Piqray® (alpelisib) Tablets for HR+ HER2- PIK3CA-Mutated Breast Cancer

What Piqray Is and How It Works

Piqray® (alpelisib) is an oral PI3K alpha inhibitor. It is used with fulvestrant to treat HR-positive, HER2-negative, PIK3CA-mutated advanced or metastatic breast cancer after disease progression on endocrine therapy. Many patients explore Piqray online to compare options, including Piqray without insurance costs. Dosing is once daily with food, and treatment continues until progression or unacceptable toxicity.

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Piqray® targets the PI3K/AKT/mTOR pathway. Many HR+/HER2- breast cancers have activating PIK3CA mutations that drive tumor growth. By inhibiting PI3K alpha, alpelisib reduces downstream signaling and tumor cell survival. Fulvestrant complements this by degrading estrogen receptors. Together they help delay progression in appropriate patients confirmed to have a PIK3CA mutation.

Dosage and Usage

Follow your prescriber’s directions. The information below is general.

• Typical starting dose: 300 mg once daily with food (two 150 mg tablets).
• Swallow tablets whole. Do not crush, split, or chew.
• Use with fulvestrant per its schedule.
• If you miss a dose by more than 9 hours, skip and take the next dose at the regular time.
• If you vomit after a dose, do not take an extra dose. Take the next dose as scheduled.
• Dose reductions (for example, to 250 mg or 200 mg daily) may be used if side effects occur.

Storage and Travel

• Store at room temperature (20–25°C/68–77°F). Short excursions 15–30°C are okay.
• Keep tablets dry in the original package. Protect from moisture.
• Keep away from children and pets.
• When you travel, carry your medication in your hand luggage with a copy of your prescription.
• Avoid heat, direct sun, and bathrooms with high humidity.

Benefits and Savings

Piqray® plus fulvestrant improved progression-free survival in patients with confirmed PIK3CA mutations who had progressed on prior endocrine therapy. Many see rash or blood sugar changes early, so teams monitor closely. Tablets are taken once daily with food, which many find convenient alongside clinic-administered fulvestrant.

YouDrugstore offers competitive Canadian pricing with prompt support. Typical customers save 60–80% compared with usual U.S. pharmacy prices. This can help those paying Piqray without insurance or with high deductibles. You can order online or by phone, and our team can assist with reorders when you are ready.

Side Effects and Safety

Not all side effects are listed here. Review the full prescribing information and speak with your oncology team.

• Common: hyperglycemia, diarrhea, nausea, vomiting, decreased appetite, fatigue, weight loss, rash, stomatitis, dry skin, alopecia, anemia.
• Lab changes: elevated fasting glucose and HbA1c, increased creatinine, liver enzymes, lipase, and triglycerides.
• Serious: severe hyperglycemia or ketoacidosis, severe cutaneous reactions (including Stevens-Johnson syndrome), pneumonitis, anaphylaxis, severe diarrhea with dehydration, severe hypersensitivity.
• Glucose management: blood sugar often rises within the first 1–2 weeks. Monitoring and antidiabetic therapy may be required.
• Dermatologic reactions: rash can appear early. Your team may start prophylaxis or treat at first signs.
• Pulmonary symptoms: new or worsening cough or shortness of breath requires prompt evaluation.
• Pregnancy and lactation: can harm an unborn baby. Use effective contraception during treatment and after as directed. Do not breastfeed during treatment and for a period after the last dose.
• Drug interactions: strong CYP3A4 inducers may reduce alpelisib exposure. Review all medications and supplements with your prescriber and pharmacist.

Onset Time

Blood sugar changes and rash often occur within the first two weeks. Gastrointestinal effects may also appear early. Tumor response and progression assessments are usually done over several weeks to months. Many clinics schedule the first imaging recheck around 8–12 weeks, based on the care plan.

Compare With Alternatives

Several therapies are used across the HR+/HER2- metastatic setting. CDK4/6 inhibitors (palbociclib, ribociclib, abemaciclib) are often given earlier with endocrine therapy. After progression, targeted options may include alpelisib for PIK3CA-mutated disease or everolimus (mTOR inhibitor) plus exemestane. Capivasertib (AKT inhibitor) with fulvestrant is another option for certain pathway alterations. Elacestrant is an oral SERD for ESR1-mutated tumors post endocrine therapy. Each option has distinct side effects and monitoring needs. Discuss goals, mutation status, prior therapy, and tolerance with your oncology team to choose a path that fits your history.

Combination Therapy

Piqray® is indicated with fulvestrant. It is generally used after progression on or after endocrine therapy, with or without prior CDK4/6 inhibitors. Diabetes management may be needed when hyperglycemia occurs, and dermatologic support can help manage rash. Care plans often include regular glucose checks, labs, and imaging. Do not start or stop other anticancer or supportive medicines without direction from your care team.

Patient Suitability and Cost-Saving Tips

Piqray® is intended for adults with HR-positive, HER2-negative metastatic or advanced breast cancer and a confirmed PIK3CA mutation. Tumor tissue or plasma (ctDNA) testing is used to confirm mutation status. Suitability depends on prior treatments, comorbidities such as diabetes, and the ability to monitor blood sugar and side effects during therapy.

YouDrugstore supports privacy and convenience. You can create an account, upload your prescription, and arrange delivery to the U.S. Our team can send gentle reorder reminders if you opt in. Multi-month supplies, when prescribed, may lower the per-month cost, and bulk promotions are sometimes available. For current offers and bulk options, see our Piqray coupon page. If paying Piqray out of pocket, compare strengths and pack sizes to find the best value per day of therapy.

Explore cancer-related information and products in our Cancer section. For general oncology side effect insights, you may find Common Darzalex Side Effects And Tips To Manage Them helpful. For background on targeted cancer medicines, see Understanding Calquence Medication For Cancer Treatment. These articles are educational and not a substitute for medical advice.

Authoritative Sources

Review official resources for full safety and prescribing details:

• FDA Prescribing Information for Piqray
• Health Canada Product Monograph for Piqray
• Novartis Piqray Patient Site

YouDrugstore makes access simple and discreet. Our licensed pharmacists review each prescription, and our customer-service team is ready during posted office hours. Order securely and choose shipping that fits your needs, including prompt, express, cold-chain shipping when required.

Disclaimer: This page provides general information and is not medical advice. Always follow your prescriber’s instructions and local guidance. Read the full patient information supplied with your medication and consult your care team with any questions.