Dasatinib (Sprycel®)

Dasatinib is a targeted therapy drug. It is used to treat chronic myeloid leukaemia (CML) and some types of acute lymphoblastic leukaemia (ALL). 

What is dasatinib?

Dasatinib is a targeted therapy. It is used to treat chronic myeloid leukaemia (CML) and may sometimes be used to treat some types of acute lymphoblastic leukaemia (ALL). 

It is best to read this information with our general information about  targeted therapies and the type of cancer you have.

Your doctor can tell you if dasatinib is suitable for you. Some people may be given dasatinib as part of a clinical trial. They can explain more about the treatment and its possible side effects before you agree (consent) to have treatment.

How dasatinib works

Dasatinib belongs to a group of targeted therapy drugs called tyrosine kinase inhibitors (TKI). Tyrosine kinase is a substance that stimulates leukaemia cells to grow and divide. Leukaemia cells can make high levels a substance called tyrosine kinase (TK).

Dasatinib works by switching off (inhibiting) tyrosine kinase and this causes the leukaemia cells to die.

How dasatinib is given

You have dasatinib as a tablet, which you can take at home. 

You will be given dasatinib as an outpatient. The nurse or pharmacist will give you the tablets to take home. 

During treatment you will see a haematologist (doctor who treats blood cancers), specialist nurse and a specialist pharmacist. This is who we mean when we mention doctor, nurse or pharmacist in this information. 

Dasatinib can reduce the number of blood cells in your blood. You will have regular blood tests during treatment to check this. A nurse or person trained to take blood (phlebotomist) will take the blood samples from you. This is to check that your blood test results are at a safe level to continue treatment. If they are not, your treatment may be delayed for a short while, to let blood cells levels to recover. 

You carry on taking dasatinib for as long as it is working for you and side effects can be managed. It is important that you do not stop taking it without talking to your doctor. 

Taking dasatinib capsules

Always take your tablets exactly as your doctor, nurse or pharmacist explains. This is important to make sure they work as well as possible for you.

You can take dasatinib with or without food. The tablets must be swallowed whole with a glass of water. They should not be chewed, opened or crushed. Take them at the same time every day. Do not take medicines for stomach acid (antacids) for 2 hours before or 2 hours after taking dasatinib. 

Other things to remember about your tablets:

  • If you forget to take the tablets, you should take the missed dose as soon as possible, within the same day. If a full day has gone by, let your doctor or nurse know. Do not take a double dose. If you are sick just after taking your tablets, contact the hospital.  Do not take another dose.
  • Wash your hands after taking your tablets. Keep them safe and out of sight and reach of children.
  • Other people should avoid direct contact with dasatinib tablets. 
  • Keep them in the original package and at room temperature, away from heat and direct sunlight.
  • It is important to get a new prescription before you run out of tablets and make sure you have plenty for holidays.
  • If your treatment is stopped, return any unused tablets to the pharmacist.

Grapefruit and grapefruit juice

Do not eat grapefruit or drink grapefruit juice while you are having this treatment. This can change how effective the drug is.

About side effects

We explain the most common side effects of this treatment here. We also include some less common side effects.

You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.

Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.

Serious and life-threatening side effects

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Contact the hospital

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

More information

We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.

Side effects of dasatinib

Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is sometimes called neutropenia.

An infection can be very serious when the number of white blood cells is low. It is important to get any infection treated as soon as possible. Contact the hospital straight away on the 24-hour contact number you have been given if:

  • your temperature goes over 37.5°C (99.5°F)
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection
  • your temperature goes below 36°C (96.8°F).

Symptoms of an infection include:

  • feeling shivery and shaking
  • a sore throat
  • a cough
  • breathlessness
  • diarrhoea
  • needing to pass urine (pee) a lot, or discomfort when you pass urine.

It is important to follow any specific advice your cancer treatment team gives you.

You will have regular blood tests during treatment. If needed, your doctor may reduce or delay your treatment for a short time, until your cell count increases.

Bruising and bleeding

This treatment can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot.

If the number of platelets is low, you may bruise or bleed easily. You may have:

  • nosebleeds
  • bleeding gums
  • heavy periods
  • blood in your urine (pee) or stools (poo)
  • tiny red or purple spots on the skin that may look like a rash.

Tell your doctor if you have any unexplained bruising or bleeding. You may need a drip to give you extra platelets. This is called a platelet transfusion.

Anaemia (low number of red blood cells)

This treatment can reduce the number of red blood cells in your blood. Red blood cells carry oxygen around the body. If the number of red blood cells is low, this is called anaemia. You may have symptoms such as:

  • pale skin
  • lack of energy
  • feeling breathless
  • feeling dizzy and light-headed.

Tell your doctor or nurse if you have these symptoms.

If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.

Fluid build-up

Dasatinib can sometimes cause swelling in the ankles or around the eyes. Sometimes fluid may build up in the lining of the lungs. This is known as pleural effusion. Rarely, fluid collects in the lining around the heart.

A build-up of fluid may be treated with steroids tablets or with drugs called diuretics. Diuretics make you pass more urine (pee). Sometimes doctors may ask you to stop taking dasatinib for a few days, until the fluid goes away.

Always tell your doctor if you develop swelling. It is important to contact your doctor or your hospital straight away if you develop any of the following:

  • a cough
  • chest pain
  • feeling more breathless than usual
  • gaining weight suddenly.

Diarrhoea

This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is usual for you, or having watery or loose stools. If you have a stoma, it will be more active than usual.

If you have diarrhoea:

  • try to drink at least 2 litres (3½ pints) of fluids each day
  • avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods
  • contact the hospital for advice.

Feeling sick

Your doctor can give you anti-sickness drugs to help prevent or control sickness. If you still feel sick, tell your doctor. They can prescribe other anti-sickness drugs that may work better for you.

Headaches

This treatment may cause headaches. If you have headaches, tell your doctor. They may give you painkillers to help.

Muscle, joint or bone pain

Muscle pain is a common side effect of dasatinib. Less commonly it can cause joint or bone pain. Your doctor can prescribe painkillers to help. Dasatinib can also cause muscle spasms in some people. Ask your doctor for advice if this is a problem for you.

Tummy (abdominal) pain

You may get pain or discomfort in your tummy (abdomen), feel bloated or have indigestion or wind. Your doctor can give you drugs to help improve these symptoms. Tell them if the pain does not get better.

Sometimes, these symptoms can be more severe.  Contact your doctor straight away if the pain does not get better, you have blood in your stools (poo) or develop a fever.

Sore mouth and throat

This treatment may cause a sore mouth and throat. You may also get mouth ulcers. This can make you more likely to get a mouth or throat infection. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.

If your mouth or throat is sore:

  • tell your nurse or doctor – they can give you a mouthwash or medicines to help
  • try to drink plenty of fluids
  • avoid alcohol, tobacco, and foods that irritate your mouth and throat.

Sucking ice chips may sometimes help relieve mouth or throat pain. But if you are having radiotherapy to the head or neck, do not suck on ice. It can cause damage.

Tiredness

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have enough time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.

Loss of appetite

If you lose your appetite during this treatment, 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 suggest how to build up your diet. They may give you food supplement drinks to try. Your doctor can prescribe these and you can buy them from chemists.

Skin changes

This treatment can affect your skin. Skin changes can include:

  • dryness
  • rashes
  • itching
  • acne
  • sweating more
  • skin being more sensitive to the sun. 

Tell your doctor or nurse if you have any skin changes or if they get worse. They can advise you about creams or lotions to use, or prescribe medicines to relieve itching.  

Rarely, more severe problems can develop.  If you have a severe rash or your skin starts to blister or peel, contact your doctor straight away.  

Hair thinning

You may notice your hair becomes thinner during treatment. This is usually temporary and hair grows back when you stop taking the dasatinib tablets. We have information on coping with hair loss.

Changes in mood and problems sleeping

Sometimes this treatment can cause mood changes such as depression or anxiety. If you feel depressed or anxious, or have other changes to your mood, tell your doctor. This treatment can also sometimes affect sleep. Tell your doctor if you are having difficulty sleeping.

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 help.

Hearing problems

Dasatinib may cause a ringing sound on your ears. It can also cause some hearing loss or problems with your balance. Contact your hospital team if this happens.

Effects on the lungs

This treatment can cause changes to the lungs. Tell your doctor if you develop:

  • a cough
  • wheezing
  • breathlessness.

You should also tell them if any existing breathing problems get worse. You may have tests to check your lungs.

Effects on the heart

This treatment can affect how the heart works. You may have tests to see how well your heart is working. These may be done before, during and after treatment.

If the treatment is causing heart problems, your doctor may change the type of treatment you are having.

 

Contact your doctor straight away on the 24-hour number the hospital has given you if you have any of these symptoms during or after treatment:
  • pain or tightness in your chest
  • breathlessness
  • dizziness
  • changes to your heartbeat.

Other conditions can cause these symptoms, but it is important to get them checked by a doctor. If you cannot get through to your doctor, call the NHS urgent advice number on 111.

Changes in blood pressure

Dasatinib may cause high blood pressure and less commonly, low blood pressure. If you already have high blood pressure and are on treatment to control it, tell your doctor. You may need to have regular blood pressure checks.

Raised levels of uric acid (tumour lysis syndrome)

This treatment may cause the cancer cells to break down quickly. This releases a waste product called uric acid into the blood. The kidneys usually get rid of uric acid but may not be able to cope with large amounts. Too much uric acid can cause swelling and pain in the joints. This is called gout. It may also cause other effects such as:

  • kidney problems
  • an abnormal heartbeat
  • seizures, although these are rare.

Your doctor may give you drugs to help prevent this. Drinking at least 2 litres (3½ pints) of fluids a day will also help. You will have regular blood tests to check the uric acid levels.

Other information

Blood clot risk

Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:

  • throbbing pain, redness or swelling in a leg or arm
  • suddenly feeling breathless or coughing
  • sharp chest pain, which may be worse when you cough or take a deep breath.

If you have any of these symptoms, contact the hospital straight away on the 24-hour contact number you have been given. If you cannot get through to your doctor, call the NHS urgent advice number on 111.

A blood clot is serious, but it can be treated with drugs that thin the blood (anticoagulants). Your doctor or nurse can give you more information.

You can help reduce the risk of developing a blood clot by:
  • staying active during treatment
  • drinking plenty of fluids, especially water.

You may be given anticoagulants to help prevent a clot.

Other medicines

Some medicines can affect how this treatment works or be harmful when you are having it. Always tell your cancer doctor about any drugs you are taking or planning to take, such as:

  • medicines you have been prescribed
  • medicines you buy in a shop or chemist
  • vitamins, herbal drugs and complementary therapies.

Tell other doctors, pharmacists or dentists who prescribe or give you medicines that you are having this cancer treatment.

You can visit the electronic Medicines Compendium (eMC) for more detailed information about your treatment.

Hepatitis B reactivation

If you have had Hepatitis B (a liver infection) in the past, this treatment can make it active again. Your doctor or nurse will talk to you about this and test you for Hepatitis B.

Lactose

This drug contains a small amount of lactose. Lactose is a type of sugar found in milk and dairy products. If you have a lactose intolerance, talk to your doctor.

Fertility

Some cancer drugs can affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

Sex

If you have sex while having this treatment, you need to use a condom. This is to protect your partner in case there is any dasatinib in the semen or vaginal fluids.

Contraception

Your doctor will advise you not to get pregnant or make someone pregnant while having this treatment. The drugs may harm a developing baby. It is important to use contraception during your treatment and for a while after treatment finishes. Your doctor, nurse or pharmacist can tell you more about this.

Breastfeeding

You are advised not to breastfeed while having this treatment, or for some time after treatment finishes. This is because the drugs could be passed to the baby through breast milk.

Your doctor or nurse can give you more information.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.

Vaccinations

Vaccinations can reduce your risk of getting certain infections. Your doctor or nurse may talk to you about having vaccinations.

Doctors usually recommend that people with cancer have a flu vaccination and a coronavirus vaccination. These are both inactivated vaccinations that can help reduce the risk of infection. People with weak immune systems can have these, as they are not live vaccinations.

If your immune system is weak, you need to avoid live vaccinations. This is because they can make you unwell. Live vaccines, such as shingles, contain a very weak version of the illness they are vaccinating you against. Your cancer doctor or GP can tell you more about live and inactivated vaccinations.