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BCR-ABL TKI (specialist)

Dasatinib

Brand names: Sprycel

Adult dose

Dose: 100mg OD (CML chronic phase); 140mg OD (advanced phase / Ph+ ALL)
Route: Oral
Frequency: OD

Clinical pearls

  • NICE TA425 / TA451: chronic-phase CML 1st/2nd-line; Ph+ ALL with chemotherapy
  • BSH CML / ESMO
  • Echo and ECG baseline; pleural effusion screening at each visit

Contraindications

  • Hypersensitivity

Side effects

  • Pleural effusion (often dose-related, may need diuretics or dose reduction)
  • Pulmonary arterial hypertension (rare)
  • Cytopenias
  • Bleeding
  • QT prolongation
  • Diarrhoea
  • Cardiac dysfunction

Interactions

  • Strong CYP3A4 inhibitors/inducers
  • Acid-suppressants
  • QT-prolonging drugs

Monitoring

  • FBC
  • BCR-ABL
  • ECG
  • Echo
  • Pleural effusion
  • LFTs

Reference: BNF; NICE TA425; BSH CML guidelines; ESMO; SmPC; https://bnf.nice.org.uk/drugs/dasatinib-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.