Dasatinib

What is this medicine?

Dasatinib is a medicine that is usually used to treat a type of cancer called leukemia. It prevents and stops the growth of cancer cells. Dasatinib may also be used to treat other conditions.

You may hear dasatinib called by its brand name, Sprycel®. Dasatinib comes in tablet form.

Before giving dasatinib to your child

Tell your doctor if your child has ever reacted badly to dasatinib or to any other medication, preservatives, foods or colouring agents.

Talk with your child’s doctor, nurse or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• an infection or recent exposure to infection (such as chickenpox or hepatitis B) 
• a low platelet count or bleeds easily
• heart problems 
• lung or breathing problems
• liver problems 
• lactose intolerance

How should you give your child dasatinib?

• Give your child dasatinib exactly as your doctor tells you, even if your child feels better. Talk with your child's doctor or pharmacist before you stop giving this medication for any reason. 
• Give your child dasatinib by mouth at about the same time each day with food or on an empty stomach.
• DO NOT give your child grapefruit and grapefruit juice for as long as your child is taking dasatinib.
• Tablets should NOT be cut, crushed or chewed. Talk to your doctor or pharmacist to discuss other options if your child has difficulties swallowing tablets.
• If your child throws up (vomits) within 30 minutes of taking dasatinib, give another dose. If your child vomits within 30 minutes of taking the second dasatinib dose, do not give another dose. Contact your child’s nurse, pharmacist or doctor during the day to discuss other options.

What should you do if your child misses a dose of dasatinib?

• Give the missed dose as soon as you remember. 
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time. Dasatinib doses should be given at least 12 hours apart.
• Do not give your child two doses to make up for one missed dose. Call your child’s doctor or nurse during the day if you are not sure what to do.

What are the possible side effects of dasatinib?

Your child may have some of these side effects while they take dasatinib. Check with your child's doctor if your child continues to have any of these side effects, if they do not go away or if they bother your child:

• headache 
• diarrhea 
• tiredness, lack of energy
• nausea (feeling like vomiting) or vomiting
• rash, dry skin or itchiness
• muscle or joint pain
• numbness or tingling of the fingers or toes
• ringing in the ears
• trouble sleeping

Most of the following side effects are not common, but they may be a sign of a serious problem.  Call your child's doctor right away or take your child to the Emergency Department if your child has any of these side effects: 

• blood in the urine
• black, tarry stools
• shortness of breath or difficulty breathing
• chest pain or uneven heartbeat
• sudden weight gain
• swelling of feet, lower legs or around the eyes
• fever
• seizures or loss of consciousness
• sudden severe headache, eyesight changes, slurred speech, loss of coordination, weakness or numbness in an arm or leg

What safety measures should you take when your child is using dasatinib?

Keep all appointments at the clinic or doctor’s office so that the doctor can check your child’s response to dasatinib.

There are some medicines that should not be taken together with dasatinib or, in some cases, the dose of dasatinib or the other medicine may need to be adjusted. It is important that you tell your doctor and pharmacist if your child takes any other medications (prescription, over the counter, herbal or natural products) including:

• antacids or other medications reducing stomach acidity (e.g., ranitidine, lansoprazole) 
• certain medications affecting the metabolism of dasatinib (e.g., ketoconazole, phenytoin, St. John’s Wort) 
• certain eczema medications (e.g., pimecrolimus, tacrolimus) 
• blood thinner medications (e.g., warfarin, aspirin)

Dasatinib can temporarily lower the number of white blood cells in the blood, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections:

• Avoid people with infections such as a cold or the flu.
• You and your child should not touch your child's eyes or inside their nose without washing the hands first.
• Your child’s nurse will review with you what to do in case of fever. 

Dasatinib can affect the platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:

• Be careful not to cut your child when using a razor, fingernail scissors or toenail clippers.
• Be careful when brushing or flossing your child's teeth. Your doctor, nurse or dentist may suggest different ways to clean your child's mouth and teeth.
• Be careful when shaving or waxing. 
• Your child should avoid contact sports where bruising or injury could occur. 
• Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking dasatinib. 

Your child should not receive any immunizations (vaccines) without their doctor's approval. 

Hepatitis B testing may be suggested for your child before starting dasatinib. Unrecognized hepatitis B infection may become worse during dasatinib treatment. 

There is a chance that dasatinib may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy.  If you are sexually active, it is recommended that you use birth control while receiving dasatinib to prevent pregnancy. Tell your doctor right away if you may be pregnant.

What other important information should you know?

• Not all pharmacies keep a supply of dasatinib.
• Make sure you always have enough dasatinib to last through weekends, holidays and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
• Keep a list of all medications your child is on and show the list to your child’s doctor, nurse or pharmacist. 
• Keep dasatinib at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines. 

Keep medication out of your child’s sight and reach and locked up in a safe place. If your child takes too much medication, call the Ontario Poison Centre at one of these numbers. These calls are free.  

• Call 416-813-5900 if you live in Toronto. 
• Call 1-800-268-9017 if you live somewhere else in Ontario. 
• If you live outside of Ontario, call your local Poison Information Centre.

Keep dasatinib out of your child’s sight and reach and locked up in a safe place. If your child takes too much dasatinib, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.