Frequently Asked Questions

PIQRAY® (alpelisib) tablets

Questions and Answers About PIQRAY

Click below to find answers to some of the most common questions about PIQRAY.

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PIQRAY is a prescription medicine used in combination with the medicine fulvestrant to treat women who have gone through menopause, and men, who have hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer with an abnormal PIK3CA gene whose disease has progressed on or after endocrine (hormone) therapy. 


Your health care provider will test your cancer for an abnormal PIK3CA gene to make sure that PIQRAY is right for you.


It is not known if PIQRAY is safe and effective in children.


Click here to learn more about who is eligible for PIQRAY.

PIQRAY is a biomarker-driven treatment approach that specifically targets proteins created by an abnormal (or mutated) PIK3CA gene, which are linked to cancer growth. PIQRAY affects cancer cells, but can also affect healthy cells. Although PIQRAY has been studied in patients with HR+, HER2- mBC, how PIQRAY works has only been demonstrated in laboratory studies.


Learn how PIQRAY and fulvestrant may help.

PIK3CA mutations can only be detected through a specific genomic test ordered by your doctor. Even if you’ve had genetic testing done before, ask your doctor about getting tested specifically for a PIK3CA mutation.

PIK3CA mutations can be detected with a blood test or with tumor tissue. If you had tumor tissue removed during biopsy or surgery, the tissue may still be viable for testing. Talk to your doctor about PIK3CA mutation testing.


If no mutation is found in the blood sample, ask your doctor to test your tissue.

Combination therapy is a treatment strategy of taking multiple medicines. By combining PIQRAY and fulvestrant, you’ll have 2 medicines working differently, but together, to help treat your HR+, HER2- metastatic breast cancer (mBC) with a PIK3CA mutation. 


Learn how PIQRAY and fulvestrant may help.

The most common side effects of PIQRAY when used with fulvestrant include hyperglycemia, diarrhea, rash, nausea, tiredness and weakness, decreased appetite, mouth sores, vomiting, weight loss, hair loss, and changes in certain blood tests. PIQRAY can also cause more serious side effects. Learn more about potential side effects here.

Although not all side effects can be managed, your health care team may offer suggestions to help manage some of the side effects of PIQRAY. It’s important to talk with your doctor or nurse about side effects you experience and the best ways to manage them. Get tips about managing some side effects here.

PIQRAY is a once-daily oral tablet that is prescribed with fulvestrant, an injectable hormone therapy administered by your health care provider. Take PIQRAY exactly as your health care provider tells you. Your doctor will prescribe the dose of PIQRAY that’s right for you. Take PIQRAY at the same time each day, with food. Swallow PIQRAY tablets whole. Do not chew, crush, or split the tablets. Do not take any PIQRAY tablets that are broken, cracked, or that look damaged. Do not change your dose or stop taking PIQRAY unless your health care provider tells you to do so. Learn more about taking PIQRAY here.

If you take too much PIQRAY, call your health care provider or go to the nearest hospital emergency room right away.


If you miss a dose of PIQRAY, you may still take it with food up to 9 hours after the time you usually take it. If it has been more than 9 hours after you usually take your dose, skip the dose for that day. The next day, take the dose at your usual time. Do not take 2 doses to make up for a missed dose. 


If you vomit after taking a dose of PIQRAY, do not take another dose on that day. Take your next dose at your usual time.

Learn about financial resources here.

Store PIQRAY at room temperature between 68°F to 77°F (20°C to 25°C). Keep PIQRAY and all medicines out of the reach of children.