Missed a dose of ribociclib? What to do

If you forget a dose of ribociclib, sold as Kisqali, the usual advice in the product information is simple: do not take an extra dose that day, and take your next dose at your normal time the following day. The same rule applies if you vomit after swallowing your tablets. Do not take another dose to replace the ones you may have brought up. Never double the next dose to catch up, because a sudden higher level of ribociclib can add to side effects such as low white cell counts and changes to the heart rhythm. One missed day is very unlikely to make a noticeable difference to how well treatment works over months or years. Ribociclib is usually taken once a day for three weeks, followed by one week off, and your hormone tablet or injection follows its own separate schedule. If you miss a ribociclib dose, do not shift the week off or stretch the cycle to make up the day unless your team tells you to. Just carry on with the calendar you were given and write the missed dose down. Tell your team at your next visit, or sooner if you are missing doses often, feel unwell or are not sure what to do. Frequent missed doses deserve a conversation, because there is usually a practical fix, such as a reminder, a different time of day or help with side effects that make tablets hard to take.

Skip, do not double

Leave out the missed dose and take the next one at the usual time.

Vomiting counts as a missed dose

If you are sick after taking the tablets, do not take more that day.

Keep a simple record

Note missed or vomited doses in a diary so your team sees the full picture.

People often feel guilty or frightened after missing a dose. It helps to keep the risk in proportion, while still taking regular dosing seriously.

An occasional missed dose

Missing a single day now and then is common, and there is no evidence that it undoes the benefit of treatment.

Frequent missed doses

Missing doses regularly over many months may reduce how well treatment works. That is why your team would want to know and help.

Missed doses are not a reason to hide

Your team hears about missed doses all the time. Being open lets them make treatment easier rather than guess what is happening.

What this page cannot tell you

It cannot tell you what to do if your team has given you special instructions, or if you are on a changed dose or schedule. Ask them directly.

Small, practical tools often work better than willpower alone, especially over the months or years that ribociclib may be taken.

A pill organiser

A seven-day box shows at a glance whether today's dose has gone. Keep the week off clearly marked so you do not take tablets by habit.

Phone alarms

Set a daily alarm labelled with the medicine name, and a separate reminder for the day the week off starts and ends.

A family helper

A partner, son, daughter or friend can check the pill box at the same time each day, without taking over your care.

Keep tablets in their packaging

Store them in the original blister pack until you take them, away from heat, damp and children.