Sprycel
Newly diagnosed adults with Ph+ CML in chronic phase; Ph+ CML with resistance or intolerance to prior therapy including imatinib (chronic, accelerated, or myeloid/lymphoid blast phase); Ph+ ALL with resistance or intolerance to prior therapy; Pediatric patients with Ph+ CML in chronic phase.
CML chronic phase: 100 mg orally once daily
CML accelerated/blast or Ph+ ALL: 140 mg orally once daily (may increase to 180 mg)
Pediatric: Tablets dosed by body weight; oral powder formulation available
Take with or without food. Do not crush or cut tablets.
Tablets: 20 mg, 50 mg, 70 mg, 80 mg, 100 mg, 140 mg
None listed.
- Myelosuppression: Grade 3-4 neutropenia (36%), thrombocytopenia (24%), anemia (13%). Monitor CBC every 2 weeks × 12 weeks, then monthly.
- Pleural Effusion: In 28% of CML-CP patients (Grade 3-4 in 3%). Consider chest X-ray if respiratory symptoms develop.
- Pulmonary Arterial Hypertension (PAH): May occur after initiation, including years after start. Evaluate if suspected; permanently D/C if confirmed.
- Cardiac Dysfunction: CHF, QT prolongation, MI reported. Monitor ECGs and electrolytes.
- Hemorrhage: Severe CNS and GI hemorrhage reported (4%). Fatal hemorrhage in 1%.
- Fluid Retention: Edema (23%), pleural effusion (28%), pericardial effusion (4%), ascites (1%).
Fluid retention (35%), diarrhea (31%), headache (33%), pleural effusion (28%), musculoskeletal pain (22%), rash (21%), nausea (24%), fatigue (19%), dyspnea (17%), hemorrhage (15%), vomiting (12%)
Consult the complete prescribing information for a comprehensive list of adverse reactions and their frequencies.
Dasatinib is a kinase inhibitor that inhibits BCR-ABL, SRC family kinases (SRC, LCK, YES, FYN), c-KIT, EPHA2, and PDGFRβ. It binds to multiple conformations of ABL kinase, including both active and inactive forms, making it effective against many imatinib-resistant BCR-ABL mutations (except T315I). Dasatinib achieves 325-fold greater potency against unmutated BCR-ABL compared to imatinib in vitro.
Tmax: 0.5-6 hours. Half-life: 3-5 hours. Protein binding: 96%. Metabolized primarily by CYP3A4. Excreted in feces (85%) and urine (4%). Steady-state by Day 7.
Clinical efficacy and safety data supporting the approval are available in the full prescribing information and from the clinical trials listed below.
- DASISION — Dasatinib vs. imatinib in newly diagnosed chronic-phase CML. Phase III, n=519.