Last update June 14, 2023

Ribociclib

High Risk

Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.

It is an inhibitor of cyclin-dependent kinases (CDK) 4 and 6. It is used to treat advanced or metastatic breast cancer oestrogen-receptor positive and human epidermal growth factor receptor 2 (HER2) negative. Oral administration once a day.

At the date of the last update we did not find any published data on its excretion in breast milk.

Its low percentage of protein binding and long elimination half-life makes it likely that significant amounts will pass into breast milk.

Diarrhea, loss of appetite, infections, leukopenia, neutropenia, anemia, and hepatotoxicity are common adverse reactions.

It is known via Pharmacokinetics that after 3 elimination half-lives (T½) 87.5% of the drug is eliminated from the body; after 4 T½ 94%, after 5 T½ 96.9%, after 6 T½ 98.4% and after 7 T½ 99%. Plasma drug concentrations in the body are negligible after 7 T½. In general, a period of al least five half-lives may be considered a safe waiting period before returning to breastfeeding. (Anderson 2016)

Taking the longest published T½ (55 hours) these 5 T½ would correspond to 11 days. Meanwhile, express and discard milk from the breast regularly to maintain production.  This does not allow breastfeeding during treatment.


See below the information of this related product:

  • Maternal Cancer ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)

Alternatives

  • Abemaciclib (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Ribociclib is also known as


Ribociclib in other languages or writings:

Tradenames

Main tradenames from several countries containing Ribociclib in its composition:

Pharmacokinetics

Variable Value Unit
Molecular weight 435 daltons
Protein Binding 70 %
VD 15.6 l/Kg
pKa 1.59 -
Tmax 1 - 4 hours
33 (30-55) hours

References

  1. Novartis. Ribociclib. Drug Summary. 2023 Full text (in our servers)
  2. EMA. Ribociclib. Ficha técnica. 2022 Full text (in our servers)

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