Dasacent 140

Introduction
Dasacent 140 is used in the treatment of blood cancer (chronic myeloid leukaemia). It is used in patients whose disease could not be treated with other medications for leukaemia or who cannot take these medications because of side effects. Dasacent 140 can be taken with or without food, but try to have it at the same time every day to get the most benefits. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to. Nausea, vomiting, abdominal pain and rash are some common side effects of this medicine. In some cases, it may cause increased heartbeat and low or high blood pressure, if it happens consult with your doctor. Your doctor might check your blood pressure regularly. It is advised to avoid antacid intake within 2 hours of taking this medicine. This medicine may reduce the number of blood cells in your blood, thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells. Many other medicines can affect, or be affected by, this medicine so let your healthcare team know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. You must avoid driving if you experience dizziness or blurred vision during treatment.

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Uses of Dasacent 140
Blood cancer (Chronic myeloid leukaemia)
Side effects of Dasacent 140
Common
Abdominal pain
Anemia (low number of red blood cells)
Breathing problems
Fatigue
Fever
Headache
Infection
Low blood platelets
Musculoskeletal (bone, muscle or joint) pain
Nausea
Rash
Vomiting
How to use Dasacent 140
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Dasacent 140 may be taken with or without food, but it is better to take it at a fixed time.
How Dasacent 140 works
Dasacent 140 is an anti-cancer medication. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps to stop or slow the spread of cancer cells.
What if you forget to take Dasacent 140?
If you miss a dose of Dasacent 140, skip it and continue with your normal schedule. Do not double the dose.
Quick Tips
Take it with or without food, preferably at the same time each day.
Diarrhea may occur as a side effect. Drink plenty of fluids and inform your doctor if it doesn’t stop or if you find blood in your stools.
Use a reliable contraceptive method to prevent pregnancy while you are taking this medicine and for a month after you stop taking it.
Monitor your blood pressure regularly while taking this medication. Inform your doctor if you notice symptoms of very high blood pressure such as severe headache, confusion, problems with your eyesight, nausea or vomiting.
It may cause serious bleeding problem. Inform your doctor if you get headaches, stomach pain or if you notice blood in your urine or stools.
Do not take this medicine if you are pregnant, planning to conceive or breastfeeding.
Brief Description
Indication
Chronic myeloid leukaemia
Administration
May be taken with or without food. Swallow whole, do not break/crush/cut.
Adult Dose
Oral Chronic myeloid leukaemia Adult: Chronic phase CML: Initially, 100 mg once daily, may increase up to 140 mg once daily. Accelerated, myeloid or lymphoid blast phase CML or Philadelphia chromosome-positive ALL: Initially, 140 mg once daily, may increase up to 180 mg once daily. Hepatic impairment: No dosage adjustment needed.

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Contraindication
Concomitant use w/ CYP3A4 inhibitors (e.g. atazanavir, clarithromycin, erythromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole or grapefruit juice); CYP3A4 inducers (e.g. carbamazepine, dexamethasone, phenytoin, phenobarbital, rifampicin or St John’s wort); antacid. Pregnancy.
Mode of Action
Dasatinib is an inhibitor of multiple tyrosine kinases. It is used for the treatment of all phases of chronic myeloid leukaemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukaemia (ALL) in adults who have resistance or intolerance to previous therapy, including imatinib.
Precaution
Patients w/ predisposing factors for QT prolongation (e.g. congenital long QT syndrome, hypokalaemia, hypomagnesaemia, on antiarrhythmic therapy, or receiving cumulative high doses of anthracyclines). Hepatic impairment. Lactation. Monitoring Parameters Evaluate patients for manifestations of underlying cardiopulmonary disease prior to and during therapy. Measure full blood counts wkly for the 1st 2 mth and then mthly thereafter. Lactation: not known if excreted in breast milk; do not nurse

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Side Effect
>10% Fluid retention, incl CHF, pulm edema, pleural effusion (50%),Diarrhea (49%),Headache (40%),Hemorrhage (40%),Fatigue (39%),Pyrexia (39%),Skin rash (35%),Infection (34%),Nausea (34%),Dyspnea (32%),Cough (28%),Pain (26%),Abdominal pain (25%),Vomiting (22%),Anorexia (19%),Arthralgia (19%),Asthenia (19%),Constipation (14%),Dizziness (14%),Musculoskeletal pain (14%),Weight loss (14%),Chest pain (13%),Neuropathy (13%),Myalgia (12%),Abdominal distention (11%),Arrhythmia (11%),Chills (11%),Pneumonia (11%),Pruritus (11%),Weight gain (11%) 1-10% (selected) Anemia,Febrile neutropenia,Thrombocytopenia,Mucosal inflammation Vascular disorders: Thrombosis/embolism (including pulmonary embolism, deep vein thrombosis) Respiratory, thoracic, and mediastinal disorders: Interstitial lung disease, pulmonary arterial hypertension Dermatologic reactions: Stevens-Johnson syndrome, erythema multiforme

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Pregnancy Category Note
Pregnancy Based on limited human data, dasatinib can cause fetal harm when administered to a pregnant woman; adverse pharmacologic effects (eg, hydrops fetalis, fetal leukopenia, and fetal thrombocytopenia) have been reported with maternal exposure to dasatinib Animal reproduction studies in rats have demonstrated extensive mortality during organogenesis, the fetal period, and in neonates; skeletal malformations were observed in a limited number of surviving rat and rabbit conceptuses; these findings occurred at dasatinib plasma concentrations below those in humans receiving therapeutic doses of dasatinib Advise a pregnant woman of the potential risk to a fetus Transplacental transfer of dasatinib has been reported Advise females of reproductive potential to avoid pregnancy, which may include the use of effective contraceptive methods, during treatment with dasatinib and for 30 days after the final dose Based on animal data, dasatinib may result in damage to female and male reproductive tissues Lactation No data are available regarding the presence of dasatinib in human milk, the effects of the drug on the breastfed child, or the effects of the drug on milk production However, dasatinib is present in the milk of lactating rats

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Interaction
Concomitant use w/ drugs that have narrow therapeutic index (e.g. alfentanil, cisapride, ciclosporin, fentanyl, pimozide, quinidine, simvastatin, sirolimus, tacrolimus, ergot alkaloids) as it may increase the serum levels of these drugs. Increased risk of bleeding and thrombocytopenia w/ antiplatelet drugs, anticoagulants, and NSAIDs. Potentially Fatal: May reduce plasma levels w/ antacids, administer antacid 2 hr apart from the admin of dasatinib. May increase plasma levels w/ CYP3A4 inhibitors (e.g. atazanavir, clarithromycin, erythromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin or voriconazole). May reduce plasma levels w/ CYP3A4 inducers (e.g. carbamazepine, dexamethasone, phenytoin, phenobarbital or rifampicin).

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