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Overview: Piqray is used to treat certain types of breast cancer. Common side effects include high blood sugar, rash, diarrhea, nausea and vomiting, tiredness, and mouth sores. Call your health care provider right away if you get a rash, fever, shortness of breath, or severe diarrhea, as these could be symptoms of a serious side effect. Piqray is a tablet that is swallowed.

Uses

What is Piqray used for?

Piqray (alpelisib) is commonly used to treat certain types of breast cancer.

Piqray may also be used for other conditions as determined by your health care provider.

How does Piqray work (mechanism of action)?

Piqray is a type of medicine known as a kinase inhibitor. It works by targeting a specific protein in certain cancer cells. By blocking the action of this protein, Piqray can help prevent cancer cells from growing or spreading.

How is Piqray supplied (dosage forms)?

Brands and other names

  • Piqray

Dosage forms and strengths

  • 50 mg, 150 mg, 200 mg oral tablets

See also: Vijoice (alpelisib)

How should I store Piqray?

Piqray should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of Piqray?

The most common side effects of Piqray are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • High blood sugar (see below)
  • Diarrhea (see below)
  • Rash (see below)
  • Nausea and vomiting
  • Tiredness
  • Decreased appetite
  • Mouth sores
  • Weight loss
  • Hair loss
  • Changes in certain lab tests

There may be other side effects of Piqray that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Piqray?

While less common, the most serious side effects of Piqray are described below, along with what to do if they happen.

Severe Allergic Reactions. Piqray may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for drug reaction with eosinophilia and systemic symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking Piqray and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Itching or skin rash
  • Bumps on the skin called hives, which can be red, pink, white, or brown depending on your skin tone
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Shortness of breath, trouble swallowing, or throat tightness
  • Swelling in your feet, ankles, or legs
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored pee
  • Your skin or the whites of your eyes turning yellowish (also called jaundice)

Rash or Severe Skin Reactions. Piqray can commonly cause a rash, but it can also cause severe skin reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), that can lead to death if not treated. If you get a rash, stop taking Piqray and call your health care provider right away. Get emergency help if you have any of the following symptoms.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, lips, nose, or genitals
  • Red, painful, watery eyes
  • Flu-like symptoms, including fever, chills, muscle aches, or swollen glands

High Blood Sugar. Piqray may increase your blood sugar levels, and sometimes it can lead to very high blood sugar. Talk to your health care provider about how to maintain healthy blood sugar levels. Keep all appointments with your health care provider for blood tests before starting and while taking Piqray. Call your health care provider right away if you have the following symptoms of high blood sugar.

  • Thirsty more than usual or dry mouth
  • Peeing more than usual
  • Increase in hunger
  • Tiredness
  • Feeling sick to your stomach
  • Confusion
  • Your breath smelling fruity
  • Nausea or vomiting
  • Flushed or dry skin

Lung Inflammation. Piqray can cause inflammation in your lungs, also called interstitial lung disease or pneumonitis. This can be serious or even life-threatening. Get emergency help if you have trouble breathing. You may also have a cough, fever, or chest pain.

Diarrhea. Diarrhea is a common side effect of Piqray, and sometimes it can be severe. Piqray can also cause inflammation in your large intestine (colitis). Call your health care provider right away if you have diarrhea. You should also drink plenty of fluids to prevent dehydration. In some cases, dehydration may lead to kidney damage. If you are given medicine to prevent or treat diarrhea, take it exactly as your health care provider tells you. Call your health care provider right away if you have any of the following symptoms.

  • Severe diarrhea
  • Diarrhea that does not go away
  • Diarrhea with weakness, dizziness, or fever
  • Stomach pain
  • Mucus or blood in your poop

Warnings & Precautions

Who should not use Piqray?

Allergies to Ingredients. People who are allergic to any of the following should not take Piqray.

  • Alpelisib
  • Piqray
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Piqray.

What should I know about Piqray before using it?

Do not take Piqray unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share Piqray with other people, even if they have the same condition as you. It may harm them.

Keep Piqray out of the reach of children.

You should take Piqray with food.

Do not crush, chew, or cut Piqray. Swallow the tablets whole. Do not take any Piqray tablets that are damaged, broken, or cracked.

If you throw up (vomit) after taking your Piqray dose, do not take another dose on that day. Take your next dose at the usual time the next day.

Keep all appointments, including for blood tests, while you are taking Piqray. This helps your health care provider know if this medicine is safe for you.

Some people taking Piqray have had certain eye problems (uveitis). It is not known whether these problems were due to Piqray or not. Tell your health care provider right away if you have any eye or vision problems, such as blurred or double vision, eye pain or redness, sensitivity to light, or if your eyes look different.

People who are aged 65 or older may be at greater risk of some side effects from Piqray. Talk to your health care provider about your risks if you are in this age group.

Piqray may make it hard for you to get pregnant or get your partner pregnant. If you have concerns, talk to your health care provider.

What should I tell my health care provider before using Piqray?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Piqray is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

  • Diabetes or high blood sugar
  • Skin rash, skin redness, or blisters or peeling on your lips, eyes, mouth, or skin
  • Breathing or lung problems

Other Medicines and Supplements. Piqray may interact with other medicines and supplements. Before taking Piqray, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Piqray may cause harm to a fetus. If you can get pregnant, your health care provider will likely give you a test to make sure you are not pregnant before you start taking Piqray. If you are able to get pregnant, you should use effective birth control while taking Piqray and for one week after your last dose. If you can get a partner pregnant, you should use effective birth control (including condoms) while taking Piqray and for one week after your last dose. Tell your health care provider right away if you are pregnant, think you are pregnant, or plan to become pregnant.

Breastfeeding. It is not known if Piqray passes into breast milk. You should not breastfeed while taking Piqray and for one week after your last dose. Tell your health care provider if you are breastfeeding or plan to breastfeed.

How can I get more information about Piqray?

For more information about Piqray, you can visit the drugmaker’s website at www.piqray.com or call them at 833-474-7729.

Interactions

Does Piqray interact with foods or drinks?

Piqray should be taken with food.

It is unknown if drinking alcohol will affect Piqray, but both Piqray and alcohol may affect blood sugar levels. Heavy drinking can also slow your immune response and make it harder for your body to fight cancer. It is best to limit the amount of alcohol you drink.

Does Piqray interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. 

In particular, make sure that you discuss if you are using any of the following before taking Piqray.

  • Tamoxifen, which is a medicine used to treat certain types of breast cancer
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Ketoconazole or voriconazole (Vfend), which are medicines used for fungal infections
  • Efavirenz, a medicine used to treat HIV

Many other medicines may alter the blood levels of Piqray. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Piqray. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Piqray?

If you or someone else has used too much Piqray, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Piqray?

If you miss a dose, take it as soon as you remember, as long as it is within nine hours of your usual time. Remember to take the dose with food. If it has been more than nine hours, skip the missed dose and only take the next dose at the usual time. Do not take double or extra doses.

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