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Dasatinib (Sprycel® )

Warning: The U.S. Food and Drug Administration (FDA) is warning the public that Sprycel (dasatinib) may increase the risk of a rare, medical condition called pulmonary arterial hypertension (PAH). This condition is characterized by abnormal high blood pressurein the arteries of the lungs, causing the heart to work harder to able to pump blood into the lungs. This overworking can make theheart muscle to become weak and unable to pump enough blood through the lungs.  

Cancer patients treated with Dasatinib may develop the PAH right after starting Sprycel or up to a year after treatment. Symptoms of pulmonary hypertension often include shortness of breath, fatigue, and swelling of the body such as the ankles and legs. Be sure to report anything you experience to your doctor. If you are concerned you are having an allergic or other negative reaction to this medication, seek medical assistance immediately.

Indications: Dasatinib is an anti-cancer medication that is best for treating metastatic melanoma and specific types of leukemia, and usually only in patients who have either reacted badly to other leukemia treatments, or cannot use other treatments for other reasons.

In some rare cases Dasatinib can be used to treat certain specific noncancerous diseases, but this is uncommon and should be thoroughly discussed with your doctor.

Dosage:  Dasatinib is available in tablet form to be taken by mouth. This medication is usually taken once or twice daily at about the same time each day, with or without food. The amount of active medicine in each tablet will vary, and it is important to follow the directions of your doctor and on your prescription label as closely as you possibly can. Depending on how you react to your medication, your doctor may either increase or decrease your dosage, but this is nothing to be concerned about unless you are experiencing uncomfortable or dangerous side effects.

Never stop talking this or any medication without first talking to your doctor, even if you are experiencing side effects or, alternatively, you start to feel better.

Storage: keep Dasatinib tightly closed in the container it came, out of the reach of children. Store Dasatinib at room temperature (15-25 ° C), away from heat above 40 ° C, light and moisture. Dasatinib and all other medications should not be used beyond the expiration date printed on the container.  

Overdose: overdosing any chemotherapy drug can be fatal. The risk of complication is even higher when the drug is overdosed for a long term. In fact, overdosing of certain chemotherapy drugs, including Dasatinib, can lead to death. Even in the absence of overdose, Dasatinib can damage the bone marrow. It is extremely important that you take the medication as indicated by your health care provider or according to the directions on the label.    

Missing dose: It is important to take the medication around the same time every day. In case you forget to take a dose, take the missed one as soon as you remember it. However, if it is almost time for your next dose, do not double the next dose to recover the missed one. Contact your doctor or wait to go back to your regular schedule.    

Contraindications : If you have ever had liver disease, heart disease, other heart conditions, low levels of magnesium or potassium in the blood, or if you have ever been lactose intolerant, you should report these things to your doctor before you begin taking your medication. If you develop any of these conditions while on Dasatinib, contact your doctor as soon as possible.

Dasatinib is contraindicated in case of:  

  • allergy to the drug or any of the constituents 
  • allergy to lactose  
  • pregnancy  
  • Breast-feeding.  

Mechanism of action (MOA): Dasatinib is a protein-tyrosine kinase inhibitor which kills cancer cells by blocking the protein kinases, proteins that are located within the leukemic cells, and are responsible for their uncontrolled proliferation.  

Interactions: A number of medications can have dire effects on patients who are taking Dasatinib. Several of these drugs, namely those which fight blood breakdown through liver enzymes, and thicken your blood and cause many undesirable and dangerous side effects (Sporanox, Biaxin, Reyataz, Crixivan, Viracept, Norvir, Invirase, Ketek, Vfend, and even grapefruit juice are examples with this side effect). Some medications and even herbal supplements can make Dasatinib ineffective by decreasing the concentration of Dasatinib in your system. Some medications that are taken to reduce acid levels in the stomach can also reduce the amount of Dasatinib that is absorbed into your system. Dasatinib can increase the side effects in the medication simvastatin and other medications that are broken down in a similar way.

Side effects: In addition to attacking cancer cells, Dasatinib may interfere with certain normal cells, and lead to the development of side effects in some patients; most common Dasatinib side effects include: 

  • headache
  • muscle pain
  • tiredness
  • loss of appetite
  • weight loss
  • weakness
  • pain in the joint, hands or feet 
  • skin rash
  • peeling skin
  • mouth sores and/or swelling 
  • diarrhea
  • constipation
  • nausea and vomiting
  • Stomach pain or swelling  

If the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor if you experience any of these symptoms:

  • dizziness
  • fainting
  • severe depression symptoms
  • infections: fever, sore throat, chills,...
  • sudden severe headache
  • swelling of the eyes, hands, arms, feet, or ankles
  • sudden weight gain
  • shortness of breath or difficulty breathing
  • coughing up bloody mucus
  • persistent chest pain or chest pressure
  • rapid or irregular heartbeat
  • unusual bruising or bleeding
  • black and tarry stools
  • blood in stools or urine
  • bloody vomit
  • slow or difficult speech
  • Weakness or numbness of an arm or leg

 

 

References: 

pslgroup.com,  

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a607063.html   

http://www.fda.gov/Drugs/DrugSafety/ucm275155.htm