Piqray (alpelisib) is a brand-name oral tablet prescribed for breast cancer in certain situations. As with other drugs, Piqray can cause side effects, including hair loss. Some side effects may start right after your first dose.

Piqray belongs to a drug class called kinase inhibitors. The drug is not available in a generic version.

Read on to learn about potential common, mild, and serious side effects of Piqray. You can also find tips about managing them. For a general overview of the drug, including details about its uses, see this article.

Piqray can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Piqray in clinical trials:

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur when taking Piqray. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Piqray’s prescribing information.

Mild side effects that have been reported with Piqray include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Piqray and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.

Piqray may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Piqray’s prescribing information.

If you develop serious side effects while taking Piqray, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

* For more information about this side effect, see “Side effect specifics” below.

Learn more about some of the side effects of Piqray.

Hair loss

Hair loss may occur with Piqray. This was a common side effect reported in the drug’s clinical trials.

What you can do

If you experience hair loss during treatment with Piqray, talk with your doctor. They can recommend medicated shampoos or other drugs that may help prevent or reduce this side effect.

Diarrhea or colitis

It’s possible to experience diarrhea with Piqray. Diarrhea was one of the most common side effects reported in clinical trials.

Sometimes, diarrhea can be severe. If you have severe diarrhea, it can cause dehydration, which may lead to more serious conditions, such as kidney problems.

In some cases, diarrhea may be sign of colitis. Colitis is inflammation of the colon lining. Colitis was not reported in Piqray’s clinical trials but has been reported since the drug became approved.

In addition to diarrhea, colitis symptoms may include abdominal pain and mucus or blood in the stool. If you experience diarrhea, your doctor will likely monitor you for other signs of colitis.

What you can do

If you develop diarrhea while taking Piqray, talk with your doctor. They will likely recommend that you drink more fluids to help prevent side effects of severe diarrhea, such as kidney problems. They may also suggest a medication to manage diarrhea.

If your diarrhea is severe, your doctor may lower your dose of Piqray. In some cases, they may recommend that you stop taking Piqray and try a different medication for your breast cancer.

Your doctor may also monitor you for symptoms of colitis, which may cause the diarrhea. If you have or develop colitis, your doctor may change your dose of Piqray or recommend another treatment option depending on the severity of your symptoms.

Rash

Rash is a common side effect of Piqray. In some cases, you may develop a mild rash. However, it’s possible to develop a severe rash, such as Stevens-Johnson syndrome, from this medication. This condition can be life threatening, so it’s important that you seek medical attention right away so you can receive treatment.

Symptoms of a severe rash may include:

Other times, a rash can be a symptom of an allergic reaction to a medication. For more information, see the “Allergic reaction” section below.

What you can do

If you develop a rash during your treatment with Piqray, talk with your doctor. They will be able to determine how severe your rash is and the best way to treat it.

In some cases, they may suggest treatment with a topical cream. If your rash is more serious, they may recommend a medication such as Benadryl (diphenhydramine) to treat your condition.

Another option your doctor may recommend for a serious rash is stopping treatment with Piqray. They may suggest a different medication to treat your breast cancer.

Allergic reaction

As with most drugs, Piqray can cause an allergic reaction in some people. Although it isn’t known how often mild allergic reactions occurred, serious allergic reactions were rare in clinical trials.

Symptoms can be mild or serious and can include:

  • rash*
  • itching
  • flushing
  • swelling under your skin, typically in your lips, eyelids, feet, or hands
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

* For more information, see the “Rash” section above.

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Piqray. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Be sure to talk with your doctor about your health history before you take Piqray. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Diabetes. If you have diabetes, be sure to tell your doctor before you start taking Piqray. This medication can affect your blood glucose levels, making them very high or low. Piqray may worsen your diabetes. Your doctor may monitor your blood glucose levels more often than usual or recommend a different treatment for you.

History of rash or skin conditions. Tell your doctor if you have or had any serious rashes, including blistering or peeling of your skin. Piqray may cause serious skin reactions. So, if you have a history of rash or other skin conditions, you may be at an increased risk of this side effect. Your doctor may monitor your skin more often than usual during your Piqray treatment.

Allergic reaction. If you’ve had an allergic reaction to Piqray or any of its ingredients, your doctor will likely not prescribe Piqray. Ask your doctor what other medications may be more suitable for you.

Alcohol and Piqray

Alcohol is not known to interact with Piqray. However, both alcohol and Piqray may cause similar effects. For example, both Piqray and alcohol can cause nausea, vomiting, or headache. They both can also cause increased levels of liver enzymes, which may be a sign of liver damage. So, consuming alcohol during treatment with Piqray may increase your risk of these side effects.

If you drink alcohol, talk with your doctor about how much, if any, is safe to consume during treatment with Piqray.

Pregnancy and breastfeeding while taking Piqray

Piqray is not safe to take while pregnant or breastfeeding.

This medication may cause harm to a fetus if taken during pregnancy. At this time, there are no studies on the use of Piqray among pregnant females.* Animal studies show that this medication can cause problems with fetal development (commonly known as birth defects) or fetal death when given to pregnant animals. However, animal studies do not always indicate what may happen in humans.

If you can become pregnant, your doctor will order a pregnancy test for you before you start taking Piqray. Throughout your treatment with this medication and for 1 week after stopping treatment, you should use an effective form of birth control.

If you’re a male* taking Piqray and your sexual partner can become pregnant, you should use an effective form of birth control. You should use birth control throughout your treatment and for 1 week after stopping treatment.

It’s unknown if Piqray passes into breast milk or what effects it may have on a child who is breastfed. However, due to the possible risks to a child, it’s recommended not to breastfeed during your treatment. You should also not breastfeed for at least 1 week after your last dose of Piqray.

If you are pregnant, planning to become pregnant, or breastfeeding, talk with your doctor before starting Piqray.

* Sex and gender exist on spectrums. Use of the terms “female” and “male” in this article refers to sex assigned at birth.

Most side effects that occur from Piqray are mild. However, some side effects may be severe. So, you should be aware of possible side effects that may occur from this medication. If you’d like to learn more about Piqray, talk with your doctor or pharmacist. They can help answer any questions you have about the side effects of taking the drug. They can also help determine whether Piqray is a safe treatment for you.

Besides talking with your doctor, you can do some research on your own. These articles might help:

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.