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Breast cancer is one of the most widespread types of cancer among females in the USA. According to the ACS (American Cancer Society), about 250.000 women annually receive the diagnosis of invasive breast cancer. Ribociclib is considered as an initial therapy for HR+/HER2− metastatic breast cancer together with an aromatase inhibitor.
Ribociclib 100 mg belongs to the group of drugs called cyclin-dependent kinase (CDK) inhibitor, which should be used together with an aromatase inhibitor as initial endocrine-based therapy for the therapy of postmenopausal women with HR-positive/human epidermal growth factor receptor 2-negative (HR+/HER2–) advanced/metastatic breast cancer.
Principle of action
The reasons for serum enzyme elevations and liver damage caused by ribociclib treatment are still unknown. Ribociclib is actively metabolized in the liver mainly through the CYP 3A4 pathway, and liver damage can be caused by the release of a toxic or immunogenic intermediate. At the same time, blockage of cyclin-dependent kinases 4 and 6 can have a negative effect on liver cells and be direct toxic. As it is a substrate for CYP 3A4, ribociclib is vulnerable to the drug interactions with the medication inhibiting or triggering this specific hepatic microsomal enzymes.
• The common dose for adults is 600 mg taken by mouth once daily in the morning for the first 3 weeks followed by a weeks off in a 4-week therapy cycle.
• Moreover, the patients using letrozole should take 2.5mg of the drug once a day within the 4-week cycle.
Dosage regulation when side effects are reported:
• Firstly, the dose should be reduced to 400 mg a day; later on, the dose can be decreases to 200 mg a day if the side effects persist.
• Therapy must be stopped if the side reactions happen even at the lowest recommended dose (200 mg once a day).
Before beginning Ribociclib 100 mg therapy, you should inform your physician about any other drugs you’re currently taking (such as prescription and non-prescription drugs, herbal supplements and vitamins). Avoid taking the aspirin-containing drugs without your doctor’s approval.
Avoid eating grenades and grapefruits or drinking grapefruit/grenade juice during the treatment with this drug.
Avoid receiving any type of vaccines without your physician’s consent during the treatment with Ribociclib.
Tell your doctor if you’re pregnant or plan a pregnancy before starting the therapy. Ribociclib 100 mg can harm the fetus if taken by a pregnant woman. Pregnant women (or those planning a pregnancy) shouldn’t take this drug. If you get pregnant during the treatment, you should inform your doctor and stop taking the drug at once.
Patients should use safe methods of contraceptives (for example, condoms) to avoid becoming pregnant during the treatment.