Dasatinib (Sprycel®)

Dasatinib comes as tablets. The nurse or pharmacist will give you them to take home. Always take them exactly as explained. This is important to make sure they work as well as possible for you. 
During treatment, you usually see a:

• blood cancer doctor (haematologist)
• cancer nurse or specialist nurse
• specialist pharmacist. 

This is who we mean when we mention doctor, nurse or pharmacist in this information. You will speak to a doctor, nurse or pharmacist before you have treatment. They will ask how you have been feeling. 

During treatment, a nurse or person trained to take blood (phlebotomist) will take regular blood samples from you. These are to check that your blood cells are at a safe level for you to have your treatment and also check your general health.

Sometimes your doctor may have to stop or lower your dose for a while depending on your blood test results.

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.

Take dasatinib at the same time every day with or without food. The tablets must be swallowed whole with a glass of water. They should not be chewed, opened or crushed. If the tablets do get broken, other people should not touch them. 

You should not take medicines for stomach acid (antacids) for 2 hours before or after taking dasatinib. 

Do not take dasatinib with grapefruit or drink grapefruit juice, as it may increase the risk of side effects.

Other things to remember about your tablets:

• If you forget to take the tablets, you should take the next dose at the scheduled time. Do not take a double dose to make up for the forgotten one. 
• If you are sick just after taking your tablets, contact the hospital.  Do not take another dose.
• Keep them in the original package and at room temperature, away from moisture, heat and direct sunlight.
• Keep them safe, somewhere children cannot see or reach them.
• Wash your hands after taking your tablets.
• Other people should avoid direct contact with the tablets. 
• If your treatment is stopped, return any unused tablets to the pharmacist.

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If your white blood cell count is low, you may be more likely to get an infection. A low white blood cell count is 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. If you have any of the following symptoms, contact the hospital straight away on the 24-hour number:

• a temperature above 37.5°C 
• a temperature below 36°C
• you feel unwell, even with a normal temperature
• you have symptoms of an infection.

Symptoms of an infection include:

• feeling shivery and shaking
• a sore throat
• a cough
• breathlessness
• diarrhoea
• needing to pass urine (pee) often, 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 your white blood cell count is low, your doctor may stop your treatment for a short time, until your cell count increases. Sometimes they will reduce the dose of your treatment.

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, brown or purple spots that may look like a rash – these spots can be harder to see if you have black or brown skin. 

If you have any unexplained bruising or bleeding, contact the hospital straight away on the 24-hour number. You may need a drip to give you extra platelets. This is called a platelet transfusion.

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 feel:

• very low in energy
• breathless 
• dizzy and light-headed. 

If you have these symptoms, contact the hospital straight away on the 24-hour number. You may need treatment for anaemia. If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.

This treatment 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 steroid tablets or with drugs called diuretics. Diuretics make you pass more urine (pee). Sometimes doctors may ask you to stop taking this drug 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.

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

If you are passing loose stools 3 or more times a day and this is not normal for you, contact the hospital as soon as possible on the 24-hour number. Follow the advice they give you about:

• taking anti-diarrhoea medicines 
• drinking enough fluids to keep you hydrated and to replace lost salts and minerals
• any changes to your diet that might help. 

They might also ask you for a specimen of your stool to check for infection.

Your doctor can prescribe 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.

This treatment may cause headaches. If you have headaches, tell your doctor, nurse or pharmacist. They can give you advice about painkillers that may help. Tell them if the headache does not get better, or gets worse.

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

You may get pain in your tummy (abdomen), or have indigestion. Your doctor can give you drugs to help improve these symptoms. Tell them if the pain gets worse or 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.

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.

Contact the hospital straight away on the 24-hour number, if:

• your mouth or throat is sore, or affecting how much fluid you can drink or food you can eat 
• your mouth, tongue, throat or lips have any blisters, ulcers or white patches. 

They can give you advice, and mouthwash or medicines to help with the pain or to treat any infection. Follow their advice and make sure you:

• drink plenty of fluids
• avoid alcohol and tobacco
• avoid food or drinks that irritate your mouth and throat.

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest between activities.

Being physically active can help to manage tiredness and give you more energy. It also:

• helps you sleep better
• reduces stress
• improves your bone health.

If you feel sleepy, do not drive or operate machinery.

This treatment can affect your appetite. Don’t worry if you do not eat much for 1 or 2 days. But if your appetite does not come back after a few days, or if you are losing weight, tell your doctor, nurse or pharmacist. They can give you advice. They may give you food or drink supplements. Or they may suggest changes to your diet or eating habits to help.

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, or you feel unwell with flu-like symptoms such as a fever and pain in your joints, contact your doctor straight away. 

While you are having this treatment, your hair may become thinner, drier and more brittle. This is usually mild. If you are worried about this, ask your nurse for advice on hair care.

You may feel low or depressed, or have mood swings, during this treatment. Talking to family and friends about how you feel might help. If mood changes last for more than a few weeks, tell your doctor, nurse or pharmacist. They can talk to you about different ways to manage low mood or depression.

This treatment can make your eyes feel dry. Your doctor may give you eye drops to help.

This treatment can also affect your eyesight. It may cause blurred vision. Do not drive if you notice this.

Tell your doctor if you notice any changes with your eyes or vision.

This treatment may cause a ringing sound on your ears. It can also cause some hearing loss, dizziness or problems with your balance. Tell your doctor or nurse if you notice this.

Do not drive or operate machinery if you feel dizzy.

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

• a cough that does not go away
• wheezing
• breathlessness.

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

This treatment can affect how the heart works. You may have tests to check 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 the hospital straight away on the 24-hour number if you have any of these symptoms during or after treatment:

• breathlessness
• dizziness
• changes to your heartbeat
• swollen feet and ankles.

Other conditions can cause these symptoms, but it is important to get them checked by a doctor. 

Always call 999 if you have:

• chest pain, pressure, heaviness, tightness or squeezing across the chest
• difficulty breathing.

This treatment may cause high blood pressure and. Sometimes, it may cause low blood pressure. You may need to have regular blood pressure checks.

Cancer and some cancer treatments can increase the risk of a blood clot. Contact the hospital straight away on the 24-hour number if you have any of these symptoms during or after treatment:

• throbbing pain or swelling in a leg or arm
• reddening of the skin in the area – if you have black or brown skin, this can be harder to notice, but the skin might become darker
• suddenly feeling breathless or coughing.

Always call 999 if you have:

• chest pain
• difficulty breathing.

A blood clot is serious, but it can be treated with drugs called anticoagulants. These thin the blood. Your doctor, nurse or pharmacist can give you more information about preventing and treating blood clots.

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

• medicines you have been prescribed
• medicines you buy in a shop, pharmacy or online
• vitamins or supplements 
• herbal drugs and complementary or homeopathic therapies
• recreational drugs – for example, cannabis.

Doctors usually recommend that people with cancer have vaccinations for flu and for coronavirus (covid). These help reduce your risk of serious illness from these infections. Most people can have these vaccines, including people with weak immune systems.

If your immune system is weak, you should not have live vaccinations. Live vaccines can make you unwell because they contain a very weak version of the illness they will protect you against. Live vaccines include Zostavax^®, which is a shingles vaccine, and the yellow fever vaccine.

It is important to ask your doctor, nurse or pharmacist for advice about having vaccinations. They can explain what vaccines are right for you and when it is best to have them.

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.

It is possible that small amounts of chemotherapy may be passed on through vaginal fluids or semen. If you have sex during this treatment, your cancer team will usually advise using condoms or a dental dam to protect your partner.

Your doctor, nurse or pharmacist will advise you not to get pregnant or make someone pregnant while having this treatment and for some time afterwards. The drugs may harm a developing baby. It is important to use contraception to prevent pregnancy. Follow their advice about:

• what types of contraception to use 
• how long after treatment you should continue to use contraception. 

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

Your doctor, nurse or pharmacist can give you more information.

If you need medical treatment for any reason other than cancer, always tell the healthcare professional that you are having cancer treatment. Give them the contact details for your cancer doctor or cancer team so they can ask for advice.

If you have appointments with a dentist, always tell them you are having cancer treatment. Talk to your cancer team before you have any dental treatment.