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The content of this website has been produced in line with the IBRANCE® Summary of Product Characteristics for Great Britain and Northern Ireland. IBRANCE® (palbociclib) Prescribing Information for Great Britain and Northern Ireland click here. Adverse event reporting information can be found at the bottom of the page.
Confidence Through Simplicity1
Please refer to the Summary of Product Characteristics of the relevant endocrine partner for full information on coadministration with palbociclib.
Management of some adverse reactions may require temporary dose interruptions/delays, and/or dose reductions, or permanent discontinuation. For full information on the IBRANCE recommended dose modifications for adverse reactions please refer to the Ibrance SmPC or visit the adverse event management page.
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® can be taken with or without food. No additional dose should be taken if a dose is missed, and the next prescribed dose should be taken at the usual time. IBRANCE® should be swallowed whole, not chewed, crushed or opened prior to swallowing.1
As with all medications, IBRANCE may interact with certain drugs.
CYP3A4 inducers or inhibitors
• Palbociclib is primarily metabolised by CYP3A and sulphotransferase (SULT) enzyme SULT2A1. In vivo, palbociclib is a weak, time-dependent inhibitor of CYP3A.
• Strong inhibitors of CYP3A4 may lead to increased toxicity.
• Concomitant use of strong CYP3A inhibitors during treatment with palbociclib should be avoided. Coadministration should only be considered after careful evaluation of the potential benefits and risks.
• If coadministration with a strong CYP3A inhibitor is unavoidable, reduce the palbociclib dose to 75 mg once daily. When the strong inhibitor is discontinued, the dose of palbociclib should be increased (after 3-5 half-lives of the inhibitor) to the dose used prior to the initiation of the strong CYP3A inhibitor.
• Coadministration of CYP3A inducers may lead to decreased palbociclib exposure and consequently a risk for lack of efficacy. Therefore, concomitant use of palbociclib with strong CYP3A4 inducers should be avoided. No dose adjustments are required for coadministration of palbociclib with moderate CYP3A inducers.
Effects on the PK of other medicines
• The dose of sensitive CYP3A substrates with a narrow therapeutic index (e.g., alfentanil, cyclosporine, dihydroergotamine, ergotamine, everolimus, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus) may need to be reduced when coadministered with palbociclib, as palbociclib may increase their exposure.
Drug-drug interaction between palbociclib and statins
• Concomitant use of palbociclib with statins may increase the risk of rhabdomyolysis. Cases of rhabdomyolysis including fatal cases have been reported following coadministration of palbociclib with simvastatin or atorvastatin.
In vitro studies with transporters
• Based on in vitro data, palbociclib is predicted to inhibit intestinal P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) mediated transport. Therefore, administration of palbociclib with medicinal products that are substrates of P-gp (e.g., digoxin, dabigatran, colchicine) or BCRP (e.g., pravastatin, rosuvastatin, sulfasalazine) may increase their therapeutic effect and adverse reactions.
• Based on in vitro data, palbociclib may inhibit the uptake transporter organic cationic transporter OCT1 and then may increase the exposure of medical product substrates of this transporter (e.g. metformin).
Please refer to the IBRANCE Summary of Product Characteristics and the Summary of Product Characteristics of any concomitant medication for a complete list of drug-drug interactions before prescribing.
References
Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk or search
for MHRA Yellow Card in Google Play or Apple App Store
Adverse events should also be reported to Pfizer Medical Information on 01304 616161
To access further materials, resources and receive communication about medicines and vaccines promoted by Pfizer.
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PP-UNP-GBR-7812. January 2024