BCR-ABL TKI (specialist)
Bosutinib
Brand names: Bosulif
Adult dose
Dose: 500mg PO OD (chronic phase 1st-line); 400mg OD (some indications); per protocol
Route: Oral
Frequency: OD with food
Clinical pearls
- NICE TA401 / TA451: CML 1st-line and resistant
- BSH CML; ESMO
- Specialist haemato-oncology — BCR-ABL monitoring
Contraindications
- Severe hepatic impairment
- Pregnancy
- Hypersensitivity
Side effects
- Diarrhoea (very common)
- Hepatotoxicity
- Cytopenias
- Cardiac dysfunction
- QT prolongation
- Renal toxicity
- Fluid retention
Interactions
- Strong CYP3A4 inhibitors/inducers
- PPIs/H2 blockers (separate / avoid)
Monitoring
- FBC
- LFTs
- Renal
- BCR-ABL
- ECG
Reference: BNF; NICE TA401; NICE TA451; BSH CML; ESMO; SmPC; https://bnf.nice.org.uk/drugs/bosutinib-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Myeloid Leukaemia Presentation · BSH; NICE — NG146
- Tumour Lysis Syndrome · Cairo-Bishop; BSH; NICE — Best Practice
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158