Dasatinib

Dasatinib is a type of targeted cancer drug. You pronounce dasatinib as da-sat-in-ib.

It is a treatment for chronic myeloid leukaemia (CML).

You might have dasatinib for acute lymphoblastic leukaemia (ALL) which is Philadelphia chromosome positive, when other treatments are no longer working. It is not available on the NHS in England or Scotland at the moment. Your doctor can make an Individual Funding Request (IFR) if they think that a treatment is the best option for you.

You might also have dasatinib as part of a clinical trial.

How does dasatinib work?

Dasatinib is a type of cancer growth blocker called a tyrosine kinase inhibitor (TKI). It works by blocking particular proteins on cancer cells that encourage the cancer to grow. This can help shrink the cancer or stop it growing.

How do you have dasatinib?

You take dasatinib as tablets. You swallow them whole. You can take them with or without food.

If you’re taking medicines for indigestion (antacids), take them either 2 hours before or 2 hours after the dasatinib. These medicines can stop the body absorbing dasatinib. You should not take any other medicines that affect the production of stomach acid.

You should take the right dose, not more or less.

Talk to your healthcare team before you stop taking a cancer drug, or if you miss a dose.

How often do you have dasatinib?

You take dasatinib once a day.

You take dasatinib for as long as it is working, and the side effects aren’t too bad.

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

What are the side effects of dasatinib?

Side effects can vary from person to person. They also depend on what other treatments you're having. 

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 

• your side effects aren’t getting any better

• your side effects are getting worse

Early treatment can help manage side effects better. 

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Increased risk of getting an infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness and looking pale

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Bruising, bleeding gums or nosebleeds

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Heavy bleeding (haemorrhage)

You may have heavy bleeding (haemorrhage) from damaged blood vessels in the body. Call your advice line if you have any form of bleeding that's unusual for you. If you are losing a large volume of blood call 999 or go straight to Accident and Emergency (A&E).

Diarrhoea

Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a stoma , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.

Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain fibre. But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables. 

Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.

Headaches

Tell your healthcare team if you keep getting headaches. They can give you painkillers to help. You might also have tests to try and find out what is causing your headaches.

Fluid around the lungs (pleural effusion)

Fluid around the lungs is called a pleural effusion. 

Skin changes

Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your healthcare team can tell you what products you can use on your skin to help.

Contact your healthcare team if you experience any severe skin changes.

Fluid build up (oedema) 

A build up of fluid may cause swelling in your arms, hands, ankles, legs, face and other parts of the body. Contact your healthcare team if this happens to you.

Tiredness and weakness (fatigue)

You might feel very tired and as though you lack energy.

Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.

Bone or muscle pain

You might feel some pain from your muscles and joints. Speak to your doctor or nurse about what painkillers you can take to help with this.

High temperature (fever)

Tell your healthcare team straightaway if you get a high temperature. Ask them if you can take paracetamol to help lower your temperature.

Tummy (abdominal) pain

Tell your treatment team if you have this. They can check the cause and give you medicine to help. 

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

• a serious reaction to an infection (sepsis) - signs can include feeling very unwell, not passing urine, being sick, a very high or very low temperature or shivering - contact your advice line straight away if you have any of these symptoms
• numbness or tingling in fingers or toes
• indigestion and heartburn
• loss or increase of appetite
• sore mouth and ulcers
• hair loss
• dizziness
• ringing in the ears (tinnitus)
• eye problems such as dry eyes or blurred vision
• aching and stiff muscles and joints
• difficulty sleeping (insomnia)
• depression
• general weakness or lack of strength
• weight changes
• feeling very cold, shaky and shivery (chills)
• high blood pressure
• flushing
• high uric acid levels in the blood
• feeling very sleepy
• heart problems symptoms might include fast or irregular heartbeat, sudden fainting, chest pain, feeling sick and cough. Tests might show there is fluid around the heart. Call 999 or go to A&E straight away if you develop chest pain.
• lung problems such as infection, fluid in the lung and a cough
• inflammation of the large bowel (colitis) and stomach lining
• swollen or bloated tummy
• difficulty passing poo (constipation)
• sweating more than usual
• twitching or jerky muscle movement (muscle spasm) or muscle weakness
• bleeding in the stomach or bowel
• high blood pressure in the vessels leading from the heart to the lungs - symptoms include being short of breath, tiredness, feeling faint, dizzy or chest pain
• taste changes

Rare side effects

These side effects happen in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

• confusion or memory changes
• low levels of thyroid hormones which can make you feel tired, unable to cope with the cold and you might get muscle cramps. Rarely you may have high levels of thyroid hormones
• lack of fluid in the body (dehydration)
• changes to the levels of chemicals in your blood due to the breakdown of tumour cells (tumour lysis syndrome) - you can have blood tests to check for this
• anxiety or emotional changes
• loss of interest in sex
• hearing loss
• balance changes
• feeling that the world is spinning (vertigo)
• liver changes - including the flow of bile from your liver being reduced or blocked
• growth of breast tissue in men (gynecomastia)
• changes to periods
• swollen glands (lymph nodes) in the body
• high levels of a fatty substance called cholesterol in the blood
• fainting
• trembling and shaking (tremor)
• watery or sticky eyes, you might also be sensitive to the light
• vision changes
• low blood pressure
• blood clots that can be life threatening; signs are pain, redness and swelling where the clot is. Feeling breathless can be a sign of a blood clot in the lung. Contact your advice line or doctor straight away if you have any of these symptoms
• inflammation of different parts of the body including the pancreas, food pipe, liver, gallbladder, bottom layers of skin, muscles, joints, tendons and veins
• difficulty swallowing
• fluid build up in the tummy (ascites) or chest
• bone loss
• kidney problems such as weeing more often and protein in your urine. You might also have changes to kidney blood tests
• an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness - some allergic reactions can be life threatening, alert your nurse or doctor if notice any of these symptoms
• a bleed inside the brain or spinal cord
• stomach ulcer
• sore or tear at the opening to the outside of the body at the end of the bowel (anus)
• nail problems
• redness, swelling, and pain on the palms of the hands or the soles of the feet
• damaged muscle tissue releasing proteins, salts and minerals into the blood – this can be serious
• stroke or mini stroke
• seizures (fits)
• asthma
• muscle tightness in the airways – symptoms are wheezing or coughing
• feeling generally unwell

Other side effects

There isn't enough information to work out how often these side effects might happen. You might have one or more of them. They include:

• if you have had hepatitis B before it could come back
• scarring of the lungs
• bleeding from the digestive system – this can be life threatening
• a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish and your eyes may be more sensitive to light. This is serious and could be life threatening

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do you need to know?

Other medicines, foods and drink

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you're having treatment and for some time afterwards. Talk to your healthcare team to find out more.

Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner falls pregnant while having treatment.

Loss of fertility

It is not known whether this treatment affects fertility in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Breastfeeding 

It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

• other vaccines, but they might not give you as much protection as usual
• the flu vaccine (as an injection)
• the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system recovers from treatment.

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.