This site is intended for patients in Great Britain (England, Scotland and Wales) who have been prescribed PIQRAY®▼ (alpelisib) + fulvestrant.

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What side effects could I experience?

As with other medicines, you may experience side effects with Piqray (alpelisib) + fulvestrant. If you have side effects, it’s important to tell your healthcare team right away so they can help you manage them. Your doctor may suggest a dose interruption or modification or prescribe additional medications to take alongside your treatment to help manage these side effects.1 Some patients may need to stop treatment permanently due to side effects.

Stopping your treatment may cause your condition to become worse. Do not stop taking Piqray unless your doctor tells you to.1

You may find it useful to keep a treatment tracker. This can help your healthcare team understand how you are feeling and how the side effects can be managed.

For more information about side effects and what to expect, please refer to the leaflet inside your medication box (your Patient Information Leaflet) and your Piqray patient brochure

What are some of the most common side effects experienced by patients taking Piqray?1

(high blood sugar)

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Diarrhoea icon

Mouth sores

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Hair loss

Hair loss



Decreased appetite

Decreased appetite


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Abnormal blood tests

Abnormal blood tests

Weight loss

Weight loss
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Some side effects may become serious.1 You should tell your doctor or pharmacist immediately if you experience any of the serious side effects listed in the Piqray Patient brochure, found here. Please also consult the Patient Information Leaflet found in your Piqray medication box.

Information about hyperglycaemia

Up to 4 out of 5 people will develop hyperglycaemia (high blood sugar) as a side effect of taking their Piqray®.2

Hyperglycaemia occurs when the level of glucose (sugar) in the blood is higher than it should be and can become serious if not managed.

Your blood sugar levels will be tested regularly before you start treatment, during treatment and after you stop treatment with Piqray + fulvestrant.1

If you develop hyperglycaemia when taking PIQRAY® + fulvestrant, your doctor may prescribe you an antidiabetic treatment and/or you may require a change to your Piqray dose temporarily, or permanently.1

Hyperglycaemia signs and symptoms infographic

Severe hyperglycaemia (high blood sugar) is considered serious, particularly if accompanied by symptoms such as confusion, dry mouth, dry or flushed skin, nausea, vomiting, tiredness, need to pass urine frequently, thirst. These could be symptoms of hyperglycaemic hyperosmolar nonketotic syndrome (HHNKS). Contact your healthcare team immediately if you have any of these symptoms1

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Follow your doctor’s instructions for monitoring your blood glucose, and any changes to the dose of your medicine(s)

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Make lifestyle changes, such as keeping to a healthy weight, eating a balanced diet and being more physically active3

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Your doctor may prescribe a medicine or a combination of medicines to help control your blood sugar. They may also recommend interrupting or reducing your dose of Piqray, or in some cases, stopping the treatment altogether1

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Watch this short video for more information on hyperglycaemia.

View the brochure and treatment tracker for help with taking alpelisib + fulvestrant

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Where would you like to go next?


aBC, advanced breast cancer.


  1. PIQRAY® (alpelisib) Patient Information Leaflet. Available at: [Accessed November 2021].
  2. André F, et al. N Engl J Med 2019;380:1929–1940.
  3. Macmillan Cancer Support. Diabetes and cancer treatment. Available at:  [Accessed November 2021].

▼This medicine is subject to additional monitoring. This will allow quick identification of new safety information. You can help by reporting any side effects you may get. See for how to report side effects.

UK | January 2022 | 147271