Medical Oncologist
Medicines
Tests and monitoring while you are on abemaciclib
Abemaciclib needs regular blood counts and liver tests, most often in the first four months, because some side effects show in results before symptoms appear. Your team also asks about breathing, legs and bowel habits. This page explains, in general terms, what is tested, how often, and what usually happens when a result changes.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
On this page
- Which tests will you have while taking abemaciclib?
- What is monitored, and why
- How often tests are usually done
- The vocabulary, in plain language
- Honest realities about monitoring
- Practical tips for blood test days
- What usually happens if a result is out of range
- What people assume about tests on abemaciclib
- Common questions about monitoring on abemaciclib
The short answer
Which tests will you have while taking abemaciclib?
Abemaciclib is a tablet, but it still needs careful monitoring, because some of its side effects show up in blood tests before you feel anything. The two main checks are a complete blood count, which looks at white cells, haemoglobin and platelets, and liver function tests, which look at liver enzymes and bilirubin. These are usually done before you start, then about every two weeks for the first two months, then about monthly for the next two months, and after that as your oncologist decides, often at each clinic visit. Kidney tests, including creatinine, are also commonly checked. Abemaciclib can raise creatinine by changing how the kidneys handle it, without necessarily harming the kidneys, so your team may use other measures if a rise needs interpreting. Before treatment, women who could become pregnant usually have a pregnancy test. Throughout treatment your team will also ask about loose motions, breathing, leg swelling and tiredness, because blood clots and lung inflammation are not picked up by routine blood tests. How well the cancer is responding is checked separately. After surgery for early breast cancer, that usually means regular examinations and yearly mammograms rather than routine scans. In advanced breast cancer, scans such as CT, bone scans or PET-CT are repeated at intervals your oncologist chooses. Results guide whether to continue, pause or lower the dose.
Blood counts
These show whether white cells, which fight infection, have dropped low enough to need a pause or a lower dose.
Liver tests
Liver enzymes can rise, most often in the first few months. Moderate rises usually settle with a pause.
Symptom checks
Questions about breathing, legs and bowel habits matter as much as blood results, because some problems only show as symptoms.
This page gives general information only. Your own schedule of tests may differ, depending on your results and health.The main checks
What is monitored, and why
Each test answers a different question about how your body is coping.
Complete blood count
Measures white cells, neutrophils, haemoglobin and platelets. Low neutrophils are the most common reason for a pause in treatment.
Liver function tests
Measure enzymes called ALT and AST, and bilirubin. Rises are usually without symptoms and are found only by testing.
Yellow skin or dark urine needs same-day advice.Kidney tests
Creatinine and salts such as potassium are checked, particularly if you have had heavy loose motions or dehydration.
Response checks
Examinations, mammograms or scans show how the cancer is doing, on a separate schedule from the safety blood tests.
Your team will also ask about
- Loose motions and fluid intake
- Cough or breathlessness
- Calf pain or swelling
A typical schedule
How often tests are usually done
Stage of treatment
Usual blood test pattern
Before starting
Blood count, liver and kidney tests, pregnancy test if relevant
First two months
About every two weeks
Third and fourth months
About monthly
After that
As your oncologist decides, often at each visit
After a pause or dose change
Often more frequent again for a while
Words you will hear
The vocabulary, in plain language
- Neutrophil count
- The number of infection-fighting white cells, often the key number on your report.
- ALT and AST
- Liver enzymes that rise when liver cells are under strain.
- Bilirubin
- A yellow pigment processed by the liver; high levels can cause yellow skin.
- Creatinine
- A waste product in the blood used to estimate kidney function.
- Cystatin C
- Another kidney marker that doctors sometimes use when creatinine is hard to interpret.
- Restaging scan
- A scan repeated during treatment to see how advanced cancer is responding.
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Being straight with you
Honest realities about monitoring
Frequent tests can feel like a burden, especially in the early months, but they are how treatment stays safe.
Numbers change, and that is expected
Small dips in blood counts or rises in liver enzymes are common and often need no change at all.
Tests do not catch everything
Clots and lung inflammation show up as symptoms, so your own reports are part of monitoring.
Normal results are not a promise
Good blood results show you are tolerating treatment, not that the cancer is responding. That needs separate checks.
What this page cannot tell you
It cannot interpret your own report or tell you what levels mean a change. Your oncologist will explain that.
Making it easier
Practical tips for blood test days
A little organisation makes frequent tests less disruptive, particularly if you travel some distance for treatment.
Ask about local testing
Some teams accept results from an accredited laboratory near your home, as long as reports reach them in time. Ask before arranging this yourself.
Keep copies in one file
A folder or phone album of every report helps any doctor you see understand how your results have changed over time.
Take tablets as usual
Unless told otherwise, you do not need to skip your dose or fast before routine blood tests on abemaciclib.
Drink water beforehand
Being well hydrated makes blood draws easier and can avoid a falsely raised creatinine after loose motions.
When results change
What usually happens if a result is out of range
Your team follows set guidance for each type of change, which usually works in steps.
Mild changes
Often treatment carries on, with a repeat test sooner than planned to check the trend.
Moderate changes
Abemaciclib may be paused until the result recovers, then restarted at the same or a lower dose.
Severe or repeated changes
A lower dose is usual, and treatment is stopped if the problem is serious or keeps coming back despite reductions.
Commonly believed
What people assume about tests on abemaciclib
If I feel well, I can skip my blood test.
Low white cells and liver changes often cause no symptoms at first.
A low count means the cancer is spreading.
It is usually an expected effect of the medicine.
I need a scan every month after surgery.
After surgery, routine scans are not usually needed without symptoms.
A raised creatinine always means kidney failure.
Abemaciclib can raise it without true kidney damage.
Questions we are asked
Common questions about monitoring on abemaciclib
Why are tests so frequent at the start?
Drops in white cells and rises in liver enzymes are most likely during the first few months. Testing often during this period lets your team spot changes early and adjust the dose before they cause problems. Once your results are stable, tests are usually spaced out.
Do I need to fast before my blood test?
Usually not for a blood count or liver tests. If other tests such as cholesterol or sugar are being checked at the same time, you may be asked to fast. Check with your team or laboratory beforehand.
What happens if my white cell count is low?
Depending on how low it is, your team may continue treatment and repeat the test, pause abemaciclib until the count recovers, or restart at a lower dose. A fever with a low count needs urgent same-day assessment.
Will I need heart tests such as an ECG?
Routine heart tracing is not a standard requirement for abemaciclib in the way it is for ribociclib. Your doctor may still order an ECG if you have heart problems, take other medicines that affect heart rhythm, or develop symptoms.
How will we know if the treatment is working?
After surgery, there is no active cancer to measure, so success is judged by staying free of recurrence, with regular examinations and mammograms. In advanced cancer, scans at intervals chosen by your oncologist, along with symptoms and sometimes tumour markers, show the response.
Are tumour markers checked?
Sometimes, in advanced breast cancer, markers such as CA fifteen-three are followed alongside scans. They are not reliable enough on their own, and they are not routinely used after surgery for early breast cancer.
Will I have bone density scans?
Not because of abemaciclib itself, but often because of the hormone therapy taken with it. Aromatase inhibitors and ovarian suppression can thin bones, so a bone density scan is commonly done at the start and repeated at intervals.
Can my family doctor do the tests?
Often yes, as long as your oncology team agrees and receives the results quickly. Make sure the laboratory is reliable and that someone is responsible for reviewing the report and acting on any abnormal value.
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Sources
- European Medicines Agency — Verzenios: product information
- Cancer Research UK — Abemaciclib (Verzenios)
- Cancer Research UK — Blood tests
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.