Verzenio Dosages: Your GoodRx Guide

We’ve come a long way with breast cancer treatments. Traditional treatments, such as radiation and chemotherapy, work. But they have a hard time distinguishing between healthy cells and cancer cells. This can lead to significant side effects. 

Scientists now have a better understanding of changes in our DNA that lead to cancer cell growth. Newer medications reflect this knowledge.

Enter targeted medications, such as Verzenio (abemaciclib). They aim to zero in on specific pathways that fuel cancer progression. Verzenio slows down hormone receptor-positive (HR+) and human epidermal growth factor 2-negative (HER2-) breast cancer by interrupting the CDK 4/6 pathway that contributes to cancer cell growth.

As exciting as targeted medications are, they’re only effective if you take the right amount. Let’s discuss Verzenio dosages in more detail so you can determine if what you’re taking is best for your situation.

What’s the typical Verzenio dosage for adults?

Verzenio is an oral tablet that’s typically taken twice a day. Verzenio comes in four tablet sizes: 50 mg, 100 mg, 150 mg, and 200 mg.

Your dose will depend on whether you’re taking it alone or with a hormone therapy medication, such as an aromatase inhibitor, tamoxifen (Soltamox), or fulvestrant (Faslodex). These medications are occasionally prescribed with Verzenio to combat breast cancer from multiple angles. 

Monotherapy — when Verzenio is taken by itself

When Verzenio is taken by itself, the typical dose is 200 mg twice a day. This dose is generally only used in people with HR+/HER2- metastatic breast cancer whose cancer has continued to grow despite treatment with both hormone therapy and chemotherapy.

Combination therapy

Verzenio’s recommended dose is slightly lower when taken with an aromatase inhibitor, tamoxifen, or fulvestrant. The typical dose is 150 mg twice a day. This dose is used in both early and metastatic HR+/HER2- breast cancer. 

For early breast cancer, you’ll only need to take Verzenio in combination with hormone therapy for up to 2 years. For metastatic cancer, you’ll continue taking it for as long as it’s working for you.

EXPERT PICKS: WHAT TO READ NEXT

• Receptor review: Understand the different types of breast cancer receptors and how they affect breast cancer treatment selection. 

• Early breast cancer alternatives: Verzenio isn’t your only treatment option. Explore medications commonly used to treat early breast cancer.

• Curious about interactions? Learn about Verzenio’s different medication interactions.

Are there any dosage adjustments for medical conditions?

Yes. Liver problems and certain medications can prevent Verzenio from being broken down as intended. This causes Verzenio blood levels to build up in the body, which increases the risk of side effects. You may need to take a lower dose of Verzenio as a result.

Dosage for people who experience side effects

Although Verzenio is a targeted medication, side effects can still happen. 

You may need a lower Verzenio dose if you experience:

• Low white blood cells, red blood cells, or platelets that force you to stop taking Verzenio on more than one occasion

• Several episodes of diarrhea per day

• Diarrhea that doesn’t get better with antidiarrheal medications or requires hospitalization

• Interstitial lung disease or pneumonitis, especially if it keeps coming back or won’t improve

• Any other bothersome side effects that keep coming back or don’t improve despite your oncologist’s best efforts to keep it under control

The exact dose adjustment depends on your starting Verzenio dose and whether you’ve already had to decrease your dose. But, in short, if you need a dose adjustment due to side effects, you’ll decrease both your morning and evening dose by 50 mg (one dose level).

*If you need a dose lower than 50 mg twice a day, it’s time to start thinking about another option.

Dosage for people with liver problems

Verzenio primarily relies on the liver for its breakdown. If you have a severe liver condition, your oncologist may have you take Verzenio only once a day.

Verzenio can also irritate the liver after you start it. Liver enzymes are proteins that break down many different medications and nutrients. Increased liver enzymes can be a sign of tissue damage and liver inflammation.

Your oncologist should regularly measure your liver enzyme levels through blood draws. If they’re seeing large increases in your readings, they’ll likely decrease your Verzenio by one dose level.

Dosage for people taking an interacting medication

Cytochrome P450 3A4 (CYP3A4) is an enzyme in your body that breaks down many medications, including Verzenio. Medications called CYP3A4 inhibitors prevent CYP3A4 enzymes from doing their job. This causes blood levels of Verzenio to build up in the body, increasing your chance of experiencing side effects.

Ketoconazole (Nizoral) is an oral antifungal medication that strongly blocks this enzyme. You shouldn’t take it with Verzenio. And it’s not just medications that behave like this. You’ll want to steer clear of grapefruit and grapefruit juice for the same reason.

Several other medications strongly block CYP3A4, too. You can still take these with Verzenio — but you’ll likely need a lower Verzenio dose. Examples include:

• Antibiotics like clarithromycin (Biaxin XL)

• Other antifungals, including itraconazole (Sporanox) and voriconazole (Vfend)

• Antiviral medications that contain ritonavir, such as nirmatrelvir / ritonavir (Paxlovid)

Verzenio dose adjustments with strong CYP3A4 inhibitors depend on your starting dose and whether you’ve already needed a dose adjustment for side effects.

Some medications block CYP3A4 to a lesser degree. These are called “moderate” CYP3A4 inhibitors. You may or may not need a dose reduction with these interactions. Examples include:

• Antibiotics like erythromycin (Ery-Tab)

• Antifungal medications like fluconazole (Diflucan)

• Heart medications such as verapamil (Calan SR, Verelan) and diltiazem (Cardizem)

Other interactions

Medications called CYP3A4 inducers speed up CYP3A4 activity. This means Verzenio is broken down too quickly, making it less effective. Examples of these products include antibiotics like rifampin (Rifadin), antiseizure medications like carbamazepine (Tegretol, Equetro), and herbal supplements like St. John’s wort.

Avoid taking medications like these with Verzenio. Your oncologist can help you keep track of what to take and what to avoid.

What happens if you miss a dose of Verzenio?

If you forget to take a dose of Verzenio, skip that dose and take the next one at your normally scheduled time. Taking Verzenio doses too close together increases the risk of side effects. You also shouldn’t take extra Verzenio to make up for missed doses.

If you’re having trouble remembering to take your medication, consider reaching out to your pharmacist for suggestions. Using phone apps, alarms, or a calendar are all helpful strategies that can combat forgetfulness.

What should you do if you take too much Verzenio?

If you think you took too much Verzenio, call your oncologist right away. If you’re unable to reach anyone or you need immediate help, call the Poison Control Center at 1-800-222-1222. You can also use their online messaging tool.

How to save on Verzenio

There are ways to save on Verzenio, which is only available as a brand-name medication. GoodRx can help you navigate copay savings cards and patient assistance programs to save money on your prescription.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 per month for Verzenio using a savings card from the manufacturer.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Verzenio’s patient assistance program, which offers the medication free of charge.

Why trust our experts?

Written by:

Rachel Feaster, PharmD, BCOP, BCPS

Rachel Feaster has over 10 years of professional experience in ambulatory, inpatient, pharmacogenomics, and oncology care. She is board certified in oncology and pharmacotherapy.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Sonja Jacobsen, PharmD, BCPS, BCOP

Sonja Jacobsen, PharmD, BCPS, BCOP,  is a clinical oncology pharmacy specialist currently practicing in Seattle. She has been practicing as a pharmacist since 2015 and is licensed to practice in Washington state and North Carolina.

Our editorial standards

Meet our experts