Dasatinib anhydrous: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
Dasatinib anhydrous: clinical details
Prescribing considerations
- Initiation and supervision require experience in diagnosing and treating leukaemia.
- Review all medicines for CYP3A4, gastric-pH, QT-prolonging and bleeding interactions.
- Assess cardiopulmonary symptoms and risk factors before treatment; investigate new dyspnoea or dry cough promptly.
- Use caution in hepatic impairment and significant cardiovascular disease.
- Test for hepatitis B before treatment and involve liver specialists when serology is positive.
- Consider reproductive counselling, contraception and fertility preservation where appropriate.
Contraindications and cautions
- Hypersensitivity to dasatinib or any product excipient.
- This lactose-containing product should not be used in rare hereditary galactose intolerance, total lactase deficiency or glucose-galactose malabsorption.
Monitoring
- Full blood count for myelosuppression, adjusted to disease phase and concurrent chemotherapy.
- Clinical assessment for bleeding, infection and fluid retention, including pleural or pericardial effusion.
- Assessment for pulmonary arterial hypertension when unexplained breathlessness or fatigue develops.
- Electrolytes and cardiac assessment where QT prolongation or cardiac risk is relevant.
- Hepatitis B monitoring in carriers during and after treatment.
- Liver function and other biochemical monitoring according to clinical status.
- Bone growth and development in paediatric patients.
Clinical pharmacology
Dasatinib inhibits BCR-ABL, SRC-family kinases and selected oncogenic kinases including c-KIT, EPH receptors and PDGF-beta receptor. It is metabolised principally through CYP3A4; its solubility and absorption decrease as gastric pH rises.
Formulation and product differences
- The selected product contains dasatinib anhydrous equivalent to dasatinib in a film-coated tablet.
- Tablets must remain intact to maintain consistent exposure and minimise skin contact with the active substance.
- Tablet and oral-suspension formulations are not bioequivalent; switching requires formulation-specific prescribing.
- The selected tablet contains lactose and is essentially sodium-free.
- Use suitable gloves when handling accidentally crushed or broken tablets.
Dasatinib anhydrous preparations and strengths
Tablet
Route: Oral
Strengths: 50 mg, 100 mg
Dasatinib anhydrous interactions
Dasatinib has clinically important interactions. Check all prescribed, pharmacy-bought and herbal products with the specialist team.
Strong CYP3A4 inhibitors, including clarithromycin, itraconazole, ketoconazole and ritonavir
May substantially increase dasatinib exposure and toxicity; concurrent use is generally avoided or specialist-managed.
Strong CYP3A4 inducers, including rifampicin, carbamazepine, phenytoin and phenobarbital
May reduce dasatinib exposure and increase the risk of treatment failure.
St John’s wort
May lower dasatinib exposure and should not be started without specialist approval.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.