Description
DK
Dr. Daria Kwaśniewska
ESMO Certified Consultant Medical Oncologist
Reviewed June 2026
⚠ Prescription required. For informational purposes only. Meds For Cancer is a Named Patient Program facilitator — not a retail pharmacy. A valid oncologist prescription is mandatory before any order is processed.
Is Palboxen 125 mg right for your situation?
Review these criteria with your oncologist before enquiring✔ You may be a candidate if
- ✓Diagnosed with HR-positive, HER2-negative advanced or metastatic breast cancer
- ✓Postmenopausal, or premenopausal with ovarian suppression, on combination endocrine therapy
- ✓Need a WHO-GMP generic alternative to Ibrance® (Pfizer)
- ✓Hold a valid oncologist prescription
✖ May NOT be suitable if
- ✗HR-negative or HER2-positive breast cancer (different treatment pathway entirely)
- ✗Severe pre-existing neutropenia or active severe infection
- ✗Pregnant, planning pregnancy, or breastfeeding
- ✗Severe hepatic impairment without oncologist dose adjustment
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Prescription required · Named Patient Program · Worldwide shipping
🛡 WHO-GMP Certified · Prescription verified · Express dispatch
What is Palboxen 125 mg?
Palboxen 125 mg is a generic formulation of Palbociclib — a CDK4/6 (cyclin-dependent kinase 4 and 6) inhibitor — manufactured by Everest Pharmaceuticals Ltd. under WHO-GMP certified conditions in Bangladesh. Each capsule contains 125 mg of palbociclib, the same active molecule found in Ibrance® (Pfizer), and is dispensed under the Named Patient Program for patients requiring an affordable, quality-assured alternative.
Palbociclib is used in combination with hormone therapy (an aromatase inhibitor or fulvestrant) — it is not used as a standalone treatment.
| Generic name | Palbociclib |
| Reference brand | Ibrance® (Pfizer) |
| Manufacturer | Everest Pharmaceuticals Ltd. |
| Standard | WHO-GMP Certified |
| Drug class | CDK4/6 Inhibitor |
| Dosage form | Capsule — 125 mg |
| Pack size | 21 capsules per pack |
| Route | Oral · once daily, 21 days on / 7 days off |
| Prescription | Required — oncologist only |
How Palbociclib Works
In HR-positive breast cancer, oestrogen signalling drives a protein pair called cyclin D1-CDK4/6, which pushes cancer cells through the cell cycle — the process of cell division and replication. Palbociclib blocks CDK4 and CDK6, halting cancer cells at a checkpoint before they can divide.
By stopping cancer cells from completing the cell cycle, palbociclib works synergistically with hormone therapy — the hormone therapy reduces the oestrogen signal driving growth, while palbociclib blocks the downstream machinery the cancer cell needs to divide regardless. In the landmark PALOMA-2 trial, adding palbociclib to letrozole more than doubled median progression-free survival compared to letrozole alone. NCCN guidelines list palbociclib combinations as a Category 1 preferred regimen for HR-positive, HER2-negative metastatic breast cancer. View NCCN Breast Cancer Guidelines →
What to Expect: First 30 Days
Palbociclib follows a distinctive 28-day cycle — understanding this schedule helps you anticipate blood test timing and symptom patterns.
- Days 1–14: Your white blood cell count, particularly neutrophils, typically begins to fall — this is the expected pharmacological action of the drug and is closely monitored. A blood test is usually scheduled around day 14 of your first two cycles.
- Days 15–21: Continue taking the capsule daily through day 21. Mild fatigue or nausea may emerge. Your blood counts typically reach their lowest point (nadir) and begin recovering toward the end of this window.
- Days 22–28 (off period): You stop taking palbociclib for 7 days, allowing your bone marrow and blood counts to recover before the next cycle begins. Do not skip this off-period — it is built into the regimen for safety.
Side Effects
The most clinically significant effect of palbociclib is on white blood cells (neutropenia), which is why frequent blood monitoring is mandatory during treatment, especially in the first two cycles.
Common · Usually Manageable
- Neutropenia (low white blood cell count)
- Fatigue and weakness
- Nausea and mouth sores
- Hair thinning
- Diarrhoea
- Decreased appetite
- Numbness or tingling in hands/feet
Serious · Report Immediately
- Febrile neutropenia (fever with low white cells)
- Interstitial lung disease / pneumonitis
- Severe infections
- Significant liver enzyme elevation
- Severe, persistent diarrhoea or vomiting
⚠ Call your doctor immediately if you experience:
- Fever of 38°C (100.4°F) or higher — especially while neutrophil counts are low
- New or worsening breathlessness, dry cough, or chest pain
- Signs of infection: chills, sore throat, mouth sores that worsen, or burning on urination
How to Take Palboxen 125 mg
Standard dose: 1 capsule (125 mg) once daily for 21 consecutive days, followed by 7 days off — a complete 28-day cycle. Taken alongside your prescribed hormone therapy.
- 1Once daily for 21 days, then 7 days off — mark your calendar to track the cycle accurately. Missing the off-period schedule can affect blood count recovery.
- 2Take with food — food improves absorption and reduces nausea. Avoid grapefruit and grapefruit juice entirely (CYP3A4 interaction).
- 3Swallow capsules whole with a full glass of water. Do not open, crush, or chew.
- 4If you miss a dose or vomit after taking one, do not take an additional dose — resume at the next scheduled time.
- 5Storage: below 30°C, protected from moisture and light, out of reach of children.
Caregiver Guidance
- ♥Watch for fever closely, especially days 10–21 — this is when neutrophil counts are typically lowest. Any temperature of 38°C or higher needs immediate medical contact — this is a possible medical emergency, not something to wait out.
- ♥Help track the 28-day cycle — use a calendar or app to mark dosing days and the 7-day off period. Missing the schedule is a common and avoidable error.
- ♥Support infection precautions — encourage hand hygiene, avoid crowded spaces when counts are low, and ensure all scheduled blood tests are attended.
If the Medicine Stops Working
Resistance to CDK4/6 inhibitors like palbociclib can develop through several mechanisms, including loss of Rb (retinoblastoma protein) function, amplification of CDK6 itself, or activation of alternative growth pathways (such as PI3K/AKT/mTOR or FGFR). When disease progresses on palbociclib, your oncologist will typically consider switching the endocrine partner (e.g. to fulvestrant), adding a PI3K inhibitor if a PIK3CA mutation is present, or moving to chemotherapy depending on disease burden and prior treatment history. Some patients are continued on a different CDK4/6 inhibitor (e.g. abemaciclib) in select circumstances — this is an evolving area of clinical research.
Frequently Asked Questions
Why do I need blood tests so often on this medicine?
Palbociclib reduces white blood cell counts (specifically neutrophils) in the majority of patients. Frequent blood monitoring — especially in the first two cycles, typically at the start of each cycle and around day 14 — allows your oncologist to catch and manage neutropenia before it becomes dangerous. This is one of the most important safety measures during palbociclib treatment.
Can Palboxen be used alone, without hormone therapy?
No. Palbociclib is approved and clinically effective only in combination with endocrine (hormone) therapy — either an aromatase inhibitor (such as letrozole) or fulvestrant. It is not used as a standalone treatment. Your oncologist will prescribe the specific hormone therapy partner appropriate for your situation.
What is the difference between Palboxen, Palbocent, and Palbonix?
All three are 125 mg palbociclib capsules with identical active ingredients and mechanism. The distinction is the manufacturer: Palboxen is made by Everest Pharmaceuticals, Palbocent by Incepta Pharmaceuticals, and Palbonix by Beacon Pharmaceuticals. All are WHO-GMP certified and dispensed under the Named Patient Program. Availability may vary by region — contact us to confirm current stock.
Will I lose my hair on Palboxen?
Mild to moderate hair thinning is a recognised side effect of palbociclib, but complete hair loss (alopecia) as seen with traditional chemotherapy is uncommon. Most patients experience gradual thinning rather than dramatic loss. Discuss any significant hair changes with your oncologist.
Can I take Palboxen with my other medications?
Palbociclib is metabolised via the CYP3A4 enzyme pathway. Strong CYP3A4 inhibitors (certain antifungals like ketoconazole, some antibiotics like clarithromycin) can increase palbociclib levels, while strong inducers (rifampicin, St John’s Wort) can reduce its effectiveness. Avoid grapefruit entirely. Always provide your full medication list to your oncologist and pharmacist.
How do I order Palboxen through Meds For Cancer?
Contact us via WhatsApp (+880 130 449 8958) or email (info@medsforcancer.com) with your oncologist’s prescription. Our team will verify the prescription, confirm availability and pricing for your country, and arrange secure international shipping under the Named Patient Program. A valid prescription is mandatory before any order is processed.
🛡 Named Patient Program — Regulatory Framework
Meds For Cancer operates as a Named Patient Program (NPP) facilitator. Under this framework, WHO-GMP certified medicines are made available to individual patients with a confirmed medical need and a valid oncologist prescription, in countries where the branded product is unavailable or unaffordable.
This service does not constitute retail pharmacy dispensing. A prescription review is mandatory before any order is processed.
Clinical References
- Finn RS, et al. Palbociclib and letrozole in advanced breast cancer (PALOMA-2). NEJM 2016;375:1925–1936.
- Cristofanilli M, et al. Fulvestrant plus palbociclib in HR-positive, HER2-negative advanced breast cancer (PALOMA-3). Lancet Oncol 2016;17:425–439.
- NCCN Clinical Practice Guidelines in Oncology: Breast Cancer. V4.2026.
- Wander SA, et al. Mechanisms of resistance to CDK4/6 inhibitors in breast cancer. Cancer Discov 2020;10:1174–1193.
