Why Is This Medication Prescribed
Palbociclib is used in combination with anastrozole , exemestane , or letrozole to treat a certain type of hormone receptorpositive, advanced breast cancer or breast cancer that has spread to other parts of the body in women who have experienced menopause or in men. Palbociclib is also used along with fulvestrant to treat a certain type of hormone receptorpositive, advanced breast cancer or breast cancer that has spread to other parts of the body in people who have been treated with an antiestrogen medication such as tamoxifen . Palbociclib is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps stop or slow the spread of cancer cells.
How To Take Ibrance
Ibrance or palbociclib has to be taken only with a doctors approval and at prescribed levels. It is important to follow all the guidelines mentioned in the label and package. There are possibilities for your doctor to alter the dosages from time to time to give you best results. Also, take the medicine only at prescribed dosage and not in smaller or larger amounts.
Ibrance or palbociclib is given during a 28 days treatment cycle. However the medicine will be given only during the first three weeks of the treatment cycle. It is your doctor who will decide how much medicine you need for your treatment.
- Take the medicine with food
- It is important to take ibrance or palbociclib at the same time every day
- Swallow the whole capsule without breaking, chewing or crushing it
- In case you vomit after taking the medicine it is important to wait until the next day to have the next dosage.
- If your pill is damaged or broken do not have it
- This medicine has properties of lowering your blood cells those responsible to fighting infections in the body and also might clot blood. This means you can bleed easily with small injuries and you can also fall ill when with people who are unwell. Blood tests must be taken very often while on this treatment.
Ibrance or palbociclib has to be kept away from heat and moisture and stored at room temperature.
Ibrance And Herbs And Supplements
Always check with your doctor or pharmacist before using any herbs or supplements with Ibrance.
Ibrance and turmeric
Its not known for sure whether turmeric interacts with Ibrance. However, some research suggests that turmeric may change the way that Ibrance is broken down in your body. This may lead to higher levels of Ibrance in your body and increase your risk of side effects.
Talk with your doctor first if you want to take turmeric while taking Ibrance.
Ibrance and St. Johns wort
Dont take St. Johns wort while youre taking Ibrance. This herbal remedy can lower the levels of Ibrance in your body and make it less effective.
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Palbociclib And Hormone Therapy
In the UK palbociclib is always given alongside a hormone therapy drug.
You may have palbociclib with:
- An aromatase inhibitor if you have not already had hormone therapy for locally advanced or secondary breast cancer
- Fulvestrant if you have had hormone therapy for locally advanced or secondary breast cancer
Some people who had hormone therapy for primary breast cancer, and who now have locally advanced or secondary breast cancer, may be offered palbociclib with an aromatase inhibitor or fulvestrant. This will depend on their circumstances.
Taking palbociclib and an aromatase inhibitor
Palbociclib is taken as a capsule once a day for 21 days followed by a seven-day break. This is known as a cycle.
The cycle is then repeated.
An aromatase inhibitor drug is taken once a day continually throughout the cycle.
Taking palbociclib and fulvestrant
Palbociclib is taken as a capsule once a day for 21 days followed by a seven-day break. This is known as a cycle.
The cycle is then repeated.
Fulvestrant is given in two injections, one into the muscle of each buttock. They are usually given every 14 days for the first three doses, then every 28 days for as long as you are having palbociclib.
If you have not been through the menopause
Aromatase inhibitors and fulvestrant are suitable for women who have been through the menopause .
Re: Ibrance And Letrozole
Was going through past messages and came across yours. Had my second clean PET early March. The last few weeks my back has been sore and of course this starts my brain working overtime. I find I get this feeling a few weeks post Denusomab injection. Do you still get bone pain especially after bone strengthened?
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Treatment Options For Stage Iv Breast Cancer
For women with stage IV breast cancer, systemic therapies are the main treatments. These may include:
- Some combination of these
Treatment can often shrink tumors , improve symptoms, and help women live longer. These cancers are considered incurable.
Will I Need Any Tests While I Take Ibrance
Yes, youll need to have regular blood tests to monitor your blood cells and your liver function while you take Ibrance.
Ibrance can cause your white blood cell count to fall, which can increase your risk of infections. Very low white blood cell counts can put you at risk of serious, potentially life-threatening infections.
Your doctor will want you to have regular blood tests to check your white blood cell counts, so any problems can be found early. If your white blood cell counts start to fall, your doctor may lower your dosage of Ibrance. They may also have you take a break from treatment until your blood cells recover.
Ibrance can also cause your red blood cell count to fall. This is called anemia. It can make you look pale and feel tired, cold, or lightheaded. Your platelet count may also fall, which can make you bruise or bleed more easily. Your blood tests will also check your red blood cell and platelet counts.
Ibrance can sometimes damage your liver, causing certain liver enzymes to be released into your blood. Your doctor will want to regularly test your blood for this. These tests are called liver function tests. If your liver function tests show damage to your liver, your doctor may lower your dose of Ibrance.
If youre a female* who can get pregnant, your doctor will also give you a pregnancy test before starting Ibrance. You shouldnt take Ibrance if you are pregnant or planning a pregnancy.
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How Effective Is Ibrance
Ibrance is also known as palbociclib which is a medicine for effective cancer treatment that helps to control and prevent the growth of cancer cells. Ibrance or palbociclib also interferes with the spread of these cells as well.
Ibrance or palbociclib is used both in women and men. In women, it is used for the effective treatment of advanced breast cancer which in normal cases would spread throughout the body.
Ibrance or palbociclib is also given to women during their postmenopausal stage with combination of letrozole otherwise known as Femara which is a hormonal medicine. For others, the medicine is given with the combination of fulvestrant also known as Faslodex.
Follow this Procedure Before Taking This Medicine:
If allergic to ibrance or palbociclib, do not take this medicine. Tell your doctor if you have these medical conditions to make the medicine safe for you
- Kidney disease
- Liver disease.
If pregnant do not take ibrance or palbociclib as there are chances of the medicine harming the unborn baby. It is necessary you take effective birth control pills especially when you are on treatment and also for the next weeks after the final dosage is taken. Also, before starting this treatment you must have a negative pregnancy test.It is not confirmed if ibrance or palbociclib gets in to breast milk which could harm the child. Therefore, while on this treatment do not breast feed your child.
Effectiveness For Breast Cancer
Ibrance has been studied as a breast cancer treatment in combination with two different hormone therapies: fulvestrant and letrozole . Below, we describe the results of these studies.
Effectiveness of Ibrance with letrozole
One clinical study looked at postmenopausal females who had HR+, HER2-negative, advanced breast cancer. These females hadnt yet taken systemic treatment for the advanced cancer.
Some females were given Ibrance plus letrozole, while other females were given letrozole alone. Females in this study are still being followed, but so far, the following results have been seen:
- 50% of females taking Ibrance plus letrozole didnt have their cancer worsen for at least 24.8 months
- 50% of females taking letrozole alone didnt have their cancer worsen for at least 14.5 months
Another clinical study looked at postmenopausal females who had HR+, HER2-negative, advanced breast cancer. These females hadnt yet taken systemic treatment for the advanced cancer.
Some females were given Ibrance plus letrozole, while other females were given letrozole alone. Over about 40 months of treatment, the following results were seen:
- 50% of females taking Ibrance plus letrozole didnt have their cancer worsen for at least 20 months
- 50% of females taking letrozole alone didnt have their cancer worsen for at least 10 months
Effectiveness of Ibrance with fulvestrant
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What Is Ibrance And How Is It Used
Ibrance is indicated for the treatment of adult patients with hormone receptor -positive, human epidermal growth factor receptor 2 -negative advanced or metastatic breast cancer in combination with:
- an aromatase inhibitor as initial endocrine-based therapy in postmenopausal women or in men or
- fulvestrant in patients with disease progression following endocrine therapy.
Sex Contraception And Pregnancy
Taking palbociclib while pregnant may be harmful to a developing baby.
Barrier contraception should be used during treatment and for at least three weeks after stopping treatment.
Some women can still become pregnant even if their periods are irregular or have stopped.
Men taking palbociclib should use contraception during treatment and for 14 weeks after stopping.
While womens fertility may not be affected, palbociclib can decrease fertility in men. Men taking palbociclib may want to talk to their treatment team about sperm preservation before starting treatment.
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Local Or Regional Treatments For Stage Iv Breast Cancer
Although systemic drugs are the main treatment for stage IV breast cancer, local and regional treatments such as surgery, radiation therapy, or regional chemotherapy are sometimes used as well. These can help treat breast cancer in a specific part of the body, but they are very unlikely to get rid of all of the cancer. These treatments are more likely to be used to help prevent or treat symptoms or complications from the cancer.
Radiation therapy and/or surgery may also be used in certain situations, such as:
- When the breast tumor is causing an open wound in the breast
- To treat a small number of metastases in a certain area, such as the brain
- To help prevent bone fractures
- When an area of cancer spread is pressing on the spinal cord
- To treat a blood vessel blockage in the liver
- To provide relief of pain or other symptoms
In some cases, regional chemo may be useful as well.
If your doctor recommends such local or regional treatments, it is important that you understand their goalwhether it is to try to cure the cancer or to prevent or treat symptoms.
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This information summarizes the main results of reviews produced by the Institute for Quality and Efficiency in Health Care . The reviews were commissioned by the German Federal Joint Committee as part of the early benefit assessment of medications. On the basis of the reviews and the hearings received, the G-BA passed a resolution on the added benefit of palbociclib .
Institute for Quality and Efficiency in Health Care . Palbociclib Benefit assessment according to §35a Social Code Book V. Dossier assessment Commission A16-74. February 23, 2017. .
Institute for Quality and Efficiency in Health Care . Palbociclib Addendum to Commission A16-74 Commission A17-15. April 28, 2017. .
Institute for Quality and Efficiency in Health Care . Palbociclib Benefit assessment according to §35a Social Code Book V. Dossier assessment Commission A18-63. December 20, 2018. .
IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.
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Is Kisqali Better Than Ibrance
But studies have found both Kisqali and Ibrance to be effective for treating advanced or metastatic breast cancer thats HR-positive and HER2-negative. One review of studiesTrusted Source with these drugs found that Kisqali and Ibrance were equally effective for treating this type of advanced breast cancer.
Who Might Be Offered Palbociclib
You may be offered palbociclib if your breast cancer has:
- Spread to the tissues and lymph nodes around the chest, neck and under the breastbone
- Spread to another part of the body such as the bones, lungs, liver or brain
Palbociclib is not currently given for early breast cancer, though clinical trials are looking at whether this may be useful.
Find out more about availability.
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Can Bone Metastases Be Cured
Many different treatments can help if your cancer has spread to bone, commonly called bone metastasis or bone mets. Treatment cant cure bone metastasis, but it can relieve pain, help prevent complications, and improve your quality of life. Doctors use two types of treatments for metastatic cancer in the bones.
Is Ibrance Right For You
Ibrance can be prescribed with an aromatase inhibitor for postmenopausal women or men diagnosed with advanced-stage or metastatic, hormone-receptor-positive, HER2-negative breast cancer that hasnt been treated with hormonal therapy yet.
Ibrance also can be used in combination with Faslodex in women or men to treat advanced-stage or metastatic, hormone-receptor-positive, HER2-negative breast cancer that has grown after being treated with hormonal therapy.
Advanced-stage breast cancer is cancer that has come back or spread beyond the breast to the chest wall below the breast. Metastatic breast cancer is advanced-stage cancer that has spread to parts of the body away from the breast, such as the bones or liver.
Femara, Aromasin, and Arimidex are all aromatase inhibitors, a type of hormonal therapy. Aromatase inhibitors stop the production of the hormone estrogen. Aromatase inhibitors work by blocking the enzyme aromatase, which turns androgen hormones into small amounts of estrogen in the body. This means that less estrogen is available to stimulate the growth of hormone-receptor-positive breast cancer cells. All of the aromatase inhibitors are pills taken by mouth.
Faslodex is an estrogen receptor downregulator , another type of hormonal therapy. Faslodex blocks the effect of estrogen on breast tissue by sitting in the estrogen receptor in breast cells. Faslodex is a liquid given as an injection into a muscle.
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Ibrance With Other Aromatase Inhibitors
While Ibrance capsules are approved for use with letrozole specifically, Ibrance tablets can be used with other aromatase inhibitors besides letrozole. Other aromatase inhibitors include:
Youll take Ibrance tablets with an aromatase inhibitor if havent yet tried hormone therapy for your breast cancer. With Ibrance tablets, this combination is suitable for postmenopausal females* and for males.*
* Use of the terms male and female within this article refer to a persons sex assigned at birth.
What Are The Side Effects Of Ibrance
Neutropenia was the most frequently reported adverse reaction in Study 1 with an incidence of 80% and Study 2 with an incidence of 83%. A Grade 3 decrease in neutrophil counts was reported in 66% of patients receiving Ibrance plus letrozole in Study 1 and 66% of patients receiving Ibrance plus fulvestrant in Study 2. In Study 1 and 2, the median time to first episode of any grade neutropenia was 15 days and the median duration of Grade 3 neutropenia was 7 days.
Monitor complete blood counts prior to starting Ibrance therapy and at the beginning of each cycle, as well as on Day 15 of the first 2 cycles, and as clinically indicated. Dose interruption, dose reduction, or delay in starting treatment cycles is recommended for patients who develop Grade 3 or 4 neutropenia.
Based on findings from animal studies and its mechanism of action, Ibrance can cause fetal harm when administered to a pregnant woman. In animal reproduction studies, administration of palbociclib to pregnant rats and rabbits during organogenesis resulted in embryo-fetal toxicity at maternal exposures that were 4 times the human clinical exposure based on area under the curve . Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment with Ibrance and for at least 3 weeks after the last dose.
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What Drugs Interact With Ibrance
Palbociclib is primarily metabolized by CYP3A and sulfotransferase enzyme SULT2A1. In vivo, palbociclib is a time-dependent inhibitor of CYP3A.
Effect of CYP3A Inhibitors
Coadministration of a strong CYP3A inhibitor increased the plasma exposure of palbociclib in healthy subjects by 87%. Avoid concomitant use of strong CYP3A inhibitors . Avoid grapefruit or grapefruit juice during Ibrance treatment. If coadministration of Ibrance with a strong CYP3A inhibitor cannot be avoided, reduce the dose of Ibrance.
Effect of CYP3A Inducers
Coadministration of a strong CYP3A inducer decreased the plasma exposure of palbociclib in healthy subjects by 85%. Avoid concomitant use of strong CYP3A inducers .
Drugs That May Have Their Plasma Concentrations Altered by Palbociclib
Coadministration of midazolam with multiple doses of Ibrance increased the midazolam plasma exposure by 61%, in healthy subjects, compared to administration of midazolam alone. The dose of the sensitive CYP3A substrate with a narrow therapeutic index may need to be reduced, as Ibrance may increase its exposure.