Piqray (Alpelisib)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Piqray Used For?
Piqray contains alpelisib and belongs to a class of medicines called PI3K inhibitors. It is specifically designed to treat certain types of advanced breast cancer.
Primary Uses
Piqray is used together with a medicine called fulvestrant to treat adult men and women with certain types of advanced breast cancer. Before starting treatment, your tumor tissue or blood sample will be tested for a particular mutation in a gene called PIK3CA. If the result is positive, Piqray is likely to help with your type of breast cancer.
How It Works
Piqray works by blocking the effects of specific enzymes (proteins) that signal cancer cells to grow and multiply. By blocking these enzymes, Piqray can decrease cancer cell growth and the making of new cancer cells, and can also destroy cancer cells.
Good to know: Genetic testing will determine if Piqray is right for your specific type of breast cancer before you start treatment.
How to Take Piqray
It’s important to take Piqray exactly as prescribed by your doctor. The medication should be taken consistently at the same time each day with food.
Dosage Instructions
The usual starting dose is 300 mg (two 150 mg tablets) taken once daily. Take Piqray immediately after food at approximately the same time each day. Swallow the tablets whole with water – do not chew, crush, or split them. Do not take tablets that are broken or cracked. If you vomit after swallowing the tablets, do not take more until your next scheduled dose.
What If You Miss a Dose?
If you forget to take Piqray, you may still take it immediately after food, up to 9 hours after your normal time. If you remember more than 9 hours after your usual time, skip that day’s dose and take your next dose at the usual time the following day.
Important: Never take a double dose to make up for a missed dose. Your doctor may adjust your dosage based on how your body responds to treatment.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Painful and frequent urination
- Tiredness
- Pale skin
- Headache
- Loss of appetite
- Strange taste in mouth or lack of taste
- Diarrhea
- Nausea
- Vomiting
- Stomach pain
- Indigestion
- Rash
- Hair loss/thinning
- Itching
- Dry skin
- Swelling of hands or feet
- Fever
- Dry mouth
- Weight loss
- Sudden bruising
- Cracked lips
- Dry eyes
- Blurred vision
- Muscle pain/spasms
- Difficulty sleeping
- Dizziness
Seek immediate medical attention if you experience:
- Difficulty breathing
- Facial or throat swelling
- Light-headedness
- Blue discoloration of tongue or lips
- Severe skin reactions (blisters on lips/eyes/mouth, skin peeling)
- Severe abdominal pain
- Blood or mucus in stools
- Unexplained changes in urination amount
- Swelling in legs, ankles, around eyes
- Fruity smell on breath
- Signs of lung problems (chest pain while breathing, rapid breathing, hiccups)
Important Warnings
There are several important warnings and precautions to be aware of before and during treatment with Piqray.
Who Should Not Take Piqray
Do not use Piqray if you are allergic to alpelisib, fulvestrant, or any of the ingredients. Signs of allergic reaction include severe itching with red rash or raised bumps, swelling of face/lips/tongue/throat, difficulty breathing or swallowing, and dizziness. Piqray is not for use in children or adolescents under 18 years of age.
Medical Conditions to Discuss
Tell your doctor if you have high blood sugar levels or symptoms like increased thirst/dry mouth, frequent urination, feeling tired or sick, or increased appetite with weight loss. Also inform your doctor if you develop rash, red skin, blistering of lips/eyes/mouth, or skin peeling with or without fever, as these may be signs of severe skin conditions.
Pregnancy and Breastfeeding
Piqray may harm an unborn baby and should not be used during pregnancy unless clearly necessary. If you become pregnant or think you might be pregnant, tell your doctor immediately. Do not breastfeed during treatment and for at least 4 days after your last dose. Women of childbearing age should use effective birth control during treatment and for at least 4 days after stopping. Men should use condoms with female partners who could become pregnant, continuing for at least 4 days after stopping Piqray.
Blood Sugar Monitoring: Regular blood sugar monitoring is essential as Piqray can increase blood sugar levels, which could be serious and need treatment. You’ll need weekly blood tests for the first 2 weeks, then monthly monitoring.
Drug Interactions
Some medicines may interfere with Piqray and affect how it works. Always tell your doctor about all medicines you’re taking.
- Eltrombopag (for low platelet count)
- Lapatinib, ribociclib, or everolimus (breast cancer treatments)
- Pantoprazole (stomach acid reducer)
- Midazolam (sedative)
- Rifampicin (antibiotic)
- Encorafenib (skin cancer treatment)
- Warfarin (blood thinner)
Alcohol & Driving
Piqray may affect your ability to drive or operate machinery, and there are no known interactions with alcohol.
Alcohol
There are no known interactions between Piqray and alcohol. However, tell your doctor if you drink alcohol.
Driving and Operating Machinery
Piqray has minor influence on your ability to drive and use machines. Be cautious when driving or using machines as you may feel tired while taking Piqray. Be careful until you know how Piqray affects you.
Storage
Store Piqray below 30°C and protect from moisture. Keep it in a cool, dry place away from heat or sunlight. Do not store in the bathroom, near a sink, in the car, or on window sills. Keep out of reach of children. Take expired or unwanted medicine to any pharmacy for safe disposal.
Overdose Information
If you think you have taken too many Piqray tablets, you may need immediate medical attention. Call the Poisons Information Centre at 13 11 26, contact your doctor, or go to the nearest hospital Emergency Department. Take the Piqray pack with you, even if there are no signs of discomfort or poisoning.
Frequently Asked Questions
Piqray works by blocking specific enzymes that help cancer cells grow. Your doctor will monitor your progress with regular blood tests and check-ups to see how well the treatment is working for your specific type of breast cancer.
Yes, you must take Piqray immediately after food, once daily at approximately the same time each day. This is important for proper absorption of the medication.
Do not stop taking Piqray suddenly unless your doctor tells you to. Take Piqray for as long as your doctor tells you to, as stopping treatment early may affect its effectiveness.
There are no known interactions between Piqray and alcohol. However, you should tell your doctor if you drink alcohol so they can monitor your overall health during treatment.
If you forget to take Piqray, you can still take it immediately after food up to 9 hours after your normal time. If more than 9 hours have passed, skip that day’s dose and take your next dose at the usual time. Never take a double dose.
Regular blood tests are essential because Piqray can increase your blood sugar levels, which could be serious. You’ll need weekly tests for the first 2 weeks, close monitoring for the first 4 weeks, then monthly tests to ensure your blood sugar stays at safe levels.
No, you must swallow Piqray tablets whole with water. Do not chew, crush, or split the tablets before swallowing. Also, do not take tablets that are broken or cracked.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.