’t receiving one of these medications. But if you’re using Kisqali Femara Co-pack, you won’t need to worry about this since it comes with an aromatase inhibitor, letrozole.

Ask your provider or pharmacist about the best way to handle and throw away Kisqali (ribociclib) safely. Anticancer medications can be very harmful to people who handle or come into contact with them.

Frequently asked questions about Kisqali (ribociclib)

Is Kisqali (ribociclib) a kind of chemotherapy?

Kisqali (ribociclib) is not a chemotherapy medication. Chemotherapy is a class of medication that targets and kills cancer cells in your body. Kisqali (ribociclib) doesn’t kill cancer cells. Instead, it works by telling cancer cells to stop growing.

Can Kisqali (ribociclib) be used to treat any type of breast cancer?

No. Although there are many different types of breast cancer, Kisqali (ribociclib) is used to treat HR+/HER2- (hormone receptor positive (HR+) / human epidermal growth factor receptor 2 negative (HER2-)) advanced or metastatic breast cancer. Your provider will perform a biopsy or surgery to help figure out the receptor type of your cancer. Knowing what type of receptor your cancer has will help your provider decide what treatment is best for you.

Can Kisqali (ribociclib) cause me to lose my hair?

Possibly. Hair loss is a pretty common side effect of Kisqali (ribociclib). In studies, up to 33% of people taking Kisqali (ribociclib) in combination with other hormone therapies reported hair loss. Talk to your provider if you have concerns about hair loss as they might be able to recommend some treatment options.

Is Kisqali (ribociclib) safe in pregnancy?

Kisqali (ribociclib) isn’t recommended for use in pregnancy, because it might cause harm to your unborn baby. If you’re a female of childbearing age taking Kisqali (ribociclib), you should use birth control while taking Kisqali (ribociclib) and for 3 weeks after the last dose. Let your provider know right away if you become pregnant while taking this medication.

Is Kisqali (ribociclib) safe while breastfeeding?

It isn’t recommended to breastfeed while taking Kisqali (ribociclib). We don’t know if the medication can pass into your breast milk, but there’s a risk of serious harm to nursing infants if it does. Because of this risk, you shouldn’t breastfeed while taking Kisqali (ribociclib) and for 3 weeks after your last dose. Talk with your provider about other ways to feed your baby during treatment.

What’s the difference between Kisqali (ribociclib) and Kisqali Femara Co-pack?

Both Kisqali (ribociclib) and Kisqali Femara Co-pack contain ribociclib (the CDK 4/6 inhibitor). What’s different is that Kisqali Femara Co-pack is also packaged with letrozole, an aromatase inhibitor. Remember that you’ll need to take either an aromatase inhibitor or fulvestrant when using Kisqali (ribociclib). So Kisqali Femara Co-pack is a convenient combination product that requires only one prescription. But depending on other factors, there are other aromatase inhibitors that your provider might recommend instead, like anastrozole (Arimidex) or exemestane (Aromasin). Discuss with your provider about the best treatment option for you.

How to save using GoodRx

1. Compare PricesSpecify your dosage and quantity to find out exactly how much you can save.

2. Select your free couponYou can use the displayed coupon, or compare prices at other pharmacies near you.

3. Show coupon to your pharmacistPresent your printed or electronic coupon when you pick up your prescription.

Get free coupon Learn more

What are the 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 inflammation of your lungs or interstitial lung disease. Let your provider know if you develop any new or worsening breathing problems (e.g., shortness of breath, coughing, or shortness of breath). Your provider might tell you to stop taking Kisqali (ribociclib) while they figure out what’s causing these problems.

Skin problems

In studies, people taking Kisqali (ribociclib) commonly experienced rash or itchy skin. These typically weren’t serious. But in rare instances, the medication can cause serious skin reactions, like Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). Tell your provider right away if you have any symptoms of these serious skin reactions. Symptoms include pain or burning of the skin, a rash that spreads quickly, reddened skin, blisters on the skin or skin peeling, or blisters on your mouth or eyes. Your provider might tell you to stop taking Kisqali (ribociclib) while they figure out what’s causing these problems.

Changes in heart rhythm (QT prolongation)

Risk factors: History of abnormal heart rhythm | Heart problems | Low electrolytes in your blood | Taking tamoxifen or other medications that either also cause abnormal heart rhythm or interact with Kisqali (ribociclib)

Taking Kisqali (ribociclib) can cause changes in your heart rhythm (QT prolongation) which can be dangerous. You’re at a higher risk if you also take tamoxifen or other medications that interact with Kisqali (ribociclib). For your safety, let your provider know about all the medications and supplements you take.

Your provider will monitor for this problem by performing an electrocardiogram (ECG) before and during treatment with Kisqali (ribociclib). They’ll also monitor certain blood tests to check that your electrolyte levels (e.g. potassium, magnesium, calcium, and phosphorus) don’t get too low which will put you at risk for these heart rhythm changes. Contact your provider immediately if you experience a faster or slower heartbeat, or if you feel dizzy or faint.

Liver problems

Kisqali (ribociclib) can raise the level of certain liver enzymes in your body, which might lead to liver problems. You’ll need to get regular blood tests done while taking this medication to make sure that your liver is healthy. If you develop any liver problems, your provider might have you stop taking Kisqali (ribociclib) for a little while or lower your dose. Let your provider know if you experience tiredness, loss of appetite, nausea or vomiting, dark urine, right-side stomach pain, easy bruising or bleeding, or yellowing of the eyes or skin, as these can be symptoms of liver problems.

Low white blood cell counts

Kisqali (ribociclib) can cause your white blood cell count to drop. When these cell counts are lower than normal, you might be at risk of developing infections. Your provider will check your blood counts often while you’re taking Kisqali (ribociclib). Let your provider know if you develop a fever or start to feel sick. If this happens you might need to have your dose lowered or stop this medication all together.

Harm to unborn baby

Based on animal studies, Kisqali (ribociclib) can harm an unborn baby. Because of these risks, females taking Kisqali (ribociclib) should use birth control during and for at least 3 weeks after the last dose. Let your provider know right away if you become pregnant during this time.

Kisqali (ribociclib) dosage forms

Typical dosing for Kisqali (ribociclib)

The dose might be different if you experience certain side effects, have kidney or liver problems, or if you’re taking medications that interact with Kisqali (ribociclib).

Kisqali (ribociclib):

Kisqali (ribociclib) is taken in a 1 month (28 days) cycle. For the first 3 weeks (21 days) of the cycle, the typical starting dose is 600 mg by mouth once daily. During the last week (7 days), you won't take any Kisqali (ribociclib). At the end of the month, the cycle starts over again.

You’ll also need to take either an aromatase inhibitor or fulvestrant (Faslodex) for treatment. In addition, if you’re a male or a female who hasn’t undergone menopause, your provider might also recommend you take a luteinizing hormone-releasing hormone (LHRH) agonist.

Kisqali Femara Co-pak (ribociclib / letrozole):

Kisqali Femara Co-pak contains both ribociclib and letrozole (an aromatase inhibitor) packaged together. It’s taken in a 1 month (28 days) cycle. For the first 3 weeks (21 days) of the cycle, the typical starting dose is 600 mg of ribociclib by mouth once daily. During the last week (7 days), you won't take any ribociclib. At the end of the month, the cycle starts over again.
During that last week when you aren’t taking ribociclib, you’ll still continue to use letrozole 2.5 mg by mouth daily.