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AboutAboutIBRANCE experienceGuidelinesMechanism of actionDosing & MonitoringDosing & MonitoringDosing and administrationMonitoringRecommended dose modifications for IBRANCEWhat you need to know about IBRANCE tabletsEfficacyEfficacyIBRANCE + aromatase inhibitorPrimary endpointSecondary endpointsUpdated analysesSubgroup analysesIBRANCE + fulvestrantPrimary endpointSecondary endpointsUpdated analysesSubgroup analysesSafety DataSafety DataIBRANCE + aromatase inhibitorAdverse reactionsDiscontinuations and dose reductionsNeutropenia and lab abnormalitiesWarnings and PrecautionsIBRANCE + fulvestrantAdverse reactionsDiscontinuations and dose reductionsNeutropenia and lab abnormalitiesWarnings and PrecautionsReal-World Evidence​​​​​​​Real-World EvidenceIntroductionClinical trial summaryReal-world study designReal-world study patient characteristicsReal-world effectivenessLabelLinkLinkLinkLinkLabelLinkLinkLinkLinkSupport & OrderSupport &
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Prescribing Information for CapsulesPrescribing Information for Tablets Indications Patient Site
Dosing & Monitoring

Dosing and administration

IBRANCE: once-daily oral dosing

Example

For additional details, please refer to the full Prescribing Information for the aromatase inhibitor being used or fulvestrant.

Administration considerations

IBRANCE capsules should always be taken with food. IBRANCE tablets can be taken with or without food. Patients should be encouraged to take their dose at approximately the same time each day.

If the patient vomits or misses a dose, an additional dose should not be taken that day. The next prescribed dose should be taken at the usual time.

IBRANCE capsules and tablets should be swallowed whole (patients should not chew, crush, open, or split them prior to swallowing). Capsules and tablets should not be ingested if they are broken, cracked, or otherwise not intact.

Substrates: Doses of sensitive CYP3A substrates with a narrow therapeutic index may need to be reduced as IBRANCE may increase their exposure.

Inducers: Avoid concurrent use of strong CYP3A inducers.

Inhibitors: Avoid concurrent use of strong CYP3A inhibitors.

  • If the strong inhibitor cannot be avoided, reduce the IBRANCE dose to 75 mg
  • If the strong inhibitor is discontinued, increase the IBRANCE dose (after 3 to 5 half-lives of the inhibitor) to the dose used prior to the initiation of the strong inhibitor
  • Patients should avoid grapefruit or grapefruit juice during IBRANCE treatment
For patients with severe hepatic impairment (Child-Pugh class C), the recommended dosing of IBRANCE is 75 mg.Pre-/perimenopausal women treated with the combination IBRANCE + fulvestrant therapy should also be treated with LHRH agonists according to current clinical practice standards.

For men treated with combination IBRANCE + aromatase inhibitor, consider treatment with an LHRH agonist according to current clinical practice standards.

LHRH=luteinizing hormone-releasing hormone.

Dosing & MonitoringLearn how to help your patients access their prescribed IBRANCE Learn more LoadingRecommended dose modifications for IBRANCE Learn more LoadingEfficacy data for IBRANCE + aromatase inhibitorReview the dataLoadingEfficacy data for IBRANCE + fulvestrant Review the data LoadingWhat you need to know about IBRANCE tablets Learn more Loading

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INDICATIONS IBRANCE (palbociclib) 125 mg capsules and tablets are indicated for the treatment of adult patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced or metastatic breast cancer (mBC) in combination with:
  • an aromatase inhibitor as initial endocrine-based therapy in postmenopausal women or in men, or
  • fulvestrant in patients with disease progression following endocrine therapy
Important Safety Information

Neutropenia was the most frequently reported adverse reaction in PALOMA-2 (80%) and PALOMA-3 (83%). In PALOMA-2, Grade 3 (56%) or 4 (10%) decreased neutrophil counts were reported in patients receiving IBRANCE plus letrozole. In PALOMA-3, Grade 3 (55%) or Grade 4 (11%) decreased neutrophil counts were reported in patients receiving IBRANCE plus fulvestrant. Febrile neutropenia has been reported in 1.8% of patients exposed to IBRANCE across PALOMA-2 and PALOMA-3. One death due to neutropenic sepsis was observed in PALOMA-3. Inform patients to promptly report any fever.

Monitor complete blood count prior to starting IBRANCE, at the beginning of each cycle, on Day 15 of first 2 cycles and as clinically indicated. Dose interruption, dose reduction, or delay in starting treatment cycles is recommended for patients who develop Grade 3 or 4 neutropenia.
 

Severe, life-threatening, or fatal interstitial lung disease (ILD) and/or pneumonitis can occur in patients treated with CDK4/6 inhibitors, including IBRANCE when taken in combination with endocrine therapy. Across clinical trials (PALOMA-1, PALOMA-2, PALOMA-3), 1.0% of IBRANCE-treated patients had ILD/pneumonitis of any grade, 0.1% had Grade 3 or 4, and no fatal cases were reported. Additional cases of ILD/pneumonitis have been observed in the post-marketing setting, with fatalities reported.
 

Monitor patients for pulmonary symptoms indicative of ILD/pneumonitis (e.g., hypoxia, cough, dyspnea). In patients who have new or worsening respiratory symptoms and are suspected to have developed pneumonitis, interrupt IBRANCE immediately and evaluate the patient. Permanently discontinue IBRANCE in patients with severe ILD or pneumonitis.
 

Based on the mechanism of action, IBRANCE can cause fetal harm. Advise females of reproductive potential to use effective contraception during IBRANCE treatment and for at least 3 weeks after the last dose. IBRANCE may impair fertility in males and has the potential to cause genotoxicity. Advise male patients to consider sperm preservation before taking IBRANCE. Advise male patients with female partners of reproductive potential to use effective contraception during IBRANCE treatment and for 3 months after the last dose. Advise females to inform their healthcare provider of a known or suspected pregnancy. Advise women not to breastfeed during IBRANCE treatment and for 3 weeks after the last dose because of the potential for serious adverse reactions in nursing infants. 
 

The most common adverse reactions (≥10%) of any grade reported in PALOMA-2 for IBRANCE plus letrozole vs placebo plus letrozole were neutropenia (80% vs 6%), infections (60% vs 42%), leukopenia (39% vs 2%), fatigue (37% vs 28%), nausea (35% vs 26%), alopecia (33% vs 16%), stomatitis (30% vs 14%), diarrhea (26% vs 19%), anemia (24% vs 9%), rash (18% vs 12%), asthenia (17% vs 12%), thrombocytopenia (16% vs 1%), vomiting (16% vs 17%), decreased appetite (15% vs 9%), dry skin (12% vs 6%), pyrexia (12% vs 9%), and dysgeusia (10% vs 5%).
 

The most frequently reported Grade ≥3 adverse reactions (≥5%) in PALOMA-2 for IBRANCE plus letrozole vs placebo plus letrozole were neutropenia (66% vs 2%), leukopenia (25% vs 0%), infections (7% vs 3%), and anemia (5% vs 2%).
 

Lab abnormalities of any grade occurring in PALOMA-2 for IBRANCE plus letrozole vs placebo plus letrozole were decreased WBC (97% vs 25%), decreased neutrophils (95% vs 20%), anemia (78% vs 42%), decreased platelets (63% vs 14%), increased aspartate aminotransferase (52% vs 34%), and increased alanine aminotransferase (43% vs 30%). 

 

The most common adverse reactions (≥10%) of any grade reported in PALOMA-3 for IBRANCE plus fulvestrant vs placebo plus fulvestrant were neutropenia (83% vs 4%), leukopenia (53% vs 5%), infections (47% vs 31%), fatigue (41% vs 29%), nausea (34% vs 28%), anemia (30% vs 13%), stomatitis (28% vs 13%), diarrhea (24% vs 19%), thrombocytopenia (23% vs 0%), vomiting (19% vs 15%), alopecia (18% vs 6%), rash (17% vs 6%), decreased appetite (16% vs 8%), and pyrexia (13% vs 5%).
 

The most frequently reported Grade ≥3 adverse reactions (≥5%) in PALOMA-3 for IBRANCE plus fulvestrant vs placebo plus fulvestrant were neutropenia (66% vs 1%) and leukopenia (31% vs 2%). 
 

Lab abnormalities of any grade occurring in PALOMA-3 for IBRANCE plus fulvestrant vs placebo plus fulvestrant were decreased WBC (99% vs 26%), decreased neutrophils (96% vs 14%), anemia (78% vs 40%), decreased platelets (62% vs 10%), increased aspartate aminotransferase (43% vs 48%), and increased alanine aminotransferase (36% vs 34%). 
 

Avoid concurrent use of strong CYP3A inhibitors. If patients must be administered a strong CYP3A inhibitor, reduce the IBRANCE dose to 75 mg. If the strong inhibitor is discontinued, increase the IBRANCE dose (after 3-5 half-lives of the inhibitor) to the dose used prior to the initiation of the strong CYP3A inhibitor. Grapefruit or grapefruit juice may increase plasma concentrations of IBRANCE and should be avoided. Avoid concomitant use of strong CYP3A inducers. The dose of sensitive CYP3A substrates with a narrow therapeutic index may need to be reduced as IBRANCE may increase their exposure.
 

For patients with severe hepatic impairment (Child-Pugh class C), the recommended dose of IBRANCE is 75 mg. The pharmacokinetics of IBRANCE have not been studied in patients requiring hemodialysis

Please see full Prescribing Information for IBRANCE capsules and tablets.

INDICATIONS IBRANCE (palbociclib) 125 mg capsules and tablets are indicated for the treatment of adult patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced or metastatic breast cancer (mBC) in combination with:
  •  
  • an aromatase inhibitor as initial endocrine-based therapy in postmenopausal women or in men, or
  •  
  •  
  • fulvestrant in patients with disease progression following endocrine therapy
  •  

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