Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Drug

Dasatinib (Sprycel)

A second-generation tyrosine kinase inhibitor tablet for chronic myeloid leukaemia and Philadelphia-positive ALL

Updated: 27 October 20262 min read3 references
Generic name
Dasatinib
Brand names
Sprycel
Drug class
Tyrosine kinase inhibitor (BCR-ABL, second generation)
Route
Oral (tablet)
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Key points

  • Dasatinib is a tablet that blocks the faulty protein in leukaemia cells (BCR-ABL) and is taken once a day [1].
  • In newly diagnosed CML, it controlled the disease faster and more deeply than imatinib [2].
  • Fluid around the lungs is its most typical side effect; report shortness of breath or a new cough [1].
  • Medicines that reduce stomach acid (such as omeprazole) lower its absorption [1].

What is this drug and how does it work?

For patients

Dasatinib is a tablet that blocks the faulty protein that drives chronic myeloid leukaemia cells to grow [1]. It is used if imatinib has not worked or caused side effects, or sometimes from the start [1, 3].

For physiciansSpecialist notes
For physicians

A multi-kinase inhibitor (BCR-ABL, SRC family, KIT, PDGFR) [1]; active against most imatinib-resistant mutations except T315I, and its choice after treatment failure is guided by ABL1 mutation testing [3].

Which cancers is it used for?

For patients
What is this drug for?
  • Chronic myeloid leukaemia (CML) in chronic phase, from the start or after imatinib [1]
  • Philadelphia-positive acute lymphoblastic leukaemia (Ph+‎ ALL) [1]
For physiciansApproved uses and evidence
For physicians
Approved uses and evidence
DiseaseUseKey evidence
Newly diagnosed chronic-phase CMLFirst line [1]DASISION: 12-month complete cytogenetic response 77% vs 66% and major molecular response 46% vs 28% with imatinib [2]
CML resistant or intolerant to imatinib (all phases)Second line [1]Choice based on ABL1 mutations and comorbidities [3]
Ph+‎ ALLResistant or intolerant; in children with chemotherapy [1]—

How it is taken and dosing

Show detailsHide

Dasatinib is taken once a day, in the morning or evening, with or without food; do not break or chew the tablet [1]. Take it at the same time every day and do not stop it without your doctor's advice.

For physiciansStandard dosing (FDA label), 1 regimen
For physicians

Standard dosing (FDA label)

Dasatinib

CML and Ph+ ALL in adultsCycle length: Daily and continuous

CML and Ph+‎ ALL in adults

DrugDoseRouteSchedule
Dasatinib100 mg once daily (chronic phase); 140 mg once daily (accelerated or blast phase, or Ph+‎ ALL)OralDaily
Cycle length
Daily and continuous
Duration
Until progression or toxicity; stopping treatment only with a deep, sustained molecular response and under monitoring [3]

Strong CYP3A4 inhibitors: avoid; if unavoidable, reduce to 20 mg (from 100) or 40 mg (from 140). Strong inducers and St John's wort: avoid. Proton pump inhibitors and H2 antagonists: avoid; antacids at least 2 hours before or after the drug [1].

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Side effects

For patients

The most common side effects: low blood cells and platelets, fluid build-up in the body (especially around the lungs), diarrhoea, headache, skin rash, bleeding, shortness of breath, tiredness, nausea and muscle pain [1].

For physiciansSpecialist notes
For physicians

Common adverse reactions (15% or more as monotherapy): myelosuppression, fluid retention (including pleural effusion), diarrhoea, headache, rash, haemorrhage, dyspnoea, fatigue, nausea and musculoskeletal pain [1].

Serious side effects

For patients

Serious but less common side effects: severe bleeding, a lot of fluid around the lungs or heart, high blood pressure in the lung arteries (worsening shortness of breath), heart problems, severe skin rashes and liver damage [1].

For physiciansSpecialist notes
For physicians
  • Myelosuppression: blood counts weekly for the first 2 months, then monthly [1].
  • Pleural effusion: interrupt, give a diuretic and a short course of steroids; resume at a lower dose after recovery [1].
  • Pulmonary arterial hypertension (PAH): assess before starting and if symptoms occur; if confirmed, discontinue permanently [1].
  • QT prolongation, cardiac events, severe skin reactions, tumour lysis and hepatotoxicity [1].

When should I call my doctor?

  • Shortness of breath, cough or chest pain
  • Bleeding (gums, nose, urine, black stools) or a lot of bruising
  • Fever or signs of infection
  • Swollen legs or rapid weight gain
  • A widespread skin rash

Interactions, pregnancy and precautions

  • Other medicines: antifungal drugs (ketoconazole, itraconazole), the antibiotic clarithromycin and grapefruit raise the level of dasatinib; the tuberculosis drug rifampicin and St John's wort lower it [1].
  • Stomach medicines: omeprazole, pantoprazole and ranitidine reduce absorption of the drug; if you need an antacid, leave at least 2 hours between them [1].
  • Pregnancy: this drug may harm an unborn baby; use effective contraception during treatment and tell your doctor straight away if you become pregnant. Do not breastfeed during treatment [1].
For patients

Frequently asked questions

Is dasatinib better than imatinib?

In newly diagnosed CML it controlled the disease faster, but both help patients live a long time; the choice depends on other illnesses and side effects [2, 3].

What should I do if I forget a dose?

Do not make up the missed dose; take the next one at the usual time.

Related cancer types

Leukaemia

Related drugs

Arsenic trioxide (Trisenox)Azacitidine (Vidaza)BendamustineCyclophosphamide (Endoxan)Doxorubicin (Adriamycin)Filgrastim (Neupogen)Hydroxyurea (Hydrea)Ibrutinib (Imbruvica)

References

3 references
Show all references, 1 with a study cardClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    SPRYCEL (DASATINIB) — Prescribing InformationE.R. Squibb & Sons, L.L.C · FDA label · 2026
    Source Back to text: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
  2. 2
    Dasatinib versus imatinib in newly diagnosed chronic-phase chronic myeloid leukemiaKantarjian H, Shah NP, Hochhaus A, et al · N Engl J Med · 2010;362:2260-70
    DOIPubMed Back to text: 1 2 3
  3. 3
    European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemiaHochhaus A, Baccarani M, Silver RT, et al · Leukemia · 2020;34:966-984
    Study cardDOIPubMed Back to text: 1 2 3 4 5

This page is based on reputable scientific sources and was last updated on 27 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/drugs/dasatinib/

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