Palbociclib (Ibrance®)

Palbociclib (Ibrance®) is a targeted therapy drug that is used to treat some types of breast cancer.

What is palbociclib (Ibrance®)?

Palbociclib (Ibrance®) is used to treat breast cancer that is oestrogen receptor positive and HER2 negative. It may be used if the cancer has spread:

  • to the tissues and lymph nodes close to the breast (locally advanced), and surgery is not possible
  • from the breast to other parts of the body (metastatic or secondary breast cancer). 

It is best to read this information with our information about breast cancer

Palbociclib belongs to a group of  targeted therapy drugs known as cancer growth inhibitors.

Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.

How palbociclib is given

Palbociclib is given as tablets, so you can take it at home. 

You take palbociclib with a hormonal therapy drug. Palbociclib works with the hormonal therapy drug to slow the cancer growing and spreading.

During treatment you usually see a cancer doctor, a cancer nurse or specialist nurse, and a specialist pharmacist. This is who we mean when we mention doctor, nurse or pharmacist in this information.

You have your blood checked regularly during treatment.  Your doctor or nurse will tell you when your blood will be checked. A nurse or person trained to take blood (phlebotomist) will take a blood sample from you. This is to check that your blood cells are at a safe level to have treatment.

Taking palbociclib tablets

You take palbociclib every day for 21 days. You then have a break of 7 days when you do not take any palbociclib. After this, you start taking it again in the same way.

You carry on taking it in this way for as long as it is working for you and any side effects can be managed.

Take the tablets at the same time each day with or without food. Swallow them whole with a large glass of water. Do not crush or dissolve tablets. If you find it difficult to swallow your tablets, speak to your doctor or pharmacist.

Always take palbociclib and the hormonal therapy drug exactly as your nurse or pharmacist explains. This is important to make sure the treatment works as well as possible for you.

Never take a double dose of palbociclib. If you forget to take your tablets, do not take another dose. Take the next dose at the usual time.

Other things to remember about your tablets:

  • After taking your tablets, wash your hands. 
  • Keep the tablets in the original package and at room temperature, away from heat or direct sunlight.
  • Keep the tablets safe and out of sight and reach of children. 
  • If you are sick just after taking the tablets, contact the hospital. Do not take another dose.
  • Do not eat grapefruit or drink grapefruit juice at any time during your treatment. Grapefruit may affect how palbociclib works in the body.
  • If your treatment is stopped, return any unused tablets to the pharmacist.

About side effects

We explain the most common side effects of this treatment here. We also include some less common side effects.

You may get some of the side effects we mention, but you are unlikely to get all of them. You may have some rarer side effects that we have not listed here.

You take this treatment with a hormonal therapy drug. Hormonal therapy drugs can cause side effects not listed here. It is best to read this information with our information about the hormonal therapy drug you are having. Always tell your doctor, nurse or pharmacist about any side effects you have.

Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects.

Serious and life-threatening side effects

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Contact the hospital

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

More information

We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.

Common side effects

Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is sometimes called neutropenia.

An infection can be very serious when the number of white blood cells is low. It is important to get any infection treated as soon as possible. Contact the hospital straight away on the 24-hour contact number you have been given if:

  • your temperature goes over 37.5°C (99.5°F) 
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection
  • your temperature goes below 36°C (96.8°F). 

Symptoms of an infection include:

  • feeling shivery and shaking
  • a sore throat
  • a cough 
  • breathlessness
  • diarrhoea
  • needing to pass urine (pee) a lot, or discomfort when you pass urine.

It is important to follow any specific advice your cancer treatment team gives you.

The number of white blood cells will usually return to normal before your next treatment. You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may delay your treatment for a short time, until your cell count increases. Sometimes your doctor may lower the dose of your treatment.

Anaemia (low number of red blood cells)

This treatment can reduce the number of red blood cells in your blood. Red blood cells carry oxygen around the body. If the number of red blood cells is low, this is called anaemia. You may have symptoms such as:

  • pale skin
  • lack of energy
  • feeling breathless
  • feeling dizzy and light-headed.

Tell your doctor or nurse if you have these symptoms.

If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.

Bruising and bleeding

This treatment can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot.

If the number of platelets is low, you may bruise or bleed easily. You may have:

  • nosebleeds
  • bleeding gums
  • heavy periods
  • blood in your urine (pee) or stools (poo)
  • tiny red or purple spots on the skin that may look like a rash.

Tell your doctor if you have any unexplained bruising or bleeding. You may need a drip to give you extra platelets. This is called a platelet transfusion.

Feeling tired (fatigue)

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest between activities.

Being physically active can help to manage tiredness and give you more energy. It also:

  • helps you sleep better
  • reduces stress
  • improves your bone health.

If you feel sleepy, do not drive or operate machinery.

Feeling sick

Your doctor can prescribe anti-sickness drugs to prevent or control sickness during your treatment. If you feel sick or are sick (vomit), tell your nurse or doctor. They may change the anti-sickness drug to one that works better for you.

Diarrhoea

This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is usual for you, or having watery or loose stools. If you have a stoma, it will be more active than usual.

If you have diarrhoea:

  • try to drink at least 2 litres (3½ pints) of fluids each day
  • avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods
  • contact the hospital for advice.

Skin changes

This treatment may make your skin:

  • become red
  • turn lighter or darker 
  • feel dry. 

It can cause a rash, which may be itchy. Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help.

Sore mouth and throat

This treatment may cause a sore mouth and throat. You may also get mouth ulcers. This can make you more likely to get a mouth or throat infection. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.

If your mouth or throat is sore:

  • tell your nurse or doctor – they can give you a mouthwash or medicines to help
  • try to drink plenty of fluids
  • avoid alcohol, tobacco and foods that irritate your mouth and throat.

Sucking ice chips may sometimes help relieve mouth or throat pain. 

Hair thinning

Your hair may become thinner when you are taking this treatment. This is usually mild. Ask your nurse for advice if you are worried about this.

Changes in the way the liver works

Palbociclib may affect how your liver works. If you have any liver conditions, it is important to tell your doctor before you start treatment. You will have blood tests to check how well your liver is working. If you have changes to your liver, your doctor may change the dose of treatment.

Less common side effects

Effects on the lungs

This treatment can cause changes to the lungs. Tell your doctor if you develop:

  • a cough
  • wheezing
  • breathlessness.

You should also tell them if any existing breathing problems get worse. You may have tests to check your lungs.

If your symptoms come on suddenly, contact the hospital immediately. You may have inflammation of the lungs (pneumonitis). Your doctor can tell you more about this.

Changes in taste or loss of appetite

You may lose your appetite when taking palbociclib. Or you may notice changes in how food tastes. You can ask to see a dietitian or specialist nurse at your hospital if this does not improve. They can give you advice on improving your appetite and coping with taste changes.

Eye problems

This treatment may affect your eyes. You may notice they are dry or watery. If this is a problem, speak to your doctor. They may be able to give you something to help. Contact your doctor if you have blurry vision or changes to your vision.

Other information

Blood clot risk

Cancer and some cancer treatments can increase the risk of a blood clot. Contact the hospital straight away on the 24-hour number if you have any of these symptoms during or after treatment:

  • throbbing pain or swelling in a leg or arm
  • reddening of the skin in the area – if you have black or brown skin, this can be harder to notice, but the skin might become darker
  • suddenly feeling breathless or coughing.

Always call 999 if you have:

  • chest pain
  • difficulty breathing.

A blood clot is serious, but it can be treated with drugs called anticoagulants. These thin the blood. Your doctor, nurse or pharmacist can give you more information about preventing and treating blood clots.

Vaccinations

Vaccinations can reduce your risk of getting certain infections. Your doctor or nurse may talk to you about having vaccinations.

Doctors usually recommend that people with cancer have a flu vaccination and a coronavirus (covid) vaccination. These are both inactivated vaccinations that can help reduce the risk of infection. People with weak immune systems can have these, as they are not live vaccinations. 

If your immune system is weak, you need to avoid live vaccinations. This is because they can make you unwell. Live vaccines contain a very weak version of the illness they are vaccinating you against. Your cancer doctor or GP can tell you more about live and inactivated vaccinations.

Other medicines

Some medicines can affect how this treatment works or be harmful while you are having it. Always tell your cancer doctor, nurse or pharmacist about any drugs you are taking or planning to take, such as: 

Contraception

Your doctor will advise you not to get pregnant or make someone pregnant while having this treatment. The drugs may harm a developing baby. It is important to use contraception during your treatment and for a while after treatment finishes. Your doctor, nurse or pharmacist can tell you more about this.

Breastfeeding

You are advised not to breastfeed while having this treatment, or for some time after treatment finishes. This is because the drugs could be passed to the baby through breast milk.

Your doctor or nurse can give you more information.

Fertility

Some cancer drugs can affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert health professionals and people living with cancer.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Date reviewed

Reviewed: 01 June 2022
|
Next review: 01 December 2024
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

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