BCR-ABL tyrosine-kinase inhibitor
Ponatinib (Specialist drug)
Brand names: Iclusig
Adult dose
Dose: Specialist initiation only — refer to BNF/SmPC
Route: PO
Frequency: OD
Clinical pearls
- CML/Ph+ ALL resistant/intolerant to other TKIs (incl. T315I mutation)
- Specialist haem-onc — high vascular risk
Contraindications
- Severe hepatic impairment
- Recent arterial/venous thrombosis
Side effects
- Arterial thrombotic events (black box)
- Hepatotoxicity
- HF
- Hypertension
- Pancreatitis
- Severe haemorrhage
Interactions
- Strong CYP3A4 modulators
- Anticoagulants
Monitoring
- BP
- ECG
- LFTs
- Lipase
- Cardiovascular assessment
Reference: BNF; NICE TA451/TA764; SmPC; https://bnf.nice.org.uk/drugs/ponatinib-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
- 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
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO