Bosutinib (Bosulif ®)
Bosutinib is used to treat chronic myeloid leukaemia (CML).
Bosutinib, also called Bosulif®, may be used to treat some people with chronic myeloid leukaemia (CML).
Bosutinib is a type of treatment called a tyrosine kinase inhibitor (TKI). It’s also known as a cancer growth blocker. A kinase is a protein that helps cells in the body grow and divide. Kinase inhibitors block (inhibit) these types of protein and stop them working on the cells.
Bosutinib works by blocking signals in the leukaemia cells that make them grow and divide. Blocking the signals causes these cells to die.
Bosutinib is a treatment for people with Philadelphia chromosome positive chronic myeloid leukaemia (Ph+ CML) and who have been previously treated with one or more tyrosine kinase inhibitors (TKIs). It is also used for people who aren’t able to have other TKIs.
Bosutinib may only be available in some situations. Your cancer doctor can tell you if it's appropriate for you. Some people may be given it as part of a clinical trial.
If a drug isn’t available on the NHS, there may be different ways you are still able to have it. Your cancer doctor can give you advice. We have further information on what to do if a treatment isn’t available.
Bosutinib is a tablet that is taken once a day. The tablet should be swallowed whole and taken after food at around the same time every day. There are some important things to remember when taking your tablets:
- Do not eat grapefruit or drink grapefruit juice when you take bosutinib, as this may make side effects worse.
- Keep the tablets in the original packaging and store them at room temperature away from heat and direct sunlight.
- Keep the tablets in a safe place, out of reach of children.
- If your doctor decides to stop the treatment, return any remaining tablets to the pharmacist. Don't flush them down the toilet or throw them away.
- If you're sick just after taking the tablets, let your doctor know. You may need to take another dose. Don't take another tablet without telling your doctor first.
- If you forget to take a tablet, don't take a double dose. Tell your doctor and keep to your regular dose schedule.
Bosutinib is a long-term treatment and you should carry on taking it for as long as your specialist doctor (haematologist) tells you. During your treatment you’ll have regular blood tests to see how well it is working for you.
Possible side effects of bosutinibBack to top
We have included the most common side effects of bosutinib here. We haven’t included all of the less common and rarer side effects. You may get some of the side effects we mention, but you will not get them all.
It's important to let your doctor know straight away if you feel unwell or have any severe side effects. Your doctor can prescribe drugs to help control some side effects. It is very important to take them exactly as your nurse or pharmacist has explained. This will help the drugs work as well as possible for you.
Your nurse will give you advice about managing side effects. After your treatment is over, side effects will start to improve. Always tell your doctor or nurse about the side effects you have.
Serious and life threatening side effects
Sometimes cancer drugs can result in very serious side effects, which rarely may be life threatening. Your haematology doctor and nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. You can call them if you feel unwell or need advice any time of day or night. Save these numbers in your phone or keep them somewhere safe.
More Information about the drug
We’re not able to list every side effect for this treatment here, particularly the rarer ones. For more detailed information you can visit the electronic Medicines Compendium (eMC).
Risk of infection
Bosutinib can reduce the number of white cells in your blood. This will make you more likely to get an infection. When the number of white blood cells is low, it’s called neutropenia.
Contact the hospital straight away on the contact number you’ve been given 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 hospital
- 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.
You will have blood tests while you’re taking bosutinib to check the number of white blood cells. If they get too low, your doctor may ask you to stop taking bosutinib or reduce the dose for a time.
Anaemia (low number of red blood cells)
Bosutinib can reduce the number of red blood cells which carry oxygen around the body. A low red blood cell count is called anaemia. This may make you feel tired and breathless. Tell your doctor or nurse if you have these symptoms. You may need to have a blood transfusion if the number of red blood cells becomes too low. Your dose of bosutinib may also be reduced.
Bruising or bleeding
Bosutinib can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. Rarely, you may need to have a platelet transfusion if your platelet count is low. If this happens, your doctor will adjust the bosutinib dose.
This can happen after taking the first dose of bosutinib. It can usually be controlled with medicine, but tell your doctor if it is severe or continues. It's important to drink around two litres (three and a half pints) of fluid every day if you have diarrhoea.
Your doctor can prescribe effective anti-sickness (anti-emetic) drugs to prevent or reduce sickness or vomiting. 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.
Tummy (abdominal) pain
Some people find that bosutinib causes pain or discomfort in their tummy. Let your doctor or nurse know if this happens to you. They can give you painkillers to relieve it.
Effects on the lungs
Bosutinib can cause a cough and shortness of breath. Always tell your doctor if you develop wheezing, a cough, a fever or feel breathless. You should also let them know if any existing breathing problems get worse. If necessary, they can arrange for you to have tests to check your lungs.
Your skin may become dry and itchy or you may develop a mild skin rash. Making sure you drink enough fluids can help. Your doctor can also prescribe medicine or creams to help with skin changes, or reduce the bosutinib dose.
Feeling very tired is common. It’s important to try to pace yourself and get as much rest as you need. Try to balance this with some gentle exercise, such as short walks, which will help.
Some people find that bosutinib causes headaches. Let your doctor or nurse know if this happens to you. They can give you painkillers to relieve it.
Loss of appetite
Some people lose their appetite while they’re having bosutinib. If it doesn’t improve, you can ask to see a dietitian or specialist nurse at your hospital. They can give you advice on improving your appetite and keeping to a healthy weight.
Changes in the way the liver or kidneys work
You'll have regular blood tests to check how well your liver and kidneys are working.
Changes to the heart
A small number of people taking bosutinib develop a change in their heart rhythm. Heartbeats may become less regular or the heart may feel as if it's beating too fast. If you notice any changes in your heart rhythm, or if you have pain in your chest, let your doctor know straight away.
You’ll have tests to check your heart rhythm (ECG) before your treatment starts.
Some people may feel light-headed or as if they’re going to lose their balance. If this happens, be careful not to move too quickly.
Muscle and joint pains
You may have joint or muscle pains, especially in your back. Let your doctor know if you develop these. They can prescribe painkillers to help.
Tell your doctor or nurse if your temperature goes over 37.5°C (99.5°F) or 38°C (100.4°F), depending on the advice given by your hospital.
Fluid build-up (retention) can affect different parts of the body. Most commonly, it causes swelling of the ankles or swelling around the eyes. Drugs that make you pass more urine (diuretics) can help to get rid of some of the fluid. A short course of steroids may also be helpful. Usually, fluid build-up settles without treatment.
Sometimes fluid may collect in the lining of the lungs, which is known as pleural effusion. Rarely, fluid collects in the tummy area, called ascites, or in the sac around the heart, called pericardial effusion.
It's important that you drink around two litres (three and a half pints) of fluids every day while having treatment with bosutinib.
If you develop a cough, have chest pain, feel breathless or gain weight suddenly, let your doctor know straight away. It’s important to let your doctor know immediately if you feel unwell or have any severe side effects, even if they’re not mentioned above.
Other information about bosutinibBack to top
Some medicines, including those that you can buy in a shop or chemist, can increase the side effects of bosutinib or reduce its effectiveness. 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.
It is not advisable to become pregnant or father a child while taking bosutinib. This is because little is known about the effects of bosutinib on a developing baby.
It is safest to avoid sex or use a condom for about 48 hours after treatment. This is to protect your partner, as bosutinib may be present in your semen or vaginal fluid.
Women are advised not to breastfeed during treatment and for a few months afterwards. This is in case bosutinib is present in their breast milk.
If you’re admitted to hospital for a reason not related to cancer, it’s important to tell the doctors and nurses looking after you that you are having bosutinib treatment. You should tell them the name of your cancer specialist so that they can ask for advice.
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.
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