Topic: Need your tips for taking a CDK 4/6 inhibitor

Forum: Stage IV/Metastatic Breast Cancer ONLY — Please respect that this forum is for members with stage IV/metastatic breast cancer ONLY. There is a separate forum for caregivers and friends: Caring for Someone with Stage IV or Mets.

Posted on: Jul 30, 2019 11:59AM - edited Jul 31, 2019 10:03AM by moderators

Posted on: Jul 30, 2019 11:59AM - edited Jul 31, 2019 10:03AM by moderators

moderators wrote:

Tips for Taking a CDK 4/6 inhibitor such as Abemaciclib (Verzenio), Palbociclib (Ibrance), Ribociclib (Kisqali)—Before and During Treatment:

Please share your advice for preparing to start treatment, dealing with side effects, testing during treatment, etc.

Thank you!!

p.s. this is to help us in a new content piece we are writing.

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Jul 30, 2019 02:49PM 3-16-2011 wrote:

I am taking Verzinio which is notorious for GI SE. It does get better after the first 30 days. Also, I can almost eliminate all problems if I eat several small meals and avoid dairy. I do struggle with fatigue and would love to hear if others have found a good answer for this SE.

Thanks to all

Mary

3-16-2011 Dx 3/16/2011, IDC, 2cm, Stage IIA, Grade 2, 1/15 nodes, ER+/PR+, HER2- Chemotherapy 5/3/2011 AC + T (Taxol) Surgery 10/18/2011 Prophylactic ovary removal Radiation Therapy 11/10/2011 Surgery 10/10/2012 Reconstruction (left): Free TRAM flap; Reconstruction (right): Free TRAM flap Dx 11/5/2014, Stage IV, ER+/PR+ Hormonal Therapy 1/1/2015 Aromasin (exemestane) Targeted Therapy 10/15/2015 Afinitor (everolimus)
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Jul 30, 2019 11:26PM jensgotthis wrote:

Pfizer suggests that it’s very important to take Ibrance with a small amount of fat, so many here take it after breakfast or dinner. Some have found it disrupts sleep less if taken in the morning. Lastly, it’s imperative to drink a lot of water while taking this drug. For the fatigue, exercise and water intake seem to make a positive difference

Dx 12/3/2015, IDC: Tubular, Left, 2cm, Stage IV, metastasized to bone, Grade 1, 0/12 nodes, ER+/PR+, HER2- Chemotherapy 1/5/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 5/2/2016 External Local Metastases 5/2/2016 Radiation therapy: Bone Hormonal Therapy 5/24/2016 Surgery 5/25/2016 Lymph node removal; Lymph node removal (Left); Mastectomy; Mastectomy (Left) Targeted Therapy 9/14/2016 Ibrance (palbociclib) Hormonal Therapy 9/14/2016 Femara (letrozole) Radiation Therapy Whole breast: Breast, Lymph nodes, Chest wall Targeted Therapy
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Jul 31, 2019 01:24PM vlnrph wrote:

As described in the managing diarrhea post, I use a special weapon against this well known side effect of Verzenio. For me, the suggested OTC Imodium=generic name loperamide worked too well: everything stopped up and then there were terrible abdominal cramps, etc as it wore off. I did go for a dose reduction also.

By taking two FiberCon tablets or the much less expensive calcium polycarbophil daily, I get absorption of excess fluid which remains in the gastrointestinal tract so the stool bulks up without creating constipation. Curiously, this productis stocked with laxative agents. Look near the Metamucil canisters.

As far as fatigue, I pace myself by not over scheduling, allowing time to lie down as needed and doing a water exercise 2-3 class times each week. Like Jen above, I feel better when hydrated. We have had to hire out jobs around the house which I would have attempted previously and have the funds for that by taking advantage of the Social Security disability allowance for those with metastatic disease. I am collecting the amount I would be getting if I were at full retirement age!

both ILC & IDC; rt mx; DIEP; ALND; TC x 4; tamoxifen x 30 months; AI x 1 yr; bone mets 8/2018: Zometa (stopped after 3 years due to tooth extraction), Faslodex, Verzenio; liver mets 11/2022 PR-, HER2 low, PIK3 mutation: alpelisib, continue fulvestrant Dx 3/7/2011, ILC, 2cm, Stage IIA, Grade 2, 1/25 nodes, ER+/PR+, HER2-
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Jul 31, 2019 03:13PM moderators wrote:

We really appreciate you sharing your experiences with us! Please keep them coming. This is SO helpful!

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Jul 31, 2019 07:20PM movingsoccermom wrote:

Since I started Faslodex and Ibrance at the same time, not sure which drug to blame for light headedness, but that has been my biggest challenge. Another member carries potato chips for the salt when needed--I chose salted peanuts and always have a water bottle in tow. I take Ibrance with dinner and have had no other issues besides the fatigue, and neither exercise nor water have helped. :(

Dx 3/3/2015, IDC, Right, 2cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 4/1/2015 Lumpectomy: Right; Lymph node removal: Right, Sentinel Radiation Therapy 5/27/2015 Whole breast: Breast, Lymph nodes Dx 5/7/2019, IDC, Right, 2cm, Stage IV, metastasized to bone/lungs/other, Grade 2, 0/3 nodes, ER+/PR+, HER2-, Targeted Therapy Ibrance (palbociclib) Hormonal Therapy Faslodex (fulvestrant)
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Aug 5, 2019 08:49PM Laurie11374 wrote:

I have been taking Kisqali/Femara combination since May 2018. Only side effect I fight is joint pain and mild fatigue. I feel like my normal self 99% of the time. This disease has not slowed me down! My scans have been clear since Nov 2018. Lumpectomy in Jan 2019, there was only crumbs left of the original tumor of 5cm. Radiation April 2019, made it through 24 out of 30 treatments due to severe burn.

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Aug 5, 2019 09:25PM kanga_roo wrote:

Tips:Kisqali/Letrozol combo

Everyone is put on highest dose initially. If sideFX are really bad you can always go on a lower dose.

Always take after food.

If you have sideFX, take medication in the evening and sleep the worst of it off over night

If you suffer nausea, take nausea prevention half hour before you take your medication

Drink plenty of water to ensure you stay hydrated.

Exercise 15 minutes per day, even if it is a gentle walk to the end of your street and back, or a couple of laps of the mall.

Femara reduces hormone production and results in an increase of ageing sideFX. Treat yourself kindly - moisturise your skin, avoid harsh sunlight, take some Panadol for the aches and pain etc, etc

Try not to obsess over your treatment. Let it do it's job whilst you get on with your life.

Get the OK from your Oncologist before doing the following:

Femara may increase your sugar levels and you may put on weight. Look to improve your diet where possible. I have had great results on Keto.

Supplement your Vit D to aid in utilising calcium to strengthen bones. Get 15 minutes of sunshine per day where possible.

Magnesium citrate helps with cramps and aches, and can also alleviate constipation.

Sleeping pills can help if you are having problems settling down at night.

Don't ignore depression or anxiety - plenty of medication and ideas to alleviate these symptoms.

Jackie

Dx 1/24/2018, IDC, Left, 5cm, Stage IV, metastasized to liver, ER+/PR+, HER2- Hormonal Therapy 2/11/2018 Femara (letrozole) Targeted Therapy 2/15/2018 Kisqali
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Aug 6, 2019 01:48AM simone60 wrote:

Mouth sores are a common side effect. To help avoid getting sores: use a soft bristle tooth brush. Biotene toothpaste and mouthwash work well and are less harsh than regular toothpaste. Swish with baking soda throughout the day.

Your MO can also prescribe Miracle Mouthwash which will numb your mouth and help with the pain.

Dx 7/2001, IDC, Right, 1cm, Stage IIIA, Grade 3, 7/13 nodes, ER+/PR+, HER2- Dx 1/2019, IDC, 1cm, Stage IV, metastasized to bone/other, ER+/PR+, HER2- Targeted Therapy Ibrance (palbociclib) Hormonal Therapy Femara (letrozole)
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Aug 6, 2019 08:53AM moderators wrote:

Thanks again, and the more feedback, the better!


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Aug 7, 2019 01:04PM Pirving wrote:

Hi new to the site. I need your help l am taken ibrance and flasadex. Ibrance does is 75mg. When I have my week off of ibrance I get severe muscle spasms and pain in my lower back

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