Dasatinib

Dasatinib Brand Name– Sprycel

What is Dasatinib

Dasatinib is an oral multi-tyrosine kinase inhibitor. It is indicated for the treatment of adult patients with previously untreated, chronic-phase Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML); chronic-phase, accelerated-phase, or myeloid or lymphoid blast-phase Ph+ CML with resistance or intolerance to prior therapy including imatinib; and Ph+ acute lymphoblastic leukemia (ALL) with resistance or intolerance to prior therapy.

Dasatinib is also indicated for use in pediatric patients 1 year of age and older with chronic-phase Ph+ CML (as a single agent) and newly diagnosed Ph+ ALL in combination with chemotherapy.

Severe myelosuppression has been reported; transfusions may be necessary.

Indications

1. acute lymphocytic leukemia (ALL)
2. chronic myelogenous leukemia (CML)

For the treatment of Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML)

NOTE: The FDA has designated dasatinib as an orphan drug for the treatment of CML.

for the treatment of myeloid or lymphoid blast-phase Ph+ CML with resistance or intolerance to prior therapy, including imatinib

Side Effects

1. abdominal pain
2. abdominal pain
3. acne vulgaris
4. acute respiratory distress syndrome (ARDS)
5. alopecia
6. amnesia
7. anemia
8. angina
9. anorexia
10. anorexia
11. anxiety
12. arthralgia
13. arthralgia
14. ascites
15. asthenia
16. ataxia
17. atopic dermatitis
18. atrial fibrillation
19. atrial flutter
20. bleeding
21. bleeding
22. blurred vision
23. bronchospasm
24. bullous rash
25. cardiac arrest
26. cardiomyopathy
27. chest pain (unspecified)
28. chills
29. cholecystitis
30. cholestasis
31. colitis
32. confusion
33. conjunctivitis
34. constipation
35. constipation
36. cough
37. cough
38. dehydration
39. dehydration
40. depression
41. diarrhea
42. diarrhea
43. dizziness
44. drowsiness
45. dysgeusia
46. dyspepsia
47. dysphagia
48. dysphonia
49. dyspnea
50. dyspnea
51. ecchymosis
52. edema
53. edema
54. elevated hepatic enzymes
55. enterocolitis
56. epistaxis
57. epistaxis
58. erythema
59. erythema
60. erythema multiforme
61. erythema nodosum
62. esophagitis
63. exfoliative dermatitis
64. fatigue
65. fatigue
66. fever
67. fever
68. fluid retention
69. fluid retention
70. flushing
71. gastritis
72. gastroesophageal reflux
73. GI bleeding
74. growth inhibition
75. growth inhibition
76. gynecomastia
77. headache
78. headache
79. hearing loss
80. heart failure
81. hematoma
82. hematuria
83. hepatitis
84. hyperbilirubinemia
85. hyperhidrosis
86. hypertension
87. hypertension
88. hyperuricemia
89. hypoalbuminemia
90. hypocalcemia
91. hypokalemia
92. hyponatremia
93. hypophosphatemia
94. hypotension
95. hypotension
96. hypoxia
97. ileus
98. increased urinary frequency
99. infection
100. infection
101. insomnia
102. interstitial lung disease
103. intracranial bleeding
104. lacrimation
105. libido decrease
106. livedo reticularis
107. lymphadenopathy
108. lymphopenia
109. maculopapular rash
110. maculopapular rash
111. malaise
112. menstrual irregularity
113. muscle cramps
114. musculoskeletal pain
115. musculoskeletal pain
116. myalgia
117. myocarditis
118. nausea
119. nausea
120. nephrotic syndrome
121. neutropenia
122. ocular hemorrhage
123. optic neuritis
124. oral ulceration
125. oral ulceration
126. osteonecrosis
127. osteopenia
128. palmar-plantar erythrodysesthesia (hand and foot syndrome)
129. palpitations
130. pancreatitis
131. panniculitis
132. peptic ulcer
133. pericardial effusion
134. pericarditis
135. peripheral edema
136. peripheral neuropathy
137. peripheral neuropathy
138. petechiae
139. phlebitis
140. photophobia
141. photosensitivity
142. pleural effusion
143. pneumonitis
144. proteinuria
145. pruritus
146. pruritus
147. pulmonary edema
148. pulmonary embolism
149. pulmonary hypertension
150. QT prolongation
151. rash
152. rash
153. rectal fistula
154. red cell aplasia
155. renal failure (unspecified)
156. rhabdomyolysis
157. seizures
158. sinus tachycardia
159. sinusitis
160. sinusitis
161. skin irritation
162. skin irritation
163. skin ulcer
164. spontaneous fetal abortion
165. Stevens-Johnson syndrome
166. stomatitis
167. stroke
168. syncope
169. thrombocytopenia
170. thrombosis
171. thrombotic microangiopathy
172. tinnitus
173. tremor
174. tumor lysis syndrome (TLS)
175. urticaria
176. vaginal bleeding
177. vasculitis
178. ventricular tachycardia
179. vertigo
180. vesicular rash
181. vesicular rash
182. visual impairment
183. vomiting
184. vomiting
185. weakness
186. weight gain
187. weight loss
188. xerophthalmia
189. xerosis

Monitoring Parameters

• CBC with differential
• serum electrolytes
• serum uric acid

Contraindications

• alcoholism
• anemia
• anticoagulant therapy
• bleeding
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• children
• contraception requirements
• diabetes mellitus
• edema
• females
• geriatric
• GI bleeding
• growth inhibition
• heart failure
• hypokalemia
• hypomagnesemia
• infants
• infertility
• intracranial bleeding
• lactase deficiency
• long QT syndrome
• malnutrition
• neonates
• neutropenia
• pericardial effusion
• pleural effusion
• pregnancy
• pulmonary hypertension
• QT prolongation
• reproductive risk
• thrombocytopenia
• thyroid disease
• tumor lysis syndrome (TLS)

Interactions

• Abarelix
• Abciximab
• Aclidinium; Formoterol
• Albuterol
• Albuterol; Ipratropium
• Alfuzosin
• Aluminum Hydroxide
• Aluminum Hydroxide; Magnesium Carbonate
• Aluminum Hydroxide; Magnesium Hydroxide
• Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
• Aluminum Hydroxide; Magnesium Trisilicate
• Amiodarone
• Amlodipine; Celecoxib
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Anagrelide
• Antacids
• Anticoagulants
• Antithrombin III
• Apalutamide
• Apixaban
• Apomorphine
• Arformoterol
• Argatroban
• Aripiprazole
• Arsenic Trioxide
• Artemether; Lumefantrine
• Asenapine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Atazanavir
• Atazanavir; Cobicistat
• Atomoxetine
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azithromycin
• Bedaquiline
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Betrixaban
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bivalirudin
• Brigatinib
• Budesonide; Formoterol
• Buprenorphine
• Buprenorphine; Naloxone
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Carbamazepine
• Celecoxib
• Ceritinib
• Chloramphenicol
• Chloroquine
• Chlorpromazine
• Cilostazol
• Ciprofloxacin
• Cisapride
• Citalopram
• Clarithromycin
• Clofazimine
• Clopidogrel
• Clozapine
• Cobicistat
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• Conivaptan
• Crizotinib
• Dabigatran
• Dalteparin
• Danaparoid
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Degarelix
• Delavirdine
• Desirudin
• Deutetrabenazine
• Dextromethorphan; Promethazine
• Dextromethorphan; Quinidine
• Diclofenac
• Diclofenac; Misoprostol
• Diflunisal
• Digoxin
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Dipyridamole
• Disopyramide
• Dofetilide
• Dolasetron
• Dolutegravir; Rilpivirine
• Donepezil
• Donepezil; Memantine
• Dronedarone
• Droperidol
• Duvelisib
• Edoxaban
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elbasvir; Grazoprevir
• Eliglustat
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Encorafenib
• Enoxaparin
• Entrectinib
• Enzalutamide
• Eptifibatide
• Eribulin
• Erythromycin
• Erythromycin; Sulfisoxazole
• Escitalopram
• Esomeprazole; Naproxen
• Etodolac
• Ezogabine
• Famotidine; Ibuprofen
• Fenoprofen
• Fingolimod
• Flecainide
• Fluconazole
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluphenazine
• Flurbiprofen
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• Fluvoxamine
• Fondaparinux
• food
• Formoterol
• Formoterol; Mometasone
• Fosamprenavir
• Foscarnet
• Fosphenytoin
• Gemifloxacin
• Gemtuzumab Ozogamicin
• Gilteritinib
• Glasdegib
• Glycopyrrolate; Formoterol
• Goserelin
• Granisetron
• grapefruit juice
• H2-blockers
• Halofantrine
• Halogenated Anesthetics
• Haloperidol
• Heparin
• Histrelin
• Hydrocodone; Ibuprofen
• Hydroxychloroquine
• Hydroxyzine
• Ibuprofen
• Ibuprofen; Oxycodone
• Ibuprofen; Pseudoephedrine
• Ibutilide
• Idelalisib
• Iloperidone
• Indacaterol
• Indacaterol; Glycopyrrolate
• Indinavir
• Indomethacin
• Inotuzumab Ozogamicin
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Itraconazole
• Ivosidenib
• Ketoconazole
• Ketoprofen
• Ketorolac
• Lansoprazole; Naproxen
• Lapatinib
• Lefamulin
• Lenvatinib
• Lepirudin
• Letermovir
• Leuprolide
• Leuprolide; Norethindrone
• Levalbuterol
• Levofloxacin
• Lithium
• Lofexidine
• Long-acting beta-agonists
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Lumacaftor; Ivacaftor
• Macimorelin
• Magnesium Hydroxide
• Maprotiline
• Meclofenamate Sodium
• Mefenamic Acid
• Mefloquine
• Meloxicam
• Meperidine; Promethazine
• Metaproterenol
• Methadone
• Metronidazole
• Midostaurin
• Mifepristone
• Mirtazapine
• Mitotane
• Moxifloxacin
• Nabumetone
• Naproxen
• Naproxen; Pseudoephedrine
• Naproxen; Sumatriptan
• Nefazodone
• Nelfinavir
• Nevirapine
• Nonsteroidal antiinflammatory drugs
• Norfloxacin
• Octreotide
• Ofloxacin
• Olanzapine
• Olodaterol
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole; Sodium Bicarbonate
• Ondansetron
• Osimertinib
• Oxaliplatin
• Oxaprozin
• Palifermin
• Paliperidone
• Panobinostat
• Pasireotide
• Penicillamine
• Pentamidine
• Pentosan
• Perphenazine
• Perphenazine; Amitriptyline
• Phenobarbital
• Phenylephrine; Promethazine
• Phenytoin
• Pimavanserin
• Pimozide
• Pirbuterol
• Piroxicam
• Pitolisant
• Posaconazole
• Prasugrel
• Prednisolone
• Primaquine
• Primidone
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Proton pump inhibitors
• Quetiapine
• Quinidine
• Quinine
• Ranolazine
• Ribociclib
• Ribociclib; Letrozole
• Rifampin
• Rilpivirine
• Risperidone
• Ritonavir
• Rivaroxaban
• Rofecoxib
• Romidepsin
• Salmeterol
• Saquinavir
• Sertraline
• Short-acting beta-agonists
• Siponimod
• Sodium Bicarbonate
• Solifenacin
• Sorafenib
• Sotalol
• St. John’s Wort, Hypericum perforatum
• Sulindac
• Sunitinib
• Tacrolimus
• Tamoxifen
• Telavancin
• Telithromycin
• Terbutaline
• Tetrabenazine
• Thioridazine
• Ticagrelor
• Ticlopidine
• Tinzaparin
• Tiotropium; Olodaterol
• Tipranavir
• Tolmetin
• Tolterodine
• Toremifene
• Trazodone
• Tricyclic antidepressants
• Trifluoperazine
• Triptorelin
• Tuberculin Purified Protein Derivative, PPD
• Umeclidinium; Vilanterol
• Valdecoxib
• Vandetanib
• Vardenafil
• Venlafaxine
• Vorapaxar
• Voriconazole
• Vorinostat
• Warfarin
• Ziprasidone