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Tyrosine Kinase Inhibitor — CML

Nilotinib

Brand names: Tasigna

Nilotinib is an oral second-generation BCR-ABL tyrosine kinase inhibitor used to treat Philadelphia chromosome-positive chronic myeloid leukaemia.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It selectively inhibits the constitutively active BCR-ABL tyrosine kinase produced by the Philadelphia chromosome, blocking the proliferative signalling that drives the leukaemic clone.

Prescribing in practice

  • It can prolong the QT interval and has been associated with sudden death, so correct electrolytes, review interacting drugs and obtain ECGs as advised; it must be taken on an empty stomach because food increases absorption and QT risk.
  • It is a CYP3A4 substrate, so strong inhibitors and inducers and other interacting drugs require careful management.
  • Cardiovascular and peripheral arterial occlusive events have been reported, so optimise cardiovascular risk factors.

Monitoring

Monitor ECG and electrolytes, full blood count, liver function, lipids, glucose and lipase during treatment.

Counselling the patient

  • Take the capsules on an empty stomach, avoiding food for the periods stated in the SPC.
  • Avoid grapefruit and tell your team about all other medicines.
  • Report palpitations, blackouts or symptoms of poor circulation in the legs.

Evidence & guidelines

Nilotinib is an established first- and second-line treatment for chronic-phase CML, supported by NICE technology appraisals.

Reference: ENESTnd Trial (Saglio et al. NEJM 2010); NICE TA251; SPC Tasigna; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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