Kisqali is a prescription drug that forms an essential part of combination therapies designed to fight off hormone-related breast cancer.

Cancer, without a doubt, is one of the world’s most significant problems, causing millions of deaths worldwide and leaving many more people living in pain. In particular, breast cancer, one of the most common types of cancer, affects over 270,000 people every year.

Specifically, Kisqali treats HR-positive and HER2-negative advanced or metastatic breast cancer among postmenopausal women.

The medication is used in conciliation with other cancer medications like letrozole (Femara). It is a significant component of an integrated approach to addressing complex diseases and improving patient results and treatment performance.

How Does Kisqali Work?

Kisqali acts by preventing the interaction of cyclin-dependent kinases 4 and 6 (CDK4/6) with their co-factors Rb and E2F, essential for preventing excess cancer cell proliferation.

By blocking these molecular mechanisms, Kisqali prevents tumor cell growth and slows down tumor division and proliferation, thereby providing therapeutic relief.

Precautions and Warnings with Kisqali

Kisqali, just like any other drug, is not meant for everyone. For safe use, people with certain conditions should use it with care and with close monitoring or keep off it altogether.

  • Liver Impairment: Kisqail may damage the liver or worsen liver condition in people with liver damage. Frequent liver function tests should be carried out to determine the suitability of the drug before use.
  • Heart Conditions (e.g., QT prolongation, arrhythmias): A cardiac evaluation is needed before starting Kisqali for patients with pre-existing heart conditions due to its potential to extend the QT interval.
  • Allergic Reactions: Patients allergic to Kisqali or its components should not take this drug. Kisqali may cause rare or persistent skin rashes and more dangerously anaphylaxis.
  • Infection: Notify your doctor about any infection you may have for it to be treated before starting Kisqali.
  • Bone Marrow Suppression: Kisqali can cause myelosuppression, which can lead to decreased levels of blood cells. Doctors should monitor blood cell counts regularly and adjust dosages or discontinue treatment if severe suppression occurs.

Kisqali Side Effects

Kisqali (ribociclib) has a wide scope of side effects ranging from common to severe. Patients should recognize possible adverse effects and notify healthcare providers of any reactions without delay.

Common Side Effects

  • Nausea
  • Fatigue
  • Diarrhea
  • Vomiting
  • Decreased appetite
  • Hair loss
  • Headache
  • Constipation

Severe Side Effects

  • QT prolongation (irregular heartbeats)
  • Liver problems
  • Neutropenia (low levels of white blood cells, increasing the risk of infections)
  • Interstitial lung disease
  • Anaphylaxis

Drug Interactions With Kisqali 

Ketoconazole, Clarithromycin, RitonavirKetoconazole, ritonavir (Norvir), and clarithromycin (Biaxin) inhibit the CYP3A4 enzyme, which is responsible for metabolizing Kisqali in the liver. This inhibition leads to increased levels of Kisqali in the bloodstream hence intensifying side effects.
Carbamazepine (Tegretol), Phenytoin (Dilantin), and Rifampin (Rifadin)These medications induce the activity of the CYP3A4 enzyme, accelerating the metabolism of Kisqali in the liver. This results in decreased levels of Kisqali in the blood, potentially reducing its effectiveness. Close monitoring is necessary to ensure adequate therapeutic response.
AntipsychoticsCertain antipsychotic medications may prolong the QT interval in the heart. When used concurrently with Kisqali, which also has QT-prolonging effects, there is an increased risk of further prolongation of the QT interval leading to irregular heart rhythms.

Kisqali Strengths and Dosages

Kisqali is available in tablet form taken orally. Patients should take the medication once daily with or without food.

The initial dose of Kisqali is 600 mg. Users should take Kisqali together with an aromatase inhibitor continuously for 3 weeks and then spend the next week taking the aromatase inhibitor alone, completing the scheduled cycle of 28 days.

Dose for Adverse EffectsDosageFrequency
Starting dose600mgDaily for 21 days
First dose reduction400mgDaily for 21 days
Second dose reduction200mgDaily for 21 days
Dose below 200mgDiscontinue TreatmentN/A

The dose can be rescheduled or changed by a doctor based on how effective the drug is to an individual and how well they tolerate it.

Why is Kisqali so Expensive?

Kisqali is expensive due to several factors, including:

  • Manufacturing Cost: Manufacturing Kisqali demands specialized facilities and equipment due to its intricate processes. Maintaining quality, and purity increases the manufacturing cost.
  • Research and Development: Kisqali requires extensive research over a long period from discovery to regulatory approval, incurring the need for research and development costs. These costs get recovered through the drug’s cost.
  • Regulatory Requirements: Pharmacies must adhere to the strict regulatory standards set by the FDA. Costs linked to meeting the regulations, encompassing clinical trials and post-market surveillance, contribute to the overall expense.

Kisqali Alternatives

Even though Kisqali has shown to be a highly effective treatment, patients and healthcare professionals have other options when navigating the difficult decisions surrounding treatment. By being aware of these options, patients and healthcare professionals can make decisions specific to their needs and instances, boosting treatment plans and eventually contributing to better patient outcomes.

The alternatives include:

  • Anastrozole (Arimidex) – It works by preventing the existing aromatase enzyme which is responsible for creating estrogen from androgens. By drastically reducing estrogen, the aromatase inhibitor denies the hormone receptor-positive breast cancer cells the estrogen hormone they need to grow.
  • Ibrance – Palbociclib, the active component of Ibrance, aids in regaining control over the cell cycle in cancer cells by inhibiting cyclin-dependent kinase 4 and 6 (CDK4/6).
  • Other Alternatives – Letrozole, abemaciclib (Verzenio), fulvestrant and exemestane.

FAQs of Kisqali

How long does it take for Kisqali to work?

Kisqali takes almost two to three weeks for it to start taking effect after a patient starts the medication.

What is Kisqali used for?

It is a medication used for the treatment of advanced breast cancer, HER2-negative breast cancer, and hormone receptor-positive cancer.

Why take Kisqali in the morning?

The drug can be taken at any time of the day but it is advised to be taken in the morning because it will help in keeping a good level of the drug in the body.

How long do you take Kisqali?

You will be instructed to take the medication for 21 consecutive days followed by a seven-day break. The circle will be repeated as long as your doctor remains safe and beneficial for your treatment.

How long does Kisqali extend life?

Kisqali has been shown to increase survival by approximately one year compared to alternative treatments in both pre- and postmenopausal women. It provides an overall survival benefit of around 5 years.

How effective is Kisqali?

The medication has demonstrated effectiveness in extending progression-free survival in HER2-negative advanced or metastatic breast cancer when used in combination with hormone therapy.

When was Kisqali approved?

The medication was approved on March 13, 2017, by the US FDA as a first-line treatment alongside an aromatase inhibitor for metastatic breast cancer.

How long does Kisqali stay in your system?

Kisqali has a half-life of about 32 hours, which is the time taken for half of the drug to be cleared from the body.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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