Mabic

Indications

Dasatinib is a cancer medicine used in adults and children for:

• chronic myeloid leukaemia (CML) that is Philadelphia chromosome-positive, either newly diagnosed or when earlier treatment such as Imatinib has stopped working or was not tolerated;
• Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL), often together with chemotherapy.

It is started and supervised by a blood cancer specialist (haematologist or oncologist).

How It Works

Dasatinib is a tyrosine kinase inhibitor. In these leukaemias, an abnormal protein called BCR-ABL sends constant signals that make white blood cells grow out of control. Dasatinib blocks this protein and some related ones, which slows or stops the growth of the leukaemia cells.

Dosage and Administration

As prescribed by the cancer specialist. The dose depends on the type and stage of leukaemia and, in children, on body weight. It is usually taken once a day.

Swallow the tablet whole with water, at about the same time each day, in the morning or evening, with or without food. Do not crush, cut or chew it.

The specialist may pause treatment or change the dose based on blood counts and side effects. If a dose is missed, skip it and take the next dose at the usual time; do not take two doses together. Do not stop treatment without the specialist.

Interactions

• Ketoconazole, Itraconazole, Clarithromycin, Ritonavir and grapefruit juice can raise Dasatinib levels.
• Rifampicin, Carbamazepine, Phenytoin, Dexamethasone and St John's wort can lower its levels.
• Stomach acid reducers such as Omeprazole, Esomeprazole and Famotidine reduce its absorption and are usually avoided. If an antacid is needed, take it at least 2 hours before or 2 hours after Dasatinib.
• Warfarin, Aspirin, Clopidogrel and other blood thinners raise the risk of bleeding.
• Medicines that affect heart rhythm (QT prolongation) need caution.

Contraindications

Do not use Dasatinib if you are allergic to Dasatinib or any ingredient of the product.

Side Effects

Common: low blood counts (raising the risk of infection, bleeding and anaemia), fluid retention and swelling, diarrhoea, nausea, headache, rash, tiredness, muscle pain and shortness of breath.

Get urgent medical help if you have:

• fever, chills, sore throat or other signs of infection;
• unusual bleeding or bruising, black stools or blood in the urine;
• new or worsening shortness of breath, chest pain or cough (fluid around the lungs or high pressure in the lung arteries);
• rapid weight gain or swelling;
• a fast or irregular heartbeat or fainting;
• severe diarrhoea or vomiting;
• a severe skin rash with blisters.

Pregnancy and Lactation

Dasatinib can harm an unborn baby. Do not use it during pregnancy. Women who could become pregnant should use effective contraception during treatment and for at least 30 days after the last dose. Do not breastfeed during treatment and for at least 2 weeks after the last dose.

Precautions and Warnings

• Regular blood counts are needed, more often at the start.
• Tell your doctor if you have heart or lung disease, liver problems, or a history of hepatitis B, which can become active again.
• The doctor will watch for fluid around the lungs and for high blood pressure in the lungs.
• Children taking Dasatinib need regular checks of growth and bone development.
• Pregnant women should not handle crushed or broken tablets.

Overdose

An overdose may cause severe low blood counts and bleeding. Contact the treating specialist or go to the nearest hospital at once.

Therapeutic Class

Anticancer medicine; tyrosine kinase inhibitor (BCR-ABL inhibitor).

Storage

Store below 30°C in a dry place, away from light, in the original pack. Keep out of the reach of children.