(palbociclib)

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6 ADVERSE REACTIONS

6 ADVERSE REACTIONS

The following clinically significant adverse reactions are described elsewhere in the labeling:

Neutropenia [see Warnings and Precautions (5.1)]
ILD/Pneumonitis [see Warnings and Precautions (5.2)]

6.1 Clinical Studies Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

PALOMA-2: IBRANCE plus Letrozole

Patients with estrogen receptor (ER)-positive, HER2-negative advanced or metastatic breast cancer for initial endocrine-based therapy

The safety of IBRANCE (125 mg/day) plus letrozole (2.5 mg/day) versus placebo plus letrozole was evaluated in PALOMA-2. The data described below reflect exposure to IBRANCE in 444 out of 666 patients with ER-positive, HER2-negative advanced breast cancer who received at least 1 dose of IBRANCE plus letrozole in PALOMA-2. The median duration of treatment for IBRANCE plus letrozole was 19.8 months while the median duration of treatment for placebo plus letrozole arm was 13.8 months.

Dose reductions due to an adverse reaction of any grade occurred in 36% of patients receiving IBRANCE plus letrozole. No dose reduction was allowed for letrozole in PALOMA-2.

Permanent discontinuation associated with an adverse reaction occurred in 43 of 444 (10%) patients receiving IBRANCE plus letrozole and in 13 of 222 (6%) patients receiving placebo plus letrozole. Adverse reactions leading to permanent discontinuation for patients receiving IBRANCE plus letrozole included neutropenia (1.1%) and alanine aminotransferase increase (0.7%).

The most common adverse reactions (≥10%) of any grade reported in patients in the IBRANCE plus letrozole arm by descending frequency were neutropenia, infections, leukopenia, fatigue, nausea, alopecia, stomatitis, diarrhea, anemia, rash, asthenia, thrombocytopenia, vomiting, decreased appetite, dry skin, pyrexia, and dysgeusia.

The most frequently reported Grade ≥3 adverse reactions (≥5%) in patients receiving IBRANCE plus letrozole by descending frequency were neutropenia, leukopenia, infections, and anemia.

Adverse reactions (≥10%) reported in patients who received IBRANCE plus letrozole or placebo plus letrozole in PALOMA-2 are listed in Table 4.

Table 4. Adverse Reactions (≥10%) in PALOMA-2
IBRANCE plus Letrozole
(N=444)
Placebo plus Letrozole
(N=222)
Adverse ReactionAll Grades
%
Grade 3
%
Grade 4
%
All Grades
%
Grade 3
%
Grade 4
%
Grading according to CTCAE 4.0.
CTCAE=Common Terminology Criteria for Adverse Events; N=number of patients; N/A=not applicable;
*
Infections includes all reported preferred terms (PTs) that are part of the System Organ Class Infections and infestations.
Most common infections (≥1%) include: nasopharyngitis, upper respiratory tract infection, urinary tract infection, oral herpes, sinusitis, rhinitis, bronchitis, influenza, pneumonia, gastroenteritis, conjunctivitis, herpes zoster, pharyngitis, cellulitis, cystitis, lower respiratory tract infection, tooth infection, gingivitis, skin infection, gastroenteritis viral, respiratory tract infection, respiratory tract infection viral, and folliculitis.
Stomatitis includes: aphthous stomatitis, cheilitis, glossitis, glossodynia, mouth ulceration, mucosal inflammation, oral pain, oral discomfort, oropharyngeal pain, and stomatitis.
§
Grade 1 events – 30%; Grade 2 events – 3%.
Grade 1 events – 15%; Grade 2 events – 1%.
#
Rash includes the following PTs: rash, rash maculo-papular, rash pruritic, rash erythematous, rash papular, dermatitis, dermatitis acneiform, and toxic skin eruption.

Infections and infestations

  Infections*

60

6

1

42

3

0

Blood and lymphatic system disorders

  Neutropenia

80

56

10

6

1

1

  Leukopenia

39

24

1

2

0

0

  Anemia

24

5

<1

9

2

0

  Thrombocytopenia

16

1

<1

1

0

0

Metabolism and nutrition disorders

  Decreased appetite

15

1

0

9

0

0

Nervous system disorders

  Dysgeusia

10

0

0

5

0

0

Gastrointestinal disorders

  Stomatitis

30

1

0

14

0

0

  Nausea

35

<1

0

26

2

0

  Diarrhea

26

1

0

19

1

0

  Vomiting

16

1

0

17

1

0

Skin and subcutaneous tissue disorders

  Alopecia

33§

N/A

N/A

16

N/A

N/A

  Rash#

18

1

0

12

1

0

  Dry skin

12

0

0

6

0

0

General disorders and administration site conditions

  Fatigue

37

2

0

28

1

0

  Asthenia

17

2

0

12

0

0

  Pyrexia

12

0

0

9

0

0

Clinically relevant adverse reactions in <10% of patients who received IBRANCE plus letrozole in PALOMA-2 included epistaxis (9%), lacrimation increased (6%), dry eye (4.1%), vision blurred (3.6%), and febrile neutropenia (2.5%).

Table 5. Laboratory Abnormalities in PALOMA-2
IBRANCE plus Letrozole
(N=444)
Placebo plus Letrozole
(N=222)
Laboratory AbnormalityAll Grades
%
Grade 3
%
Grade 4
%
All Grades
%
Grade 3
%
Grade 4
%
N=number of patients; WBC=white blood cells.

WBC decreased

97

35

1

25

1

0

Blood creatinine increased

96

2

<1

91

0

0

Neutrophils decreased

95

56

12

20

1

1

Hemoglobin decreased

78

6

0

42

2

0

Platelets decreased

63

1

1

14

0

0

Aspartate aminotransferase increased

52

3

0

34

1

0

Alanine aminotransferase increased

43

2

<1

30

0

0

PALOMA-3: IBRANCE plus Fulvestrant

Patients with HR-positive, HER2-negative advanced or metastatic breast cancer who have had disease progression on or after prior adjuvant or metastatic endocrine therapy

The safety of IBRANCE (125 mg/day) plus fulvestrant (500 mg) versus placebo plus fulvestrant was evaluated in PALOMA-3. The data described below reflect exposure to IBRANCE in 345 out of 517 patients with HR-positive, HER2-negative advanced or metastatic breast cancer who received at least 1 dose of IBRANCE plus fulvestrant in PALOMA-3. The median duration of treatment for IBRANCE plus fulvestrant was 10.8 months while the median duration of treatment for placebo plus fulvestrant arm was 4.8 months.

Dose reductions due to an adverse reaction of any grade occurred in 36% of patients receiving IBRANCE plus fulvestrant. No dose reduction was allowed for fulvestrant in PALOMA-3.

Permanent discontinuation associated with an adverse reaction occurred in 19 of 345 (6%) patients receiving IBRANCE plus fulvestrant, and in 6 of 172 (3%) patients receiving placebo plus fulvestrant. Adverse reactions leading to discontinuation for those patients receiving IBRANCE plus fulvestrant included fatigue (0.6%), infections (0.6%), and thrombocytopenia (0.6%).

The most common adverse reactions (≥10%) of any grade reported in patients in the IBRANCE plus fulvestrant arm by descending frequency were neutropenia, leukopenia, infections, fatigue, nausea, anemia, stomatitis, diarrhea, thrombocytopenia, vomiting, alopecia, rash, decreased appetite, and pyrexia.

The most frequently reported Grade ≥3 adverse reactions (≥5%) in patients receiving IBRANCE plus fulvestrant in descending frequency were neutropenia and leukopenia.

Adverse reactions (≥10%) reported in patients who received IBRANCE plus fulvestrant or placebo plus fulvestrant in PALOMA-3 are listed in Table 6.

Table 6. Adverse Reactions (≥10%) in PALOMA-3
Adverse ReactionIBRANCE plus Fulvestrant
(N=345)
Placebo plus Fulvestrant
(N=172)
All GradesGrade 3Grade 4All GradesGrade 3Grade 4
%%%%%%
Grading according to CTCAE 4.0.
CTCAE=Common Terminology Criteria for Adverse Events; N=number of patients; N/A=not applicable.
*
Infections includes all reported preferred terms (PTs) that are part of the System Organ Class Infections and infestations.
Most common infections (≥1%) include: nasopharyngitis, upper respiratory infection, urinary tract infection, bronchitis, rhinitis, influenza, conjunctivitis, sinusitis, pneumonia, cystitis, oral herpes, respiratory tract infection, gastroenteritis, tooth infection, pharyngitis, eye infection, herpes simplex, and paronychia.
Stomatitis includes: aphthous stomatitis, cheilitis, glossitis, glossodynia, mouth ulceration, mucosal inflammation, oral pain, oropharyngeal discomfort, oropharyngeal pain, stomatitis.
§
Grade 1 events – 17%; Grade 2 events – 1%.
Grade 1 events – 6%.
#
Rash includes: rash, rash maculo-papular, rash pruritic, rash erythematous, rash papular, dermatitis, dermatitis acneiform, toxic skin eruption.

Infections and infestations

  Infections*

47

3

1

31

3

0

Blood and lymphatic system disorders

  Neutropenia

83

55

11

4

1

0

  Leukopenia

53

30

1

5

1

1

  Anemia

30

4

0

13

2

0

  Thrombocytopenia

23

2

1

0

0

0

Metabolism and nutrition disorders

  Decreased appetite

16

1

0

8

1

0

Gastrointestinal disorders

  Nausea

34

0

0

28

1

0

  Stomatitis

28

1

0

13

0

0

  Diarrhea

24

0

0

19

1

0

  Vomiting

19

1

0

15

1

0

Skin and subcutaneous tissue disorders

  Alopecia

18§

N/A

N/A

6

N/A

N/A

  Rash#

17

1

0

6

0

0

General disorders and administration site conditions

  Fatigue

41

2

0

29

1

0

  Pyrexia

13

<1

0

5

0

0

Clinically relevant adverse reactions in <10% of patients who received IBRANCE plus fulvestrant in PALOMA-3 included asthenia (8%), dysgeusia (7%), epistaxis (7%), lacrimation increased (6%), dry skin (6%), vision blurred (6%), dry eye (3.8%), and febrile neutropenia (0.9%).

Table 7. Laboratory Abnormalities in PALOMA-3
Laboratory AbnormalityIBRANCE plus Fulvestrant
(N=345)
Placebo plus Fulvestrant
(N=172)
All Grades
%
Grade 3
%
Grade 4
%
All Grades
%
Grade 3
%
Grade 4
%
N=number of patients; WBC=white blood cells.

WBC decreased

99

45

1

26

0

1

Neutrophils decreased

96

56

11

14

0

1

Blood creatinine increased

95

1

0

82

0

0

Hemoglobin decreased

78

3

0

40

2

0

Platelets decreased

62

2

1

10

0

0

Aspartate aminotransferase increased

43

4

0

48

4

0

Alanine aminotransferase increased

36

2

0

34

0

0

INAVO120: IBRANCE plus Inavolisib and Fulvestrant

Adults with PIK3CA-mutated, HR-positive, HER2-negative, locally advanced or metastatic breast cancer whose disease progressed during or within 12 months of completing adjuvant endocrine therapy and who have not received prior systemic therapy for locally advanced or metastatic disease

The safety of the combination of IBRANCE plus inavolisib and fulvestrant was evaluated in a randomized, double-blind, placebo-controlled study (INAVO120) in 324 patients with PIK3CA-mutated, HR-positive, HER2-negative, locally advanced or metastatic breast cancer [see Clinical Studies (14)].

Patients received either IBRANCE 125 mg orally once daily for 21 consecutive days followed by 7 days off treatment to comprise a cycle of 28 days plus fulvestrant in combination with inavolisib (n=162) or placebo (n=162). The median duration of treatment for IBRANCE plus inavolisib and fulvestrant was 9 months (range: 0 to 39 months).

Serious adverse reactions occurred in 24% of patients who received IBRANCE plus inavolisib and fulvestrant. Serious adverse reactions occurring in ≥1% of patients receiving IBRANCE plus inavolisib and fulvestrant included anemia (1.9%), diarrhea (1.2%), and urinary tract infection (1.2%).

Fatal adverse reactions occurred in 3.7% of patients who received IBRANCE plus inavolisib and fulvestrant, including (0.6% each) acute coronary syndrome, cerebral hemorrhage, cerebrovascular accident, COVID-19 infection, and gastrointestinal hemorrhage.

Permanent discontinuation of IBRANCE associated with an adverse reaction occurred in 8 of 162 (4.9%) patients receiving IBRANCE plus inavolisib and fulvestrant and in 0 of 162 patients receiving IBRANCE plus placebo and fulvestrant. Adverse reactions leading to discontinuation of IBRANCE in patients receiving IBRANCE plus inavolisib and fulvestrant were neutropenia, infections, alanine aminotransferase increased, gastric ulcer, intestinal perforation, hyperglycemia, type 2 diabetes mellitus, bone pain, musculoskeletal pain, transitional cell carcinoma, and acute kidney injury (0.6% each).

Dose reduction of IBRANCE due to an adverse reaction occurred in 38% of patients receiving IBRANCE plus inavolisib and fulvestrant and in 30% of patients receiving IBRANCE plus placebo and fulvestrant. Adverse reactions leading to dose reductions of IBRANCE in ≥2% patients receiving IBRANCE plus inavolisib and fulvestrant were neutropenia (30%), leukopenia (6%), and thrombocytopenia (3.7%).

Dose interruption of IBRANCE due to an adverse reaction occurred in 71% of patients receiving IBRANCE plus inavolisib and fulvestrant and in 61% of patients receiving IBRANCE plus placebo and fulvestrant. Adverse reactions leading to dose interruption of IBRANCE in ≥2% patients receiving IBRANCE plus inavolisib and fulvestrant were neutropenia (56%), infections (29%), leukopenia (12%), stomatitis (4.9%), anemia (6%), thrombocytopenia (4.3%), diarrhea (3.7%), pyrexia (3.1%), alanine aminotransferase increased (2.5%), hyperglycemia (2.5%), and nausea (2.5%).

The most common (≥20%) adverse reactions, including laboratory abnormalities, were decreased neutrophils, decreased hemoglobin, increased fasting glucose, decreased platelets, decreased lymphocytes, stomatitis, diarrhea, decreased calcium, fatigue, decreased potassium, increased creatinine, increased alanine aminotransferase (ALT), nausea, decreased sodium, decreased magnesium, rash, decreased appetite, COVID-19 infection, and headache.

Adverse reactions and laboratory abnormalities in INAVO120 are summarized in Table 8 and Table 9, respectively.

Table 8. Adverse Reactions (≥10% with ≥5% [All Grades] or ≥2% [Grade 3-4] Higher Incidence in the IBRANCE plus inavolisib and fulvestrant Arm) in INAVO120
Adverse ReactionIBRANCE plus Inavolisib and Fulvestrant
(N=162)
IBRANCE plus Placebo and Fulvestrant
(N=162)
All Grades
(%)
Grade 3-4
(%)
All Grades
(%)
Grade 3-4
(%)
*
Includes aphthous ulcer, glossitis, glossodynia, lip ulceration, mouth ulceration, mucosal inflammation, and stomatitis.
No Grade 4 adverse reactions were observed.
Includes other related terms.
§
Includes dry skin, skin fissures, xerosis, and xeroderma.

Gastrointestinal Disorders

  Stomatitis*

51

6

27

0

  Diarrhea

48

3.7

16

0

  Nausea

28

0.6

17

0

  Vomiting

15

0.6

4.9

1.2

General Disorders and Administration Site Conditions

  Fatigue

38

1.9

25

1.2

Skin and Subcutaneous Tissue Disorders

  Rash

26

0

19

0

  Alopecia

19

0

6

0

  Dry skin§

13

0

4.3

0

Metabolism and Nutrition Disorders

  Decreased appetite

24

0

9

0

Infections and Infestations

  COVID-19 infection

23

1.9

10

0.6

  Urinary tract infection

15

1.2

9

0

Nervous System Disorders

  Headache

22

0

14

0

Investigations

  Decreased weight

17

3.7

0.6

0

Clinically relevant adverse reactions occurring in <10% of patients who received the triplet combination of IBRANCE plus inavolisib and fulvestrant included abdominal pain, dry eye, dysgeusia, and dyspepsia.

Table 9. Select Laboratory Abnormalities (≥10% with a ≥2% [All Grades or Grade 3-4] Higher Incidence in the IBRANCE plus Inavolisib and Fulvestrant Arm) in INAVO120
ALT=alanine aminotransferase.
*
The denominator used to calculate the rate varied from 122 to 160 based on the number of patients with a baseline value and at least one post-treatment value.
The denominator used to calculate the rate varied from 131 to 161 based on the number of patients with a baseline value and at least one post-treatment value.
No Grade 4 laboratory abnormalities were observed.
§
Grading according to CTCAE version 4.03.

Laboratory Abnormality

IBRANCE plus Inavolisib and Fulvestrant*

IBRANCE plus Placebo and Fulvestrant

All Grades (%)

Grade 3-4 (%)

All Grades (%)

Grade 3-4 (%)

Hematology

Neutrophils (total, absolute) decreased

95

82

97

79

Hemoglobin decreased

88

8

85

2.5

Platelets decreased

8

16

71

3.7

Lymphocytes (absolute) decreased

72

9

68

14

Chemistry

Glucose (fasting) increased§

85

12

43

0

Calcium decreased

42

3.1

32

3.7

Potassium decreased

38

6

21

0.6

Creatinine increased

38

1.9

30

1.2

ALT increased

34

3.1

29

1.2

Sodium decreased

28

2.5

19

2.5

Magnesium decreased

27

0.6

21

0

Lipase (fasting) increased

16

1.4

7

0

Other Clinical Trials Experience

The following adverse reaction has been reported following administration of IBRANCE: venous thromboembolism.

6.2 Postmarketing Experience

The following adverse reactions have been identified during post-approval use of IBRANCE. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Respiratory Disorders: Interstitial lung disease (ILD)/non-infectious pneumonitis

Skin and Subcutaneous Tissue Disorders: Palmar-plantar erythrodysesthesia syndrome (PPES)

Male Patients with HR-Positive, HER2-Negative Advanced or Metastatic Breast Cancer

Based on limited data from postmarketing reports and electronic health records, the safety profile for men treated with IBRANCE is consistent with the safety profile in women treated with IBRANCE.

Medication Guide

MEDICATION GUIDE

This Patient Information has been approved by the U.S. Food and Drug Administration. Revised September 2025

PATIENT INFORMATION
IBRANCE® (EYE-brans)
(palbociclib)
Capsules

What is the most important information I should know about IBRANCE?

IBRANCE may cause serious side effects, including:

Low white blood cell counts (neutropenia). Low white blood cell counts are very common when taking IBRANCE and may cause serious infections that can lead to death. Your healthcare provider should check your white blood cell counts before and during treatment.

If you develop low white blood cell counts during treatment with IBRANCE, your healthcare provider may stop your treatment, decrease your dose, or may tell you to wait to begin your treatment cycle. Tell your healthcare provider right away if you have signs and symptoms of low white blood cell counts or infections such as fever and chills.

Lung problems (pneumonitis). IBRANCE may cause severe or life-threatening inflammation of the lungs during treatment that can lead to death. Tell your healthcare provider right away if you have any new or worsening symptoms, including:

chest pain
cough with or without mucus
trouble breathing or shortness of breath

Your healthcare provider may interrupt or stop treatment with IBRANCE completely if your symptoms are severe.

See "What are the possible side effects of IBRANCE?" for more information about side effects.

What is IBRANCE?

IBRANCE is a prescription medicine used:

In adults to treat hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer that has spread to other parts of the body (metastatic) in combination with:

an aromatase inhibitor as the first hormonal based therapy, or
fulvestrant in people with disease progression following hormonal therapy.

In adults with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative and with an abnormal phosphatidylinositol-3-kinase catalytic subunit alpha (PIK3CA) gene breast cancer that has spread to nearby tissue or lymph nodes (locally advanced), or to other parts of the body (metastatic) in combination with:

inavolisib and fulvestrant in people with disease progression during or after adjuvant hormonal therapy.

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

What should I tell my healthcare provider before taking IBRANCE?

Before taking IBRANCE, tell your healthcare provider about all of your medical conditions, including if you:

have fever, chills, or any other signs or symptoms of infection.
have liver or kidney problems.
have any other medical conditions.
are pregnant, or plan to become pregnant. IBRANCE can harm your unborn baby.
o
Females who are able to become pregnant should use effective birth control during treatment and for at least 3 weeks after the last dose of IBRANCE. Your healthcare provider may ask you to take a pregnancy test before you start treatment with IBRANCE.
o
Males with female partners who can become pregnant should use effective birth control during treatment with IBRANCE for at least 3 months after the last dose of IBRANCE.
o
Talk to your healthcare provider about birth control methods that may be right for you during this time.
o
If you become pregnant or think you are pregnant, tell your healthcare provider right away.
are breastfeeding or plan to breastfeed. It is not known if IBRANCE passes into your breast milk. Do not breastfeed during treatment with IBRANCE and for 3 weeks after the last dose.

Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. IBRANCE and other medicines may affect each other causing side effects.

Know the medicines you take. Keep a list of them to show your healthcare provider or pharmacist when you get a new medicine.

How should I take IBRANCE?

Take IBRANCE exactly as your healthcare provider tells you.
Take IBRANCE with food.
IBRANCE should be taken at about the same time each day.
Swallow IBRANCE capsules whole. Do not chew, crush or open IBRANCE capsules before swallowing them.
Do not take any IBRANCE capsules that are broken, cracked, or that look damaged.
Avoid grapefruit and grapefruit products during treatment with IBRANCE. Grapefruit may increase the amount of IBRANCE in your blood.
Do not change your dose or stop taking IBRANCE unless your healthcare provider tells you.
If you miss a dose of IBRANCE or vomit after taking a dose of IBRANCE, do not take another dose on that day. Take your next dose at your regular time.
When IBRANCE is used in combination with inavolisib and fulvestrant, or an aromatase inhibitor, also read the Patient Information for the prescribed products.

What are the possible side effects of IBRANCE?

IBRANCE may cause serious side effects. See "What is the most important information I should know about IBRANCE?"

The most common side effects of IBRANCE when used with either letrozole or fulvestrant include:

Low red blood cell counts and low platelet counts are common with IBRANCE. Call your healthcare provider right away if you develop any of these symptoms during treatment:
o
dizziness
o
shortness of breath
o
weakness
o
bleeding or bruising more easily
o
nosebleeds
infections (see "What is the most important information I should know about IBRANCE?")
tiredness
nausea
sore mouth
abnormalities in liver blood tests
diarrhea
hair thinning or hair loss
increased blood creatinine

The most common side effects of IBRANCE when used in combination with inavolisib plus fulvestrant include:

high blood sugar levels leading to excessive thirst and urination
sore mouth
diarrhea
decreased white blood cell counts, red blood cell counts, and platelet counts
decreased blood levels of calcium, potassium, sodium, and magnesium
increased creatine blood levels
tiredness
abnormalities in liver blood tests
nausea
rash
loss of appetite
COVID-19 infection
headache

IBRANCE may cause fertility problems in males. This may affect your ability to father a child. Talk to your healthcare provider about family planning options before starting IBRANCE if this is a concern for you.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all of the possible side effects of IBRANCE.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How should I store IBRANCE?

Store IBRANCE at 68 °F to 77 °F (20 °C to 25 °C).

Keep IBRANCE and all medicines out of the reach of children.

General information about the safe and effective use of IBRANCE

Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use IBRANCE for a condition for which it was not prescribed. Do not give IBRANCE to other people, even if they have the same symptoms you have. It may harm them. You can ask your pharmacist or healthcare provider for more information about IBRANCE that is written for health professionals.

What are the ingredients in IBRANCE?

Active ingredient: palbociclib

Inactive ingredients: microcrystalline cellulose, lactose monohydrate, sodium starch glycolate, colloidal silicon dioxide, magnesium stearate, and hard gelatin capsule shells.

The light orange, light orange/caramel and caramel opaque capsule shells contain: gelatin, red iron oxide, yellow iron oxide, and titanium dioxide.

The printing ink contains: shellac, titanium dioxide, ammonium hydroxide, propylene glycol, and simethicone.

This product’s labeling may have been updated. For the most recent prescribing information, please visit www.pfizer.com.


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