How have you tolerated Kisquli (ribociclib)?

Briarrose offered wise advice. Please try to consult with a cardiologist. I had preexisting afib when diagnosed with breast cancer. Kisqali was added to my treatment plan a couple of months after a heart ablation My afib episodes were episodic and not severe. I was diagnosed with afib in 2023 and breast cancer in 2024.

I was lucky to be referred to a cardiologist who specialized in oncology. She deferred to my oncologist whom she considered the primary physician in managing Kisqali. She, btw, also recommended I remain on Eliquis despite the ablation. I've had no known afib episodes since the ablation and since I started Kisqali in November 2025.

Kisqali recommends a schedule of EKGs which are regularly scheduled in the beginning. That is to help monitor your QT intervals. I can't remember who ordered additional Echo exams - my regular cardiologist or my cardiologist with the oncology specialty - but I was also monitored with Echos. My cardiologist/oncology subspecialist also eventually added an Echo with contrast. After several EKGs, the time between EKGs has lengthened. So far, no obvious problems.

Hope you are able to find a cardiologist who can help assist you in making your decision. Good wishes going forward!

I know we all tolerate medications differently. I was started on Verenzio which I threw up within 30 seconds. I was then switched to Kisquli which caused horrible headaches. I am currently not on either and still have headaches. My oncologist thinks my body cannot metabolize these medications. I have been transported by EMS to a couple of hospitals. Doctors thought I had a stroke as I could not remember my name. No stroke they said drug interaction - still not solved to date. Not going to lie it is pretty frustrating. I now only take Letrozole, nausea medication and emergency headache medicine. I am 61, ILC stage 3, stopped active treatment in December 2025. This year has been tough. I sailed through active treatment.

I wish you all the best on this journey.

Thank you all for your contributions. I am suffering badly at the moment from my ribociclib med. Feeling really nauseous, back pain and soreness on my chest . My cancer has spread really disgustingly to the skin on my chest and I also suffer from quite severe radiation fibrosis down the side of my chest as well as ulnar nerve damage in my hand. Finding it all very uncomfortable at the moment. My team tells me it should get better in 3-4 months!!! Can I last that long?? They insist I take paracetamol for the pain but it doesn’t work for me so I use aspirin instead. I would like to know if any of you “recovered “ after having taken the ribociclib for some months?? Here’s hoping for a pain free future. All the best to all of you🙏

@ginny100
So very sorry to read of your pain, ginny100.
I know there are success stories out there re: ribociclib recovery.
Must you continue it or stopped already? Any other alternatives for you? Another oncology opinion indicated? Just throwing out some obvious thoughts.
Sending positive energy your way.
I believe the future will get better for you but so very difficult right now.
God bless.

Thank you for your kind words. I feel at loss at what to do at the moment. Just managing on aspirins to get me through the day. No energy to take charge of anything.😔

@ginny100 I am sorry you are feeling this way. I took Ibrance and the first few months were difficult but it work and dosage got reduced. I am currently addressing radiation fibrosis by going to an occupational therapist and because I had lumpectomy the first few sessions were massaging at the site. But in less than 3 sessions the pain and needles has diminished and now she is tapping my breast and has ordered a compression bra. So I highly suggested. I am on a chemo pill. If you are having a tough time with treatment your oncologist may be able to lower your dosage. Just make sure you report your side effects so it will be easier to refer you to a specialist. Hope you feel relief soon.

Have you tried reduced dosage? I was terrified to take Verzenio (abemaciclib), a similar drug, and my oncologist agreed to start me on the lowest dosage (50mg twice daily, the recommended dosage was 150mg twice a day). I have now increased to 100mg twice daily during the second year. I read that these drugs are the best that has come along for breast cancer and even at low dosage is helpful. So sorry that it is so difficult for you. Hope you find some solutions soon.

My cardiologist (an electropsysiologist) says palpitations are harmless. She also says patients worry about them. As for the rest of your cardiac symptoms, I'm guessing only the AFIB might be a problem if taking Kisqali. As another person has said, Verzenio is an option. Why not investigate that?
When I was started on Kisqali, I had to have weekly EKGs for the 1st month to make sure I wasn't developing prolonged QT syndrome--the heart rhythm problem that Kisqali (and many other meds) can cause. You can ask for that if you're worried.

@peggydobbs
I have only occasional heart palpitations (no concern for me) and I don't have Afib.
I have had a stent placement for a 100% block coronary artery - which is now stenosed at 50% but cardiology won't re-stent until 70% block.
And I have cardiac microvascular disease - or ischemic heart disease (MVD) or cardiac syndrome X (whatever you wish to call it). The very small arteries in the heart are blocked which can cause angina (heart pain). These arteries are too small to stent. Very common in women.
Medication treatment only.
Since I am already cardiac compromised a possible prolonged QT interval is risky for me...Verzenio and Kisquli are considered "twins". Their side effect of diarrhea (which can be severe) is suppose to be a bit less with Kisquli. I would never be a candidate for Verzenio as I have chronic IBS - I already have frequent bouts of diarrhea.
I apologize if I have already posted this information (feel like I did).
Starting Verzenio or Kisquli are no longer an issue for me since my cardiologist did not give his medical clearance for either drug for me. He and my oncologist consulted with each other.
And I trust my cardiologist and his team completely.

I forgot say that Kisqali interacts with atorvastatin, raising liver enzymes greatly. This happened to me. I stopped the atorvastatin. It took a couple of months before my liver recovered enough that I could restart Kisqali. My cholesterol was only a bit elevated, so it was considered better to treat the cancer.