This leaflet provides information on a course of treatment called ribociclib. The leaflet will explain what this is and when and how it will be given. It will also tell you about common side effects that you may experience. Contact telephone numbers are given at the end of the leaflet.
What is ribociclib?
Ribociclib is a cancer treatment which is given as tablets. It is given alongside your hormone medication.
Why am I having ribociclib?
Ribociclib has been found to help some patients with your type of cancer.
How often will I see the specialist team?
You will see the specialist team at regular intervals. You will have regular blood tests to check for any abnormalities and we will check how you are feeling and discuss any problems you may have. This is so we can check how the treatment is affecting you. You will need to have an ECG (monitoring of the heart rhythm) at the start of your treatment and at intervals – your doctor will let you know when it is required.
How should I take the ribociclib tablets?
Ribociclib tablets should be taken once a day for 21 days, and then 7 days rest, on a 28 day cycle. You should continue to take your hormone medication for the 7 days rest.
Try to take Ribociclib tablets every morning at approximately the same time every day. You can take the tablets with or without food. The tablets should be swallowed whole with a glass of water. They must not be chewed or crushed. Do not take any tablets that are broken in any way.
You must avoid eating grapefruits, pomegranates or drinking grapefruit or pomegranate juice at any time whilst you are taking Ribociclib.
How many ribociclib tablets will I need to take?
The number of tablets you take will be labelled on the box, although this may change, for example if you have side effects.
What should I do if I forget to take my tablets?
If you forget to take your tablets, miss the dose and take the normal dose the next day, also if you vomit, miss the dose. Never take a double dose.
What if I take too many tablets?
Please contact Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet. Please ask for the treatment helpline.
How should I store the tablets?
Your tablets should be stored in their original packaging and in a safe place away from children.
Any unused tablets should be returned to the hospital Pharmacy or your local chemist for safe disposal.
Can I bring relatives and friends with me?
You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not usually room for more than one person. Treatment areas are not suitable for young children.
What are the possible side effects?
This treatment is usually well tolerated but there are some possible side effects that you need to be aware of. The doctors, nurses and pharmacists can give you advice or answer any questions you may have
You are at an increased risk of picking up infections because your white blood cells which help fight infections can be reduced by this treatment.
Effects on your bowels
This treatment has been known to cause either constipation or diarrhoea.
Loss of appetite or sickness
You may experience loss of appetite, this varies from person to person and some people may have a problem with nausea and vomiting. If you do have these symptoms please tell your doctor or nurse. They can give you anti-sickness medication to take at home. If you are sick more than once in 24 hours despite taking regular anti-sickness medicine, contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
Tiredness and fatigue
The treatment can make you feel more tired than usual. It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as taking rest.
Your mouth may become sore or you may notice small ulcers. Please follow the advice on caring for your mouth in the general chemotherapy leaflet. Your doctor may prescribe mouthwashes or medication to prevent or clear any infection. If you are unable to eat or drink because of a sore mouth, contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
This treatment should not make you lose your hair. However, some people may experience hair thinning, but this will be due to the hormone medication .We have a leaflet that tells you more about coping with hair loss, if needed. Please ask your nurse if you would like a copy.
Some patients will develop a rash. Usually this can be easily treated with some non-perfumed cream or lotion.
If this becomes itchy or widespread, contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
This treatment may cause you to become anaemic. Your team will monitor your bloods to check for anaemia. Let your team know if you feel extremely tired or short of breath, as this may be a symptom of anaemia.
Ribociclib may reduce the production of platelets (which help the blood to clot). This will increase your risk of bruising or bleeding. If you notice any excessive bruising on your body or bleeding such as nosebleeds or bleeding from your gums you should contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
Very rarely some people taking this treatment experience heart problems. You will have a heart tracing, called an ECG before starting the medication, and at intervals. It is important you inform the doctor if you have a heart condition or you take any heart medication
If you do have any chest pain or feel your heart is beating faster than normal you should seek urgent medical attention.
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.
Other side effects and information
Some patients may experience headaches whilst taking ribociclib. This can be treated with whatever painkillers you would usually take.
Ribociclib can affect your liver, but your bloods (or liver function tests) will be checked regularly in clinic to look for any problems. If you have had any problems with your liver or with your liver function, inform your team at Velindre.
Some patients experience indigestion and/or upper abdominal pain, if this causes you problems, ring Velindre Cancer Centre, and inform when next in clinic.
Very rarely some people may experience breathing problems caused by this treatment. If you notice shortness of breath, cough or any breathing problems, please contact your doctor or specialist nurse. You will be monitored at regular clinic visits.
Pregnancy and breast-feeding
It is important you do not become pregnant or father a child whilst having treatment. This is because ribociclib could damage the unborn baby. In addition, it should not be used whilst breast feeding.
Is it alright to take other medicines?
Ribociclib can cause serious interactions with a number of medicines. Therefore, in clinic, your doctor will discuss your current medicines with you before starting ribociclib to check for any interactions. It is important, before starting any new medication, to check there are no serious interactions with ribociclib. Your doctor, nurse or pharmacist at Velindre, can advise. The following are some examples of medicines that interact: some heart medication, antibiotics, ondansetron, antifungals, anti-epileptics. In addition, there are many over the counter medicines that you have to avoid, for example, St. John’s Wort. It is important to check with your pharmacist before taking any over the counter medication.
Ribociclib contain soya lecithin. Do not take ribociclib if you are allergic to soya or peanuts.
Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at www.medicines.org.uk. Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy
Contact telephone numbers
Velindre Cancer Centre 029 2061 5888
For urgent advice at any time of the day or night please ask for the treatment helpline
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Tenovus freephone 0808 808 1010
7 days a week 8am – 8pm for general queries on cancer
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.