Dasatinib (Sprycel ®)
Dasatinib is a targeted therapy used to treat chronic myeloid leukaemia (CML) and also acute lymphoblastic leukaemia (ALL).
When dasatinib is used
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Dasatinib may be used to treat:
chronic myeloid leukaemia (CML), a cancer of white blood cells
a type of acute lymphoblastic leukaemia (ALL) called Philadelphia chromosome positive (Ph+ALL), if other treatment hasn’t worked or has caused too many side effects.
The National Institute for Health and Clinical Excellence (NICE) gives advice on which new drugs or treatments should be available in the NHS in England and Wales. The Scottish Medicines Consortium (SMC) makes recommendations for Scotland. The Department of Health, Social Services and Public Safety (DHSSPS) makes recommendations for Northern Ireland. All of these bodies agree dasatinib is not recommended for use in the NHS to treat CML, on grounds of cost effectiveness.
The SMC has also said that dasatinib is not a cost-effective treatment for ALL, so it isn’t recommended for use within the Scottish NHS. NICE and DHSSPS haven’t issued guidance on dasatinib for ALL. Dasatinib is not widely available in the NHS, although you may be given it as part of a clinical trial.
Dasatinib is a type of treatment called a tyrosine kinase inhibitor. It works by blocking (inhibiting) signals within the leukaemia cells that make them grow and divide. Blocking the signals causes the cells to die.
Dasatinib is usually taken once a day. Take the tablets at the same time each day with a large glass of water. You can take them with or without a meal. It’s important not to crush or break the tablets. Do not take medicines that neutralise stomach acids (antacids) for two hours before or two hours after taking dasatinib. Avoid grapefruit juice as this can increase side effects.
If you forget to take a tablet, don’t take a double dose to make it up. Keep to your regular schedule and let your doctor or nurse know. If you are sick just after taking dasatinib, contact the hospital. You may need to take another dose.
Here are some other things to remember about your tablets:
Keep them in the original package at room temperature, away from heat and direct sunlight.
Keep them safe and out of the reach of children.
Return any remaining tablets to the pharmacist if your treatment is stopped.
Possible side effects of dasatinib
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Each person’s reaction to dasatinib is different. Some people have very few side effects, while others may experience more. The side effects described here won't affect everyone having this treatment.
We explain the most common side effects, but haven't included those that are less common and therefore unlikely to affect you. If you notice any effects that aren't listed here, discuss them with your doctor or specialist nurse.
The side effects of dasatinib are generally mild or moderate and usually stop once treatment finishes.
Effect on blood cells
Dasatinib can reduce the number of blood cells in your blood. This is less common if you are having treatment for chronic-phase CML. You will have regular blood tests done to check the numbers of blood cells in your blood.
Risk of infection
If you have a low number of white blood cells you are more likely to get an infection. If this happens during your treatment, your doctor or nurse will advise you how to reduce your risk of infection. Your doctor may also ask you to stop taking your tablets for a short time until your white blood cell numbers recover, or they may ask you to take a lower dose of dasatinib.
Contact the hospital straight away if:
your temperature goes over 37.5°C (99.5° F) or over 38°C (100.4° F), depending on the advice given by your healthcare team
you suddenly feel unwell, even with a normal temperature
you have symptoms of an infection – this can include feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine a lot.
Bruising and bleeding
Dasatinib can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any bruising or bleeding you can’t explain. This includes nosebleeds, bleeding gums, blood spots or rashes on the skin. You can have a platelet transfusion if your platelet count is low. Your doctor may ask you to stop taking dasatinib or reduce the dose for a while.
Anaemia (low number of red blood cells)
Dasatinib can reduce the number of red blood cells in your blood. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this. You may need to have a blood transfusion if your number of red blood cells becomes too low.
Build up of fluid
This is a common side effect. It can affect different parts of your body. Most commonly it causes swelling of the ankles or swelling around the eyes. Sometimes fluid may collect in the lining of the lungs (pleural effusion). It may be treated with drugs that make you pass more urine (diuretics) or with steroid tablets. Sometimes treatment with dasatinib is stopped for a few days until the fluid settles. It can then be restarted.
Always tell your doctor if you notice any fluid build up. It’s important to contact them straight away if you develop a cough, chest pain, feel more breathless than usual, or if you gain weight suddenly.
Dasatinib can cause diarrhoea. This can usually be easily controlled with medicine but you should tell your doctor if it's severe or continues. It's important to drink plenty of fluids if you have diarrhoea.
Feeling sick and being sick
Your doctor can prescribe anti-sickness (anti-emetic) drugs to prevent, or greatly reduce, any sickness. If the sickness isn't controlled, or if it continues, tell your doctor; they can prescribe other anti-sickness drugs that may work better for you. Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.
If you have more headaches than usual or if they are more severe let your doctor or nurse know. They can give you painkillers to relieve them.
Muscle and bone pain
Some people have muscle, joint or bone pain while having treatment. Your doctor can prescribe painkillers if you're affected this way.
If you feel more tired than usual it’s important to pace yourself and get as much rest as you need. Try to balance this with taking some gentle exercise, such as short walks, which will help.
Loss of appetite
If your appetite is affected, try to eat smaller meals more often. If you find it difficult to eat enough, ask to speak to a nurse or dietitian. They can give you advice on getting more calories and protein in your diet. They may give you food supplements or meal replacement drinks to try. Your doctor can prescribe some of these and you can buy them from chemists.
Effects on the skin
Rashes, dryness, itching, increased sweating or greater sensitivity to sunlight are quite common. These side effects are usually mild. Speak to your doctor or nurse if you have any of these skin changes. They can advise you about creams or lotions to use, or prescribe medicines to relieve itching.
Effects on the eyes
Your eyes may become dry or you may notice changes to how well you can see (blurred vision). In some people, this may affect their ability to drive safely. Tell your doctor if you notice any of these changes. They may prescribe eye drops to soothe your eyes.
A small number of people may notice a change in their heartbeat. Heartbeats may be less regular or the heart may feel as if it's beating too fast. If you notice any changes in your heartbeat, tell your doctor immediately.
It’s important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they’re not mentioned above.
Other information about dasatinib
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Some medicines, including those that you can buy in a shop or chemist, can be harmful to take when you’re taking dasatinib. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Your ability to become pregnant or father a child may be affected by having this treatment. It's important to discuss fertility with your doctor before starting treatment.
Women who could become pregnant should use an effective contraceptive while on dasatinib treatment. This is because it’s not known if dasatinib could affect a developing baby.
As dasatinib may be present in breast milk, women are advised not to breastfeed while taking dasatinib and for a few months afterwards.
If you’re admitted to hospital for a reason not related to the cancer, it’s important to tell the doctors and nurses looking after you that you are having dasatinib treatment. You should tell them the name of your cancer specialist so that they can ask for advice.
It’s a good idea to know who you should contact if you have any problems or troublesome side effects when you’re at home. During office hours you can contact the clinic or ward where you had your treatment. Your specialist nurse or doctor will tell you who to contact during the evening or at weekends.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (eMC; medicines.org.uk). If you’d like further information on the sources we use, please feel free to contact us.
This information was reviewed by a medical professional.
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