Why is this medication prescribed?

Kisqali Femara is a combination medication used for the treatment of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced or metastatic breast cancer in postmenopausal women. It is prescribed to be used in combination with another medication called letrozole (Femara), which is an aromatase inhibitor.

Kisqali, whose active ingredient is ribociclib, is classified as a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor. CDK4/6 are proteins involved in regulating the cell cycle and cell division. By inhibiting CDK4/6, Kisqali helps to slow down the growth and division of cancer cells in HR+ breast cancer.

Letrozole, on the other hand, is an aromatase inhibitor that works by reducing the production of estrogen in postmenopausal women. Estrogen can promote the growth of hormone receptor-positive breast cancer cells. By inhibiting estrogen production, letrozole helps to suppress the growth of these cancer cells.

The combination of Kisqali and letrozole has been shown to be effective in delaying disease progression and improving overall survival in postmenopausal women with HR+, HER2- advanced or metastatic breast cancer. It is usually prescribed by oncologists and healthcare professionals who specialize in the treatment of breast cancer.

How should this medicine be used?

Kisqali Femara (ribociclib and letrozole) is typically taken orally, and it’s important to follow your doctor’s instructions regarding dosage and duration of treatment. Here are some general guidelines:

• Dosage: The recommended dose of Kisqali is usually 600 mg (three 200 mg tablets) taken once daily for 21 consecutive days, followed by a break of 7 days (no treatment). Letrozole is typically prescribed at a dose of 2.5 mg once daily throughout the treatment cycle.
• Timing: Kisqali should be taken at the same time each day with or without food. Letrozole can also be taken with or without food, but it is essential to take it consistently at the prescribed time each day.
• Combination Therapy: Kisqali is always prescribed in combination with letrozole. It is crucial to take both medications as instructed by your healthcare provider.
• Swallowing: Take the tablets whole with a glass of water. Do not chew, crush, or split the tablets.
• Follow-up Appointments: Regularly attend follow-up appointments with your doctor to monitor your progress and discuss any concerns or side effects you may be experiencing.

It’s important to note that these instructions are general guidelines. The specific instructions for using Kisqali Femara may vary depending on individual factors, such as your overall health, other medications you may be taking, and the stage of your breast cancer. Always follow the instructions provided by your healthcare provider for the most accurate and personalized guidance.

Other uses for this medicine

Kisqali Femara (ribociclib and letrozole) is primarily used for the treatment of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced or metastatic breast cancer in postmenopausal women. However, it is important to note that medications are typically prescribed by healthcare professionals based on their approved indications.

What special precautions should I follow?

Regarding special precautions, here are some important points to consider:

• Pre-existing Conditions: Inform your doctor about any pre-existing medical conditions you have, including liver problems, heart rhythm disorders, or any other significant illnesses. These conditions may require additional monitoring or adjustments in your treatment plan.
• Medication Interactions: Provide a complete list of all medications, supplements, or herbal products you are taking to your healthcare provider before starting Kisqali Femara. Certain medications may interact with Kisqali, potentially affecting its effectiveness or causing adverse effects.
• Liver Function: Kisqali can affect liver function, so regular monitoring of liver function tests is necessary during treatment. If you have liver disease or a history of liver problems, your doctor may need to adjust the dose or closely monitor your liver function.
• Heart Rhythm: Kisqali can cause changes in heart rhythm, which can be serious. Inform your doctor if you have a history of heart problems or are taking any medications that may affect heart rhythm. Your doctor may perform cardiac monitoring before and during treatment.
• Pregnancy and Breastfeeding: Kisqali Femara should not be used during pregnancy as it may harm the unborn baby. It is also not recommended while breastfeeding, as the medication may pass into breast milk and potentially harm the nursing infant.
• Side Effects: Like any medication, Kisqali Femara can cause side effects. Common side effects may include neutropenia (low white blood cell count), nausea, fatigue, diarrhea, and hair loss. It is important to report any side effects to your doctor for evaluation and guidance.

It’s important to consult with your healthcare provider or oncologist for the most up-to-date and accurate information regarding the approved uses, precautions, and any potential off-label uses of Kisqali Femara.

What special dietary instructions should I follow?

There are no specific dietary instructions associated with Kisqali Femara. However, it is generally recommended to maintain a healthy and balanced diet during treatment. Eating a variety of nutritious foods and staying hydrated can help support overall well-being.

What should I do if I forget a dose?

If you accidentally miss a dose of Kisqali Femara, you should take it as soon as you remember on the same day. However, if it is already the next day or close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Kisqali Femara (ribociclib and letrozole) can cause various side effects. Here are some common side effects associated with this medication:

• Neutropenia: Kisqali can lower the number of white blood cells, particularly neutrophils, which can increase the risk of infection. Symptoms of neutropenia include fever, chills, sore throat, and mouth sores.
• Nausea: Some individuals may experience nausea or vomiting while taking Kisqali. It is important to inform your doctor if this occurs, as they may be able to provide medications to help alleviate these symptoms.
• Fatigue: Fatigue or tiredness is a common side effect reported by patients taking Kisqali Femara. It is important to get enough rest and conserve energy during treatment.
• Diarrhea: Diarrhea may occur as a side effect of Kisqali. It is essential to stay well-hydrated and inform your doctor if you experience severe or persistent diarrhea.
• Hair Loss: Some individuals may experience hair thinning or hair loss while taking Kisqali Femara. Hair typically grows back once treatment is completed.
• Increased Liver Enzymes: Kisqali can affect liver function, leading to an increase in liver enzyme levels. Regular monitoring of liver function tests is usually conducted during treatment.
• QT Interval Prolongation: Kisqali has the potential to prolong the QT interval, which is a measure of the heart’s electrical activity. This can increase the risk of an abnormal heart rhythm. Cardiac monitoring may be performed before and during treatment.
• Other Side Effects: Additional side effects that may occur with Kisqali Femara include headache, dizziness, constipation, cough, back pain, joint pain, and hot flashes.

It’s important to note that individual experiences with side effects can vary, and not all patients will experience these effects. If you are prescribed Kisqali Femara, it’s essential to discuss potential side effects with your doctor, as they can provide further information, guidance, and support to manage any adverse effects that may arise.

What should I know about storage and disposal of this medication?

• Storage: Store Kisqali Femara at room temperature, typically between 68°F and 77°F (20°C and 25°C). Keep the medication in its original container, away from excessive heat, moisture, and light. Do not freeze the tablets.
• Keep Out of Reach of Children and Pets: Store Kisqali Femara in a secure location, out of the reach of children and pets, to prevent accidental ingestion.
• Disposal: Properly dispose of any unused or expired Kisqali Femara tablets. Follow local regulations or consult with your healthcare provider or pharmacist on the best way to dispose of medication safely. Do not dispose of it in household trash or flush it down the toilet.

In case of emergency/overdose

If you believe you have taken too much Kisqali Femara or if someone experiences severe symptoms after taking the medication, immediately seek emergency medical attention or contact your local poison control center at once. You can also call the emergency services hotline in your country.

What other information should I know?

• Adherence to Treatment: It is important to take Kisqali Femara exactly as prescribed by your healthcare provider. Do not change the dose or frequency of administration without consulting your doctor.
• Regular Check-ups: Follow the recommended schedule for follow-up appointments and laboratory tests as advised by your doctor. These appointments help monitor your response to treatment and manage any potential side effects.
• Interactions with Other Medications: Inform your healthcare provider about all medications, including prescription, over-the-counter drugs, supplements, and herbal products you are taking. Some medications may interact with Kisqali Femara and affect its effectiveness or increase the risk of side effects.
• Hormonal Contraception: Kisqali Femara may render hormonal contraceptives less effective. Discuss alternative methods of contraception with your doctor if you are of childbearing potential and taking Kisqali Femara.
• Financial Assistance Programs: There may be financial assistance programs available to help with the cost of Kisqali Femara. Speak with your healthcare provider, pharmacist, or check with the manufacturer to explore potential options.

Remember, it is crucial to consult with your healthcare provider or pharmacist for the most accurate and up-to-date information regarding the storage, disposal, emergency procedures, and any additional information specific to your situation.