Ribociclib

Uses	HR-positive, HER2-negative advanced and metastatic breast cancer
Therapy	Anti-Neoplastic
Side Effects	Nausea, diarrhoea, low white cell counts, liver test changes

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Molecule Description

Ribociclib is an anti-cancer medicine belonging to a group called CDK inhibitors. It works by slowing the growth and spread of cancer cells. It is prescribed for hormone receptor (HR) positive, HER2-negative advanced or metastatic breast cancer. It is given in combination with an aromatase inhibitor or with fulvestrant, as part of hormonal anti-cancer therapy. It is taken by mouth and must be used exactly as the doctor advises. Before starting, tell your doctor about any existing medical conditions, particularly heart rhythm problems, and about every medicine you take. Liver function is checked before treatment and monitored during it, and your doctor may also check kidney function and blood counts. Tell your doctor if you are pregnant, planning a pregnancy or breastfeeding. Avoid grapefruit and grapefruit juice during treatment.

Uses

Ribociclib is used to treat hormone receptor positive, HER2-negative advanced or metastatic breast cancer.

Contraindications

When should one not use Ribociclib

If you are allergic to Ribociclib.

Side effects

Common side effects of this drug are:

Nausea
Vomiting
Diarrhoea
Abdominal pain
Mouth sores (stomatitis)
Loss of appetite
Shortness of breath
Rash
Hair loss
Headache and dizziness
Low white blood cell counts, which can increase the risk of infections
Changes in liver blood tests
Changes in the heart rhythm seen on the ECG due to QT interval prolongation

Precautions and Warnings

Pregnancy

Ribociclib is not recommended during pregnancy, as it can harm the unborn baby. Use effective contraception during treatment and for the period your doctor advises after the last dose.

Breast Feeding

People receiving Ribociclib should not breastfeed, during treatment and for the period their doctor advises after the last dose as it may harm the nursing infant.

Driving

Ribociclib may have a minor effect on the ability to drive or use machinery. Take care if you experience tiredness, dizziness or vertigo during treatment.

Alcohol

There is no information available about interactions between Ribociclib and alcohol. However it is best to avoid alcohol during tretment as it may worsen your side effects. Please consult your doctor before consuming alcohol.

Other General Warnings

Talk to your doctor if

You are taking any other medicines, particularly any that affect the heart rhythm.
You already have, or are at high risk of, QTc prolongation.
You are pregnant or plan to become pregnant.
You develop any side effect or allergic reaction after taking this medicine.
You have a fever, sore throat, any infection, or a low white blood cell count.
You are due for liver function tests, which are done before treatment and monitored during it.
Your blood creatinine rises during treatment, as your kidney health may need further assessment.

Mode of Action

How Does It Work?

Ribociclib selectively blocks two proteins called CDK4 and CDK6. These proteins are present in healthy cells and in cancer cells, and they control how cells multiply and divide. In breast cancer they can become overactive, so the cells grow and divide uncontrollably. By interrupting them, Ribociclib slows or stops the abnormal growth of cancer cells.

Interactions

Interactions with other medicines

Tell your doctor about all the medicines, supplements and herbal products you take, as some may interact with ribociclib.
Take particular care with medicines that can affect the heart rhythm, as ribociclib can prolong the QT interval.
Medicines that affect the CYP3A enzyme can change the level of ribociclib in your body. Strong CYP3A inhibitors can increase ribociclib levels, while strong CYP3A inducers can decrease them.

Interactions with food items

It can be taken with or without food. Do not take grapefruit, grapefruit juice or foods containing grapefruit during treatment, as they block the enzyme that breaks Ribociclib down and can raise its level in the blood.

Dosage

Overdose

In the event of an overdose, contact your doctor immediately or go to the nearest hospital.

Missed a Dose

Tell your doctor if you miss a dose. Do not take extra doses to make up for a missed one, and do not take an additional dose on the same day if you vomit after a dose.

Frequently Asked Questions (FAQs)

Take it at the same time each day, preferably in the morning, as directed by your doctor. If you vomit after a dose or miss one, do not take an extra dose that day.

It can prolong the QT interval, a measure of the heart’s electrical activity. Your doctor may arrange an ECG and blood tests before and during treatment, and will take care with other medicines that have the same effect.

Changes in liver blood tests can occur. Liver function is checked before treatment starts and monitored afterwards so that any change is found early and managed accordingly.

Grapefruit blocks the enzyme that breaks this medicine down, which can raise its level in the blood and increase side effects.