Sprycel-Dasatinib

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

Uses For This Medication
  • Dasatinib is used to treat a certain type of leukemia called chronic myeloid leukemia (CML) that has never or is no longer responding to other treatments, including imatinib (Gleevec®). It is also used to treat a certain type of acute lymphoblastic leukemia (ALL) called Philadelphia chromosome positive ALL (Ph+ ALL).
  • Dasatinib is being studied for the treatment of other tumors and blood-based cancers including prostate cancer, myeloproliferative disorders, chronic lymphocytic leukemia, breast cancer, brain cancer, melanoma, hepatocelullar carcinoma (liver cancer), lung cancer, pancreatic cancer, and sarcoma.
  • This medication may also be given for other conditions as determined by your doctor.
  How This Medication Works Dasatinib is a chemotherapy medication that belongs to a group of medications known as multi-kinase inhibitors. Multi-kinase inhibitors are a new kind of treatment known as “targeted therapy” that is different from traditional chemotherapy. Most chemotherapy medications work by killing rapidly dividing cells in the body. Multi-kinase inhibitors work by blocking one or more proteins that help cancer cells divide and grow. This leads to tumor cell death. Benefits Of This Medication Dasatinib has been shown to lower the number of white blood cells or immune cells circulating throughout the body. In addition, it blocks the growth of white blood cells or immune cells that carry an abnormal protein linked to chronic myeloid leukemia (CML) or Ph+ ALL. Dasatinib has been shown to slow the progress of chronic myeloid leukemia (CML) and help prevent the development of a more severe form of leukemia. Dasatinib has also been shown to slow the progress of Ph+ ALL. Who Should Not Take This Medication You should not take this medication if you are allergic to dasatinib or any of its components. Precautions To Be Aware Of Before Taking This Medication

Blood related precautions

  • This medication may temporarily reduce the number of germ fighting white blood cells in your blood. This can increase your risk of infection. Contact your doctor or healthcare provider right away if you develop any signs of an infection such as fever, painful urination, chills or a sore throat that doesn’t go away. If your white blood cell levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed and/or you receive medication to increase the number ofwhite cells in your blood. To lower your risk of infection, stay away from crowds and people with colds or other illnesses, wash your hands well and often, and brush and floss your teeth daily.
  • This medication may temporarily reduce the number of platelets in your blood. This can increase your risk of bleeding. Contact your doctor or healthcare provider if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. If your platelet levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a platelet transfusion, and/or that you take medication to help increase the number of platelets in your blood. To lower your chance of bleeding, do not use aspirin, aspirin-containing medications, or aspirin-like medications.
  • This medication may temporarily lower the number of red cells in your blood. This can increase your risk of anemia. If your red blood cell level becomes low, you may feel tired and weak. If your red blood cell level becomes too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a red blood cell transfusion, and/or you receive a medication to help increase the red cells in your blood.
 

Organ related precautions

  • This medication should be used with caution in people with a history of heart disease, including a history of heart attack or abnormal rhythm (heartbeat). Rarely, dasatinib therapy has been shown to cause an abnormal heart rhythm (heartbeat) or heart attack. Your doctor or healthcare provider will check your heart regularly while you are on this medication to make sure that your heart is working properly. If you have any problems with your heart or are taking any medications for previous problems with your heart rhythm, make sure that you tell your doctor or healthcare provider before you start taking this medication so that he or she can watch you carefully for possible problems or side effects. In addition, you should let your doctor or healthcare provider know if you experience symptoms such as fainting, dizziness, or heart palpitations (fluttering).
 

Miscellaneous precautions

  • This medication can cause you to retain water. Your doctor or healthcare provider will weigh you regularly and check you for water retention. Contact your doctor or healthcare provider right away if you experience sudden weight gain or other signs of fluid build-up such as swollen legs or feet.
  • Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval.
  • This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent.
  • Some of the active ingredients in this medication will be excreted in your vomit, urine, or stool for about 48 hours after the dose is taken. For their protection, advise your caregiver(s) to use caution and avoid direct contact with any of these bodily fluids when assisting you during this time period.
 

Patient specific precautions

  • It is not known if this medication is safe and effective in children.
 

Pregnancy and breastfeeding precautions

  • This medication may cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
  • Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future.
  Medication And Food Interactions Before using this medication, tell your doctor or healthcare provider of all prescription or over-the- counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with dasatinib and the following medications:
  • Alfentanil (Alfenta®)
  • Amiodarone (Cordarone®)
  • Antacids (see list below)*
  • Aprepitant (Emend®)
  • Atazanavir (Reyataz®)
  • Phenytoin (Dilantin®)
  • Pimozide (Orap®)
  • Posaconazole (Noxafil)
  • Rifampin (Rifadin®)
  • Rifabutin (Mycobutin®)
  • Carbamazepine (Tegretol®)
  • Clarithromycin (Biaxin®)
  • Cyclosporine
  • Dexamethasone
  • Dihydroergotamine
  • Ergotamine
  • Erythromycin
  • Fentanyl (Fentanyl®)
  • Grapefruit, grapefruit juice
  • Indinavir (Crixivan®)
  • Itraconazole (Sporanox®)
  • Ketoconazole (Nizoral®)
  • Nefazodone (Serzone®)
  • Nelfinavir (Viracept®)
  • Phenobarbital
  • Rifapentin
  • Ritonavir (Norvir®)
  • Saquinavir (Invirase®)
  • Sirolimus (Rapamune®)
  • St.John’s wort
  • Tacrolimus (Prograf®)
  • Telithromycin (Ketek®)
  • Temsirolimus (Torisel™)
  • Voriconazole (Vfend®)
  • Medications that can increase the risk of bleeding [warfarin (Coumadin®), heparin, aspirin, NSAIDS such as ibuprofen (Advil®), naproxen (Aleve®), sulindac (Clinoril®), ketoprofen (Oruvail®)]
    • *Medications used to reduce stomach acid may interfere with dasatinib and include cimetidine (Tagamet®), esomeprazole (Nexium®), famotidine (Pepcid®), lansoprazole (Prevacid®), omeprazole (Prilosec®), pantoprazole (Protonix®), rabeprazole (Aciphex®) and ranitidine (Zantac®). You should avoid taking these medications.
    • *Medications used to buffer stomach acid may also interfere with dasatinib, such as those containing aluminum hydroxide, calcium carbonate, or magnesium hydroxide. These medications may be taken at least 2 hours before or 2 hours after taking dasatinib.
NOTE: This list may not include all medications that can have interactions with dasatinib. Side Effects  
  • The side effects associated with dasatinib listed below are taken from the manufacturer package insert.
  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • The incidence and type of side effects may vary depending on what type of cancer you have as well as whether dasatinib is being given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with dasatinib alone.
 

More common side effects

  • Swelling of the hands or feet (see Precautions To Be Aware Of Before Taking This Medication)
  • Nausea, diarrhea
  • Headache, tiredness (fatigue)
  • Bleeding (see Precautions To Be Aware Of Before Taking This Medication)
  • Muscle and bone pain, abdominal pain
  • Fever, Infection
  • Skin rash
  • Shortness of breath, cough
  • Decreased white blood cells and platelets (see Precautions To Be Aware Of Before Taking This Medication)
 

Less common side effects

  • Fluid in the lining of the lungs (pleural effusion), heart (pericardial effusion), or abdomen (ascites) (see Precautions To Be Aware Of Before Taking This Medication)
  • Vomiting, anorexia (loss of appetite), weight loss, weight gain, constipation
  • Muscle and Joint aches
  • Redness/Soreness of mouth and throat, stomach irritation
  • Chest pain, heart rhythm disturbances (see Precautions To Be Aware Of Before Taking This Medication)
  • Nerve pain and tingling, itching
  • Chills, pneumonia
  • Low red blood cells (see Precautions To Be Aware Of Before Taking This Medication)
  • Low blood phosphorus levels
  Rare side effects This is not a complete list of the rare side effects reported with dasatinib. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Other heart problems (see Precautions To Be Aware Of Before Taking This Medication)
  • Low blood calcium levels
  • Increased liver function tests or inflammation of the liver
  • Decreased kidney function
  • Inflammation of the pancreas
  • Skin and nail problems, including dry skin, acne, dermatitis, sensitivity to sunlight, skin discoloration, and hair thinning
  • Dizziness, fainting, tremors, convulsions
  • Eye problems, including inflammation of eyelids and dry eyes
  • Flushing, high or low blood pressure
  • Anxiety, difficulty sleeping, confusion, depression
  • Increased blood uric acid levels
  • Growth of breasts in male patients
  How To Take This Medication
  • This medication is taken by mouth (orally) once or twice a day with or without a meal, and should be taken at the same time each day. If you do not understand these instructions, ask your doctor or healthcare provider to explain them to you. Your dose may be changed if your doctor feels it is necessary based on how your body tolerates the medication and depending on other medications you may be taking.
  • Do not cut or crush tablets. They must be swallowed whole.
  • If you miss a dose, take it as soon as you remember. However, if it is within a few hours of your next scheduled dose, do not double up on your medication; just take your next scheduled dose and continue on at that point as prescribed.
  • It is important that you only use this medication when it’s been prescribed for you. Sharing this medication with someone for whom it is not prescribed could cause harm.
  • If you accidentally take too many pills or someone else accidentally takes your medication, contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
  Proper Storage
  • Store this medication at room temperature and keep in its original container.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.