How should I take SPRYCEL® (dasatinib)?

If you have Ph+ CML in chronic phase Chronic phase CML: the first phase of CML; it can last for months or years; most people are diagnosed with CML during this phase, the usual dose is 100 mg (one 100-mg tablet) once daily, either in the morning or in the evening.

Tips on taking SPRYCEL (dasatinib) as prescribed:

  • Ask your healthcare provider for written instructions that explain how often you should take it, how you should take it, and what you should do if you miss a dose
  • Make taking your medication part of your daily routine. For example, try keeping SPRYCEL next to the coffee maker in the kitchen if you take it in the morning, or nightstand if you take it at night
  • Stay organized. Consider using a pill-sorting container and keep track of your schedule
  • When traveling, take your medication with you in its original container. If you are flying, store your pills in your carry-on bag in case your luggage gets lost
  • Sign up for My SPRYCEL Support, a program committed to helping you learn about SPRYCEL, understand what you can expect from your medicine, and be involved in your care with your healthcare provider
  • If your out-of-pocket costs are an issue, you may be eligible to receive Co-pay assistance through My SPRYCEL Support

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, antacids, and herbal supplements.

Especially tell your healthcare provider if you take:

  • medicines that increase the amount of SPRYCEL in your bloodstream, such as:
    Nizoral® (ketoconazole)
    Sporanox® (itraconazole)
    Norvir® (ritonavir)
    Reyataz® (atazanavir sulfate)
    Crixivan® (indinavir)
    Viracept® (nelfinavir)     		Nefazodone (serzone®, nefadar)
    Invirase® (saquinavir)
    Ketek® (telithromycin)
    E-mycin® (erythromycin)
    Biaxin® (clarithromycin)
  • medicines that decrease the amount of SPRYCEL in your bloodstream, such as:
    Decadron® (dexamethasone)
    Dilantin® (phenytoin)
    Tegretol® (carbamazepine)     		Rimactane® (rifampin)
    Luminal® (phenobarbital)
  • medicines whose blood levels might change by taking SPRYCEL, such as:
    Sandimmune® (cyclosporine)
    Alfenta® (alfentanil)
    Fentanyl® (fentanyl)
    Orap® (pimozide)     		Rapamune® (sirolimus)
    Prograf® (tacrolimus)
    Ergomar® (ergotamine)

SPRYCEL is best absorbed from your stomach into your bloodstream in the presence of stomach acid. You should avoid taking medicines that reduce stomach acid, such as:

Tagamet® (cimetidine)
Pepcid® (famotidine)
Zantac® (ranitidine)
Prilosec® (omeprazole) 		Protonix® (pantoprazole sodium)
Nexium® (esomeprazole)
AcipHex® (rabeprazole)
Prevacid® (lansoprazole)

Medicines that neutralize stomach acid, such as Maalox® (aluminum hydroxide/magnesium hydroxide), Tums® (calcium carbonate), or Rolaids® (calcium carbonate and magnesia), may be taken up to 2 hours before or 2 hours after SPRYCEL.

Since SPRYCEL therapy may cause bleeding, tell your healthcare provider if you are using blood thinner medicine, such as Coumadin® (warfarin sodium) or aspirin.

Know the medicines you take. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.

SPRYCEL allows you to be treated for CML without changing when and how often you eat.

  • Do not eat grapefruit or drink grapefruit juice while taking SPRYCEL.
  • Try to take SPRYCEL at the same time each day. Swallow SPRYCEL tablets whole with water. Do not break, cut, or crush the tablets.
  • Depending on your response to treatment and any side effects that you may experience, your healthcare provider may
    • change your dose of SPRYCEL or
    • tell you to temporarily stop taking SPRYCEL.
  • Do not change your dose or stop taking SPRYCEL without first talking with your healthcare provider.
  • If you miss a dose of SPRYCEL, take your next scheduled dose at its regular time. Do not take two doses at the same time. Call your healthcare provider or pharmacist if you are not sure what to do.
  • If you take too much SPRYCEL, call your healthcare provider or go to the nearest hospital emergency room right away.

Important Safety Information about
SPRYCEL® (dasatinib)

It is not known if SPRYCEL is safe and effective in children younger than 18 years old.

Before you take SPRYCEL, tell your healthcare provider if you:

  • have problems with your immune system
  • have liver problems
  • have heart problems
  • are lactose intolerant
  • have any other medical conditions
  • are pregnant or planning to become pregnant. SPRYCEL may harm your unborn baby. Women should not become pregnant while taking SPRYCEL. Talk to your healthcare provider right away if you are pregnant or plan to become pregnant
  • are breast-feeding or plan to breast-feed. It is not known if SPRYCEL passes into your breast milk or if it can harm your baby. You and your healthcare provider should decide if you will take SPRYCEL or breast-feed. You should not do both

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, antacids, and herbal supplements.

Especially tell your healthcare provider if you take:

  • medicines that increase the amount of SPRYCEL in your bloodstream, such as:
    • Nizoral® (ketoconazole)
    Sporanox® (itraconazole)
    Norvir® (ritonavir)
    Reyataz® (atazanavir sulfate)
    Crixivan® (indinavir)
    Viracept® (nelfinavir)
    Nefazodone (serzone®, nefadar)
    Invirase® (saquinavir)
    Ketek® (telithromycin)
    E-mycin® (erythromycin)
    Biaxin® (clarithromycin)
  • medicines that decrease the amount of SPRYCEL in your bloodstream, such as:
    • Decadron® (dexamethasone)
    Dilantin® (phenytoin)
    Tegretol® (carbamazepine)
    Rimactane® (rifampin)
    Luminal® (phenobarbital)
  • medicines whose blood levels might change by taking SPRYCEL, such as:
    • Sandimmune® (cyclosporine)
    Alfenta® (alfentanil)
    Fentanyl® (fentanyl)
    Orap® (pimozide)
    Rapamune® (sirolimus)
    Prograf® (tacrolimus)
    Ergomar® (ergotamine)

SPRYCEL® (dasatinib) is best absorbed from your stomach into your bloodstream in the presence of stomach acid. You should avoid taking medicines that reduce stomach acid, such as:

Tagamet® (cimetidine)
Pepcid® (famotidine)
Zantac® (ranitidine)
Prilosec® (omeprazole)
Protonix® (pantoprazole sodium)
Nexium® (esomeprazole)
AcipHex® (rabeprazole)
Prevacid® (lansoprazole)

Medicines that neutralize stomach acid, such as Maalox® (aluminum hydroxide/magnesium hydroxide), Tums® (calcium carbonate), or Rolaids® (calcium carbonate and magnesia), may be taken up to 2 hours before or 2 hours after SPRYCEL.

Since SPRYCEL therapy may cause bleeding, tell your healthcare provider if you are using blood thinner medicine, such as Coumadin® (warfarin sodium) or aspirin.

Know the medicines you take. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.

Take SPRYCEL exactly as prescribed by your healthcare provider

  • Take SPRYCEL with or without food. Try to take SPRYCEL at the same time each day
  • Swallow SPRYCEL tablets whole with water. Do not break, cut, or crush the tablets
  • You should not drink grapefruit juice while taking SPRYCEL

SPRYCEL may cause serious side effects, including:
  • Low Blood Cell Counts: SPRYCEL may cause low red blood cell counts (anemia), low white blood cell counts (neutropenia), and low platelet counts (thrombocytopenia). Your healthcare provider will do blood tests to check your blood cell counts regularly during your treatment with SPRYCEL. Call your healthcare provider right away if you have a fever or any signs of an infection while taking SPRYCEL.
  • Bleeding: SPRYCEL® (dasatinib) may cause severe bleeding that can lead to death. Call your healthcare provider right away if you have:
    • - unusual bleeding or bruising of your skin
    • - bright red or dark, tar-like stools
    • - a decrease in your level of consciousness, headache, or change in speech
  • Your body may hold too much fluid (fluid retention): In severe cases, fluid may build up in the lining of your lungs, the sac around your heart, or your stomach cavity. Call your healthcare provider right away if you get any of these symptoms during treatment with SPRYCEL:
    • - swelling all over your body
    • - weight gain
    • - shortness of breath and cough
  • Heart problems: SPRYCEL may cause an abnormal heart rate, heart problems, or a heart attack that can lead to death. Your healthcare provider will monitor the potassium and magnesium levels in your blood, and your heart function.
  • Pulmonary Arterial Hypertension (PAH): SPRYCEL may cause high blood pressure in the vessels of your lungs. PAH may happen at any time during your treatment with SPRYCEL. Your healthcare provider should check your heart and lungs before and during your treatment with SPRYCEL. Call your healthcare provider right away if you have shortness of breath, tiredness, or swelling all over your body (fluid retention)

Other common side effects of SPRYCEL therapy include:

  • diarrhea
  • headache
  • cough
  • skin rash
  • fever
  • nausea
  • tiredness
  • vomiting
  • muscle pain
  • weakness
  • infections

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all of the possible side effects of SPRYCEL. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at
1-800-FDA-1088.

Please read the Patient Information in the full Prescribing Information.