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Alternative dosing options are available*
See SPRYCEL drug interactions and dose modifications below.
For patients with chronic-phase Ph+ CML and ANC <0.5 × 109/L or platelets <50 × 109/L on a starting dose of 100 mg
100 mg once daily
Additionally, for third episode, discontinue SPRYCEL for patients resistant or intolerant to prior therapy including imatinib.
ANC=absolute neutrophil count; CP=chronic phase; TKI=tyrosine kinase inhibitor.
*Tablets not actual size.
For adults with Ph+ CML
Strong CYP3A4 inhibitors
The coadministration with strong CYP3A inhibitors may increase dasatinib concentrations. Increased dasatinib concentrations may increase the risk of toxicity. Avoid concomitant use of strong CYP3A4 inhibitors. If concomitant administration of a strong CYP3A4 inhibitor cannot be avoided, consider a SPRYCEL dose reduction.
Strong CYP3A4 inducers
The coadministration of SPRYCEL with strong CYP3A inducers may decrease dasatinib concentrations. Decreased dasatinib concentrations may reduce efficacy. Consider alternative drugs with less enzyme induction potential. If concomitant administration of a strong CYP3A4 inducer cannot be avoided, consider a SPRYCEL dose increase.
Gastric Acid Reducing Agents
The coadministration of SPRYCEL with a gastric acid reducing agent may decrease the concentrations of dasatinib. Decreased dasatinib concentrations may reduce efficacy.
Do not administer H2 antagonists or proton pump inhibitors with SPRYCEL. Consider the use of antacids in place of H2 antagonists or proton pump inhibitors. Administer the antacid at least 2 hours prior to or 2 hours after the dose of SPRYCEL. Avoid simultaneous administration of SPRYCEL with antacids.
Consider these modifications:
†This reduced dose of SPRYCEL is predicted to adjust the area under the curve (AUC) to the range observed without a CYP3A4 inhibitor. However, there are no clinical data with this dose adjustment in patients receiving strong CYP3A4 inhibitors.1