BCR-ABL tyrosine-kinase inhibitor (2nd gen)
Nilotinib (Specialist drug)
Brand names: Tasigna
Adult dose
Dose: Specialist initiation only — refer to BNF/SmPC
Route: PO
Frequency: BD
Clinical pearls
- CML; specialist haematology
- ECG before, day 7, after dose change; correct K+/Mg2+; take fasting
Contraindications
- Long QT syndrome
- Hypokalaemia/hypomagnesaemia
- Concurrent QT-prolonging drugs
- Severe hepatic impairment
Side effects
- QT prolongation / sudden death (BLACK BOX)
- Hyperglycaemia
- Pancreatitis
- Hepatotoxicity
- Vascular events (PAOD)
- Cytopenias
- Tumour lysis syndrome
Interactions
- Strong CYP3A4 modulators
- QT-prolonging drugs
- Drugs raising gastric pH (separate)
Monitoring
- ECG
- FBC
- LFTs
- Glucose
- Lipase
Reference: BNF; NICE TA251; SmPC; https://bnf.nice.org.uk/drugs/nilotinib-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Vancomycin Dosing Calculator · Drug Dosing
- Phenytoin Correction for Albumin / Renal Failure · Drug Dosing
- Local Anaesthetic Maximum Dose Calculator · Drug Dosing
- Tisdale Risk Score for QT Prolongation · Arrhythmia
- Bazett Corrected QT Interval (QTc) Calculator · Arrhythmia
- DAPT Score for Dual Antiplatelet Therapy Duration · Antiplatelet Therapy
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