Dasatinib (Sprycel®)
Pronounce: da-SA-ti-nib
Classification: Tyrosine Kinase Inhibitor
About Dasatinib (Sprycel®)
A kinase is an enzyme that promotes cell growth. There are many types of kinases, which control different phases of cell growth. By blocking a particular enzyme from working, this medication can slow the growth of cancer cells.
How to Take Dasatinib
This medication comes as a tablet to take by mouth. It is usually taken once a day, with or without food. Take it at around the same time every day. Do not crush, chew, or break the tablets. If you miss a dose, take your next dose as scheduled. Do not take 2 doses to make up for a missed dose. This medication contains lactose, which may be important if you have lactose intolerance.
It is important to take the correct amount of medication. Before each dose, check that the medication and the amount match what your provider prescribed.
The blood levels of this medication can be affected by certain foods and medications, so they should be avoided. These include: grapefruit, grapefruit juice, verapamil, ketoconazole, rifampin, phenytoin, St. John’s wort, and modafinil. Be sure to tell your provider about all medications and supplements you take.
This medication is best absorbed by your stomach in the presence of stomach acid. For this reason, you should not take medications that reduce stomach acid, including proton pump inhibitors (omeprazole, Nexium, Protonix, Prevacid), or H2 blockers (tagamet, zantac, pepcid). Antacids, such as Tums and Rolaids, work by neutralizing stomach acid, and can be taken up to 2 hours before or 2 hours after you take this medication.
Storage and Handling
Store your medication in the original container with the label. If you want to use a pillbox, talk to your pharmacist. Keep it in a dry place at room temperature unless your provider or pharmacist tells you otherwise. Keep containers out of reach of children and pets.
If a caregiver prepares your dose for you, they should consider wearing gloves or pour the pills directly from their container into the cap, a small cup, or directly into your hand. They should avoid touching the pills. They should always wash their hands before and after giving you the medication. Pregnant or nursing people should not prepare the dose for you. Ask your provider where to return any unused medication for disposal. Do not flush down the toilet or throw in the trash.
Where Do I Get This Medication?
Some cancer medications are only available through specialty pharmacies. Your provider or pharmacist will start this process. Your insurance plan may also affect where you can get your medication. Call your prescription plan provider to find out which specialty pharmacies are in-network.
Insurance Information
This medication may be covered by your prescription plan. If you qualify, you may be able to get financial help through patient assistance programs (PAP). Co-pay cards may also be available to lower your out-of-pocket cost if you have commercial (not Medicare/Medicaid/Tricare) insurance. Your pharmacist, social worker, or navigator can help find resources for financial support.
Possible Side Effects
These are some of the most common or most serious side effects of this medication. Talk with your provider about the side effects you are having and how they can be managed.
Low White Blood Cell Count (Leukopenia or Neutropenia)
White blood cells (WBC) help your body fight infection. While you are having treatment for cancer, your WBC count can drop, putting you at a higher risk of an infection. Tell your provider right away if you have a fever (temperature greater than 100.4°F or 38°C), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.
Tips for preventing infection:
- Hand washing: both yours and your visitors is the best way to prevent the spread of infection.
- Avoid large crowds and people who are sick (those who have a cold, fever, or cough, or live with someone with these symptoms).
- When working outside, wear clothes that protect you, like long pants and gloves.
- Do not handle pet waste.
- Keep all cuts and scratches clean.
- Shower or bathe daily.
- Brush your teeth at least twice a day.
- Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
- Ask your providers before scheduling dental appointments or procedures.
- Ask your providers before you or someone you live with has any vaccines.
Low Platelet Count (Thrombocytopenia)
Platelets are blood cells that help your blood clot. Thrombocytopenia is when your platelet count is lower than normal, and you are at a higher risk of bleeding. Tell your providers if you have any bruising or bleeding, including nose bleeds, bleeding gums, or blood in your urine or stool. If your count gets too low, you may receive platelets from a donor.
- Do not use a razor (an electric razor is fine).
- Do not do activities that can cause injury or bleeding.
- Talk to your provider before taking any non-steroidal, anti-inflammatory medications (NSAIDs) like Motrin/Advil (ibuprofen), Aleve (naproxen), Celebrex (celecoxib), and others. These can raise the risk of bleeding.
- Use a soft-bristle toothbrush to brush your teeth. Ask your provider about flossing or using toothpicks.
Low Red Blood Cell Count (Anemia)
Anemia is when your red blood cell count is lower than normal. Red blood cells carry oxygen to the tissues in your body. When your red cell count is low, you may feel tired or weak. Tell your providers if you have shortness of breath, trouble breathing, or pain in your chest. If your count gets too low, you may receive a blood transfusion.
Fluid Retention
Fluid retention happens when your body holds on to too much fluid or is unable to excrete (put out) fluid. You may have swelling throughout your body, bloating of your abdomen (belly) called ascites, and a hard time breathing as fluid builds up in the lining of your lungs (pleural effusion) or around your heart.
Call your provider right away if you have new or worsening swelling, unexpected weight gain, shortness of breath, or a dry cough.
Nausea and/or Vomiting
Talk to your providers if you have nausea and/or vomiting. They can prescribe medications to help you. Making changes to your diet can also help. Avoid things that make your symptoms worse, like heavy or greasy/fatty foods and spicy or acidic foods, like tomatoes, lemons, and oranges. Try saltines or ginger ale to help your symptoms.
Call your providers if you cannot keep fluids down for more than 12 hours or if you feel lightheaded or dizzy.
Diarrhea
Diarrhea is when you pass three or more stools in a day. Your providers can suggest medications to relieve diarrhea. Do not take any medications to manage your diarrhea without talking to your provider first, as your stool may need to be tested. To manage it, try eating foods that are low in fiber and bland, like white rice and boiled or baked chicken. Try not to eat raw fruits, vegetables, whole grain breads, cereals, and seeds. Soluble fiber is a type of fiber found in some foods that helps absorb (soak up) fluid. Foods high in soluble fiber are applesauce, bananas (ripe), canned fruit, oranges, boiled potatoes, white rice, foods made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Stay hydrated by drinking 8 to 10 glasses of non-alcoholic, non-caffeinated fluid each day.
Rash
Some people may get a rash, scaly skin, or red, itchy bumps from this medication. Tell your provider if you notice any of these changes in your skin, since it could be a reaction. Your provider may suggest:
- Using an alcohol-free moisturizer on your skin and lips, and do not use moisturizers with perfumes or scents.
- Keep the area clean to avoid infection, especially if it cracks or bleeds.
- Using a topical medication (applied to the skin) if the itching bothers you.
Be sure to talk with your provider about how to care for your skin.
Fatigue
Fatigue can cause exhaustion, feeling worn out and that your body is "heavy" and hard to move, or being unable to focus. It is common when you have cancer, and it is not the same as feeling tired. You may need to adjust your schedule to manage fatigue. Plan times to rest during the day and save your energy for more important activities. Exercise can help lessen fatigue. Talk to your providers about ways to deal with this side effect.
Muscle or Joint Pain/Aches and Headache
You may have joint or muscle pain/aches and headaches while taking this medication. Your provider can recommend medications and other ways to help relieve your pain.
Fertility
This medication may affect your fertility. It can cause changes to your menstrual cycle or sperm. You may want to consider sperm banking or egg harvesting if you might wish to have a child in the future. Talk about your options with your provider before treatment.
Reproductive Concerns
There is a higher risk of health problems for your baby if you are pregnant, become pregnant, or get someone pregnant while on this medication. To lower the risk of birth defects, you should use birth control (contraception) to avoid pregnancy. Talk with your provider about what kind of birth control is safest for you and your partner.
If you can become pregnant, you will need to use effective birth control during treatment and for 1 month after the last dose of this medication, even if your menstrual cycle has stopped or changed. If you can get someone pregnant, you will need to use effective birth control during treatment and for 1 month after the last dose of this medication, even if you believe you are not producing sperm. You should not breastfeed during treatment and for 2 weeks after the last dose of this medication.
Important but Less Common Side Effects
Severe Skin Reactions
A serious allergic reaction to this medication can cause skin and mucous membrane (inside of your mouth, nose, throat, and other body parts) problems that can also affect other organs in your body. These reactions are called severe cutaneous adverse reactions (SCARs).
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are types of serious skin reactions that need treatment right away. If you have a new rash or blisters, flu-like symptoms, or lesions (sores) on mucous membranes, call your provider right away.
Bleeding
If you notice you are bleeding more easily or for no reason, especially new bleeding from your gums or nose, call your provider right away. You may also bruise more easily.
If you have bright red or dark, tarry stool, blood in your vomit, vomit that looks like coffee grounds, or have any signs of stroke (severe headache, trouble talking, weakness on one side, confusion), call 911 right away.
Heart Problems
This medication may cause an abnormal heart rate, called QT prolongation, congestive heart failure, or a heart attack. Your healthcare provider will monitor certain electrolyte levels in your blood, as well as your heart function, while you are taking this medication. Notify your provider or go to the emergency room right away if you feel chest pain, abnormal heartbeats, or if you feel dizzy or faint.
Pulmonary Arterial Hypertension
Pulmonary arterial hypertension happens when the pressure in the arteries of your lungs is too high. This puts added pressure on your heart.
If you have new or worsening shortness of breath, swelling in your ankles or feet, chest pain or pressure, or blueish lips, call 911.
Tumor Lysis Syndrome
Tumor Lysis Syndrome (TLS) is a side effect that happens when tumor cells die too quickly, and their waste overwhelms the body. You may be given a medication (allopurinol) and IV fluids to help prevent this. TLS can affect your kidney function. Your provider will monitor your kidney function with blood work. Symptoms may be:
- Nausea.
- Vomiting.
- Diarrhea.
- Lethargy (feeling tired, drowsy, sluggish).
- Little or no urine output.
Tell your provider right away if you have any of these symptoms.
Liver Toxicity
This medication can cause liver toxicity, or liver problems, which your provider may monitor for with blood tests called liver function tests. Symptoms may be:
- Yellowing of your skin or eyes.
- Dark or brown urine.
- Pain in your abdomen (belly).
Tell your provider if you have any of these symptoms.