Adult Dosing
CML, chronic Phase
- Start 100 mg PO qd; may increase to 140 mg PO qd
- If on strong CYP3A4 inhibitor: Consider decreasing dose to 20 mg/day. If dasatinib is not tolerated after dose reduction, either discontinue the CYP3A4 inhibitor or discontinue dastinib temporarily
- If on strong CYP3A4 inducer: Consider increasing dose and monitor patients for signs of toxicity
CML, accelerated, or myeloid or lymphoid blast crisis
- Start 140 mg PO qd; may increase to 180 mg PO qd
- If on strong CYP3A4 inhibitor: Consider decreasing dose to 40 mg/day. If dasatinib is not tolerated after dose reduction, either discontinue the CYP3A4 inhibitor or discontinue temporarily
- If on strong CYP3A4 inducer: Consider increasing dose and monitor patients for signs of toxicity
Ph-positive ALL
- Start 140 mg PO qd; may increase to 180 mg PO qd
- If on strong CYP3A4 inhibitor: Consider decreasing dose to 40 mg/day. If dasatinib is not tolerated after dose reduction, either discontinue the CYP3A4 inhibitor or discontinue temporarily
- If on strong CYP3A4 inducer: Consider increasing dose and monitor patients for signs of toxicity
Note:
- Tablets should not be crushed or cut and can be taken with or without meal
- See prescribing information for details about dose adjustments based on toxicity
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Severe thrombocytopenia, neutropenia, and anemia have been reported with dasatinib therapy; more frequent in patients with advanced phase CML or Ph+ ALL than in chronic phase CML. Perform complete blood counts weekly for the first 2 months and then monthly thereafter, or as clinically indicated. Myelosuppression is generally reversible and can be managed by temporarily withholding the therapy or with dose reduction
- Dasatinib causes platelet dysfunction leading to severe CNS hemorrhages, severe gastrointestinal hemorrhage and other hemorrhage including fatalities; discontinue the treatment and provide transfusions. Use cautiously in patients receiving medications that inhibit platelet function or anticoagulants
- Severe fluid retention causing ascites, generalized edema, severe pulmonary edema, pleural effusion have been reported with dasatinib therapy; manage the condition with diuretics or short courses of steroids
- Dasatinib has the potential to prolong cardiac ventricular repolarization (QT interval); use cautiously in patients who have or are at risk of developing QT prolongation. Correct hypokalemia or hypomagnesemia prior to dasatinib administration
- Cardiac adverse reactions including cardiomyopathy, heart failure congestive, diastolic dysfunction, fatal myocardial infarction, and left ventricular dysfunction have been reported in patients receiving dasatinib
- Dasatinib can cause fetal harm; advise women of childbearing potential to avoid becoming pregnant while receiving treatment
Cautions: Use cautiously in
- Hepatic impairment
- Myelosuppression
- Concomitant use of anticoagulant
- Thrombocytopenia
- Hypokalemia
- Hypomagnesemia
- Concurrent QT prolonging agents
- Have develop or at risk of QT prolongation
- Risk of cardiovascular diseases
- Fluid retention
- Thyroid disorder
- Cumulative high-dose anthracycline therapy
- Elderly patients
Supplemental Patient Information
- Advise patients not to drink grapefruit juice during therapy
Pregnancy Category:D
Breastfeeding: Safety unknown. Since many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or to discontinue the drug taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Sprycel 20 MG TABS [Bottle] (B-M SQUIBB U.S. (PRIMARY CARE))
30 mg = $2304
90 mg = $6777.22
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
