Taking abemaciclib: timing, food and daily routine

Abemaciclib (brand name Verzenio, or Verzenios in some countries) is a tablet taken twice a day, every day, without a planned break. That continuous pattern is one of the ways it differs from the other CDK4/6 inhibitors, which are usually taken for three weeks and then paused for one. You swallow each tablet whole with a glass of water, at roughly the same two times each day, about twelve hours apart. It can be taken with or without food, so you can fit it around your meals in whatever way suits you. Do not crush, chew or split the tablets. Abemaciclib is almost always taken together with a hormone (endocrine) medicine, such as letrozole, anastrozole, exemestane, tamoxifen or fulvestrant, and women who have not yet reached menopause usually also need treatment to switch off the ovaries. In early breast cancer after surgery it is usually taken for two years. In advanced breast cancer it is usually continued for as long as it keeps the cancer under control and the side effects stay manageable. Your oncologist decides the dose, and it is common for the dose to be lowered at some point to make treatment easier to live with. Keeping a simple routine, a reminder and a supply of the anti-diarrhoea medicine your team recommends makes the first weeks much smoother.

Twice a day, every day

There is no week off. Pick two times, such as after breakfast and after dinner, and stick to them.

Food is flexible

You can take it with or without a meal, but avoid grapefruit and grapefruit juice, which can raise the level of the medicine in your blood.

Be ready for loose motions

Diarrhoea is common in the first weeks. Have the medicine your team advises at home before you start.

A tablet at home sounds simpler than a drip in hospital, and in many ways it is. It also puts more of the work on you.

It is real cancer treatment

Tablets can feel less serious than chemotherapy, but abemaciclib needs regular blood tests, and side effects need reporting promptly.

The first two months are the hardest

Loose motions and low blood counts are most likely early on, and often ease with time or a dose change.

Doses often change

Many people end up on a lower dose. That is an ordinary part of treatment, not a failure.

What this page cannot tell you

It cannot tell you your dose, how long you will take it or whether it suits you. Only your oncologist can.

Your oncology team will give you a number to use for urgent problems. Use it rather than waiting for the next appointment if any of these happen.

Loose motions that do not settle

Especially if they continue a day after starting the anti-diarrhoea medicine, or you feel dizzy or cannot keep fluids down.

Fever or shivering

A temperature can mean infection when your white cell count is low, and needs checking the same day.

Breathing or chest symptoms

New cough, breathlessness or chest pain, or a painful swollen leg, which can signal a blood clot or rare lung inflammation.