Palbociclib is a type of targeted cancer drug. It is also known as Ibrance. It is a treatment for breast cancer that has spread to:
- another part of the body (advanced or metastatic breast cancer)
- the area and structures surrounding the breast, such as nearby lymph nodes, muscle and skin, but not to other parts of the body (locally advanced)
You usually have this in combination with a hormone therapy drug.
Palbociclib is used for a type of breast cancer that is hormone receptor positive (HR+) and human epidermal growth factor receptor negative (HER2 -). You have tests on your breast cancer cells to check for this.
How palbociclib works
Palbociclib is a type of cancer growth blocker that targets the proteins cyclin dependant kinase 4 and 6 (CDK4 and CDK6) on cancer cells.
CDK 4 and CDK 6 are proteins that stimulate cancer cells to grow and divide. Palbociclib works by blocking these proteins. It aims to slow or stop the growth of the cancer.
How you have palbociclib
You have palbociclib as capsules. You take it with food and swallow the capsules whole.
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking or miss a dose of a cancer drug.
When you have palbociclib
You have palbociclib as cycles of treatment. This means that you have the drug and then a rest to allow your body to recover. One cycle lasts 28 days (4 weeks).
You usually have the cycle in the following way:
- You take palbociclib as capsules – swallow it whole with a glass of water and with food.
- You have no treatment.
You then start a new cycle of treatment.
You take palbociclib for as long as it’s working, and the side effects aren’t too bad.
Side effects
We haven't listed all the side effects. It is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. For example, your side effects could be worse if you are also having other drugs.
When to contact your team
Your doctor or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
Early treatment can help manage side effects better.
Common side effects
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of infection
Increased risk of getting an infection
is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Bruising, bleeding gums or nose bleeds
This is due to a
drop in the number of platelets in your blood
. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).Breathlessness and looking pale
You might be
breathless and look pale
due to a drop in red blood cells. This is called anaemia.Loss of appetite
You might
lose your appetite
for various reasons while having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.Feeling or being sick
Feeling or being sick
is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, try eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
Diarrhoea
Contact your advice line if you have
diarrhoea
, such as if you've had 4 or more loose watery poos (stools) in 24 hours. Or if you can't drink to replace the lost fluid. Or if it carries on for more than 3 days.Your doctor may give you anti diarrhoea medicine to take home with you after treatment. Eat less fibre, avoid raw fruits, fruit juice, cereals and vegetables, and drink plenty to replace the fluid lost.
Sore mouth
Mouth sores and ulcers
can be painful. Keep your mouth and teeth clean; drink plenty of fluids; avoid acidic foods such as oranges and lemons; chew gum to keep the mouth moist and tell your doctor or nurse if you have ulcers.Skin problems
Skin problems
include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your healthcare team can tell you what products you can use on your skin to help.Hair loss
You could
lose all your hair
. This includes your eyelashes, eyebrows, underarms, legs and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.Tiredness and weakness
You might feel
very tired
and as though you lack energy.Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
Liver changes
You might have
liver changes
that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
- taste changes
- eye problems such as dry, blurred vision and watery eyes
- lung problems that could be serious. Tell your doctor or nurse straight away if you have symptoms such as shortness of breath, a cough or feeling tired and weak
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do I need to know?
Other medicines, food and drinks
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Grapefruit and grapefruit juice
You should not eat grapefruit or drink grapefruit juice when you are taking this drug because it may increase the side effects.
Lactose intolerance
This drug contains lactose (milk sugar). If you have an intolerance to lactose, contact your doctor before taking this medicine.
Loss of fertility
It is not known whether this treatment affects fertility in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Pregnancy
It is unknown whether treatment may or may not harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment.
Contraception
Whilst having palbociclib you should use 2 forms of contraception during treatment and for at least 3 weeks afterwards if you are a female. If you are a male you should use it for at least 14 weeks after finishing treatment.
Talk to your healthcare team about contraception you can use during treatment.
Breastfeeding
It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment. For example, if you need treatment for anything else, including teeth problems.
Immunisations
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.
You can have:
- other vaccines, but they might not give you as much protection as usual
- the flu vaccine (as an injection)
- the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment
Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your
recovers from treatment.
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
More information about this treatment
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.
This page is due for review. We will update this as soon as possible.
