section name header

Pronunciation

boe-SUE-ti nib

Classifications

Therapeutic Classification: antineoplastics

Pharmacologic Classification: kinase inhibitors

Indications

High Alert

Action

Therapeutic Effects:

Pharmacokinetics

Absorption: 34% absorbed following oral administration; absorption with high-fat meal.

Distribution: Extensively distributed to tissues.

Protein Binding: 96%.

Metabolism/Excretion: Mostly metabolized, mainly by the CYP3A4 isoenzyme; metabolites do not have antineoplastic activity.

Half-life: 22.5 hr.

Time/Action Profile

(beneficial hematologic response)

ROUTEONSETPEAKDURATION
POwithin 8–12 wk4–6 hr (plasma concentrations)9–18 mo or longer

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: chest pain, HF, myocardial ischemia, pericardial effusion, pericarditis, peripheral edema, QT interval prolongation, tachycardia.

Derm: itching, rash, acne, STEVENS-JOHNSON SYNDROME (SJS).

EENT: tinnitus.

Endo: hypothyroidism.

F and E: dehydration, hyperkalemia.

GI: liver enzymes, abdominal pain, diarrhea, nausea, vomiting, gastritis, GI bleeding, HEPATOTOXICITY, pancreatitis.

GU: fertility, renal impairment.

Hemat: anemia, neutropenia, thrombocytopenia.

Metab: appetite.

MS: arthralgia, back pain, myalgia.

Neuro: dizziness, fatigue, headache, dysgeusia.

Resp: cough, pulmonary edema.
Misc: fever, (INCLUDING ANAPHYLAXIS)HYPERSENSITIVITY REACTIONS .

Interactions

Drug-Drug:

Drug-Natural Products:

Drug-Food:

Route/Dosage

Chronic Phase Ph+ CML Resistant/Intolerant to Previous Therapies

Renal Impairment

Renal Impairment

Renal Impairment

Renal Impairment

Renal Impairment

Renal Impairment

Hepatic Impairment

Hepatic Impairment

Hepatic Impairment

Hepatic Impairment

Newly Diagnosed Chronic Phase Ph+ CML

Renal Impairment

Renal Impairment

Renal Impairment

Renal Impairment

Renal Impairment

Renal Impairment

Hepatic Impairment

Hepatic Impairment

Hepatic Impairment

Accelerated/Blast Phase Ph+ CML Resistant/Intolerant to Previous Therapies

Renal Impairment

Hepatic Impairment

Availability

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Bosulif