Kisqali (Ribociclib) for Breast Cancer

What Members Say Top Tips Side Effects Copay Help FAQs

Kisqali (ribociclib) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults with certain hormone receptor-positive, HER2-negative breast cancer.

What Members Say

MHT logo These insights are based on 773 comments about Kisqali from MyBCTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.

Benefits:

Scans, tumor markers, or tumor size often improve within the first few months.
Long-term disease control or stable scans can continue for months or years.
The three-weeks-on, one-week-off pill schedule can feel manageable at home.
Dose reductions sometimes make treatment easier to continue.

Considerations:

Low white blood cell counts often lead to extra labs, treatment holds, or dose changes.
Fatigue, nausea, diarrhea, constipation, and headaches are common treatment burdens.
Heart rhythm monitoring with regular ECGs can add appointments and medication interaction concerns.
Liver test increases can interrupt treatment and sometimes require stopping Kisqali.

How Kisqali Works and How It’s Taken

Kisqali is a type of medication called a kinase inhibitor. It blocks proteins called cyclin-dependent kinase 4 and 6 (CDK4 and CDK6). These proteins help cells move through the cell cycle, which is the process cells use to grow and divide.

In breast cancer models, Kisqali slowed the growth and spread of cancer cells. In HR-positive, HER2-negative breast cancer, blocking CDK4 and CDK6 may help slow cancer cell growth.

Doctors prescribe Kisqali when an adult has HR-positive, HER2-negative stage 2 or 3 early breast cancer with a high risk of coming back, advanced breast cancer, or breast cancer that has spread. The exact use depends on the stage of cancer and the treatment plan.

Kisqali may be used:

With an aromatase inhibitor after initial treatment for stage 2 or 3 early breast cancer that has a high risk of coming back
With an aromatase inhibitor as the first endocrine-based treatment for advanced breast cancer or cancer that has spread
With fulvestrant as the first endocrine-based treatment, or after endocrine therapy has stopped working, for advanced breast cancer or cancer that has spread

Kisqali is given as a tablet by mouth. It is usually taken once a day for 21 days, followed by seven days off, in 28-day cycles. It can be taken with or without food, and the tablets should be swallowed whole.

Kisqali also comes as Kisqali Femara Co-Pack. This package includes Kisqali and letrozole, another breast cancer medicine. Doctors may prescribe the Co-Pack when a person’s treatment plan includes both medicines.

Females who have not gone through menopause, or males with breast cancer, may also receive a luteinizing hormone-releasing hormone agonist with treatment.

For early breast cancer, treatment usually continues for three years, or until the cancer comes back or side effects become unacceptable. For advanced breast cancer or cancer that has spread, treatment usually continues until the cancer gets worse or side effects become unacceptable.

Typical Dosing for Breast Cancer

For early breast cancer, the recommended dose is 400 milligrams by mouth once daily for 21 consecutive days, followed by seven days off treatment in 28-day cycles, used with an aromatase inhibitor.

For advanced or metastatic breast cancer, the recommended dose is 600 milligrams by mouth once daily for 21 consecutive days, followed by seven days off treatment in 28-day cycles, used with an aromatase inhibitor or fulvestrant.

Doctors may pause treatment, lower the dose, delay the next cycle, or stop treatment if side effects are serious or too hard to manage.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Kisqali

MHT logo These insights are based on 773 comments about Kisqali from MyBCTeam members.

Members who use Kisqali often say it helps to stay in close contact with your care team, especially about blood work, heart monitoring, and side effects that change over time. Many also mention practical ways to make treatment more manageable, such as keeping a consistent routine, adjusting timing with clinician approval, and looking into financial assistance if cost becomes a barrier.

1

Get blood work and monitoring when your doctor orders it.
“My WBCs are way down so I was taken off Kisqali for a week, then redo my blood work.”
2

Ask your doctor about the best time of day to take it.
“I had insomnia when taking letrozole and Kisqali at night, but it stopped when I switched to taking them in the morning.”
3

Talk to your doctor if side effects make a dose change necessary.
“I had to come down a dose on the Kisqali because it was having a negative effect on my heart rhythm. Since lowering the dose everything is back to normal with my heart.”
4

Look into patient assistance if cost is a problem.
“Kisqali does offer payment assistance, but only if you are on a ‘commercial’ insurance plan. That means your insurance is not Medicare or Medicaid.”

Connect with others who understand life with breast cancer. Join MyBCTeam for free.

Kisqali Side Effects

In clinical trials of Kisqali for adults with hormone receptor-positive, HER2-negative early, advanced, or metastatic breast cancer, the most common side effects occurred in at least 20 percent of people taking Kisqali.

These side effects include:

Low white blood cell counts
Low neutrophil counts
Low red blood cell counts
Low lymphocyte counts
Increased liver enzyme levels
Infections
Nausea
Increased creatinine levels
Fatigue
Low platelet counts
Diarrhea
Vomiting
Headache
Constipation
Hair loss
Cough
Rash
Back pain
Low blood sugar levels
Pruritus (itching)

Serious Side Effects and Warnings

Kisqali can cause serious side effects that may require immediate medical attention. These include:

Lung problems — These can include interstitial lung disease or pneumonitis.
Severe skin reactions — These can include Stevens-Johnson syndrome, toxic epidermal necrolysis, and DRESS.
Heart rhythm problems — These can include QT prolongation.
Liver problems — Serious liver problems can occur.
Severe low neutrophil counts — These can raise the risk of serious infection.
Fetal harm — Kisqali can harm your baby if you are pregnant.

Get medical help right away if you think you are having a serious reaction.

How To Save on Kisqali

Novartis, the manufacturer of Kisqali, offers the Novartis Patient Support Co-Pay Plus program. Eligible people with commercial insurance may pay as little as $0. If you have government insurance or no insurance, the website offers information on other ways to save on your prescription.

The Novartis Patient Support Co-Pay Plus program also offers help navigating the insurance process, ongoing one-on-one support, options for saving on your prescription, help setting up your routine, educational resources, a welcome kit, tips for talking to your healthcare provider, a brochure, a list of independent support organizations, and your choice of texts, calls, and emails to stay connected.

To learn more, visit Novartis Patient Support, or call 866-433-8000.

What To Know Before Taking Kisqali

Before starting Kisqali, your doctor will test or check for:

Your heart rhythm with an electrocardiogram (ECG)
Blood tests, including electrolytes, liver function, and complete blood counts
Pregnancy status if you can become pregnant

Tell your doctor about all medications you take, including prescription drugs, over-the-counter medicines, and supplements.

If you miss a dose or vomit after taking a dose, do not take an extra dose that day. Take your next dose at the usual time.

Kisqali can harm your baby if you are pregnant. Females who can become pregnant should use effective birth control during treatment and for at least three weeks after the last dose.

Do not breastfeed during treatment with Kisqali and for at least three weeks after the last dose.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Kisqali?

In early breast cancer with a high risk of coming back, 36-month invasive disease-free survival was 90.7 percent with Kisqali plus a nonsteroidal aromatase inhibitor. It was 87.6 percent with a nonsteroidal aromatase inhibitor alone.

In advanced or metastatic breast cancer, studies showed that Kisqali combinations helped people live longer without the cancer getting worse.

In pre- or perimenopausal adults, progression-free survival was 27.5 months with Kisqali plus a nonsteroidal aromatase inhibitor and goserelin. It was 13.8 months without Kisqali.

In postmenopausal adults taking fulvestrant, progression-free survival was 20.5 months with Kisqali. It was 12.8 months without Kisqali.

In one study of postmenopausal adults taking letrozole, overall survival was 63.9 months with Kisqali. It was 51.4 months without Kisqali.

What tests or monitoring are needed with Kisqali for breast cancer?

Before starting Kisqali, people need an ECG to check heart rhythm. They also need blood tests to check electrolytes, liver function, and complete blood counts.

During treatment, ECGs are repeated around day 14 of the first cycle and as clinically needed.

Liver function tests and complete blood counts are checked every two weeks for the first two cycles. After that, they are checked at the beginning of each of the next four cycles, and as clinically needed.