What patient teaching points should be given to a patient prescribed Kisqali (ribociclib)?

Patient Teaching Points for Kisqali (Ribociclib)

Critical Safety Monitoring

Patients taking Kisqali must immediately report any new or worsening respiratory symptoms, as the medication can cause severe or life-threatening lung inflammation. 1

Lung Problems (Interstitial Lung Disease/Pneumonitis)

• Contact your healthcare provider immediately if you develop:
  • Trouble breathing or shortness of breath 1
  • New or worsening cough (with or without mucus) 1
  • Chest pain 1

Severe Skin Reactions

• Seek immediate medical attention for:
  • Severe rash or rash that keeps worsening 1
  • Skin pain or burning sensation 1
  • Blistering of lips, eyes, or mouth 1
  • Skin peeling with or without fever 1
  • Flu-like symptoms accompanied by skin changes 1

Heart Rhythm Problems (QT Prolongation)

• Report immediately if you experience:
  • Fast or irregular heartbeat 1
  • Dizziness or feeling faint 1
  • This is a serious condition that can cause abnormal heartbeat and requires immediate evaluation 1

Liver Problems

• Contact your provider right away for signs of liver toxicity:
  • Yellowing of skin or whites of eyes (jaundice) 1
  • Dark or brown (tea-colored) urine 1
  • Severe fatigue 1
  • Loss of appetite 1
  • Pain in upper right abdomen 1
  • Unusual bleeding or bruising 1

Infection Risk (Low White Blood Cell Counts)

• Neutropenia is very common with Kisqali and increases infection risk:
  • Report fever and chills immediately 1
  • Low white blood cell counts may result in severe infections 1
  • Your provider will monitor blood counts regularly 1

Medication Administration

Dosing Instructions

• Take Kisqali at approximately the same time every day 1
• Swallow tablets whole—do not chew, crush, or split them 1
• May be taken with or without food 1
• Standard dosing: 400 mg once daily for 3 weeks, followed by 1 week off (28-day cycle) for up to 3 years 2, 3
• If you vomit or miss a dose: Take the next prescribed dose at the usual scheduled time (do not double up) 1

Storage Requirements

• After dispensing, store at room temperature 20°C to 25°C (68°F to 77°F) for up to 2 months 1
• Keep tablets in original blister pack 1

Drug Interactions

Critical Medications to Avoid

• Avoid strong CYP3A inhibitors (can increase Kisqali levels dangerously) 1, 4
• Avoid strong CYP3A inducers (can decrease Kisqali effectiveness) 1, 4
• Avoid medications that prolong QT interval (increases heart rhythm problems) 1
• Inform all healthcare providers about Kisqali before starting any new medications 1

Pregnancy and Contraception

Reproductive Considerations

• Kisqali can cause serious harm to an unborn baby 1
• Use effective contraception during treatment and for at least 3 weeks after the last dose 1
• Notify your provider immediately if you become pregnant or suspect pregnancy 1
• Do not breastfeed during treatment and for at least 3 weeks after the last dose 1

Expected Side Effects

Common Adverse Events

• Nausea (23% of patients) 2
• Headache (22% of patients) 2
• Fatigue (21.9% of patients) 2
• Neutropenia (43.8% grade 3 or higher) 2
• Liver enzyme elevations (8.3% grade 3 or higher) 2

Monitoring Requirements

Regular Testing

• Your healthcare provider will perform:
  • Heart monitoring (ECGs) before and during treatment 1
  • Blood tests to check liver function regularly 1
  • White blood cell counts frequently 1
  • Blood tests to check electrolytes (potassium, magnesium) 1

Dose Modifications

When Dose Reductions May Occur

• Your provider may decrease your dose to 400 mg or 200 mg if you develop:
  • Serious side effects 1
  • Severe neutropenia 4
  • QT interval prolongation 4
  • Liver toxicity 5
• Patients with moderate or severe liver impairment should start at 400 mg daily 5

Treatment Duration and Goals

Expected Treatment Course

• Kisqali is typically given for 3 years in combination with endocrine therapy 2, 3
• Endocrine therapy continues for at least 5 years total 2
• This combination significantly reduces risk of cancer recurrence by approximately 25% 3
• At 4 years, the absolute benefit is 4.9 percentage points in disease-free survival 6