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CDK4/6 inhibitor

Ribociclib (Specialist drug)

Brand names: Kisqali

Adult dose

Dose: Specialist initiation only — refer to BNF/SmPC
Route: PO
Frequency: OD x 21 days q28

Clinical pearls

  • HR+ HER2- advanced/metastatic breast cancer with endocrine therapy
  • ECG and electrolytes pre-treatment + during

Contraindications

  • QT prolongation
  • Concurrent strong CYP3A4 inhibitors
  • Severe hepatic impairment

Side effects

  • Severe neutropenia
  • QT prolongation
  • Hepatotoxicity
  • ILD/pneumonitis
  • Severe skin reactions (SJS/TEN)

Interactions

  • Strong CYP3A4 modulators
  • QT-prolonging drugs
  • Tamoxifen (avoid concomitant)

Monitoring

  • FBC
  • LFTs
  • ECG
  • Electrolytes

Reference: BNF; NICE TA496/TA593; SmPC; https://bnf.nice.org.uk/drugs/ribociclib-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.