Nodriga (Dasatinib)

• Dasatinib targets BCR‑ABL‑positive leukemias and related tyrosine‑kinase driven disease pathways.
• Chronic myeloid leukemia (CML): reduces disease progression and achieves cytogenetic responses in chronic phase patients.
• Accelerated phase CML: provides hematologic and cytogenetic improvement in advanced disease.
• Philadelphia chromosome‑positive acute lymphoblastic leukemia (Ph+ ALL): enhances remission rates when used in combination regimens.

• Dasatinib binds to the ATP‑binding site of BCR‑ABL and Src family tyrosine kinases, inhibiting their enzymatic activity. This blockade prevents downstream signaling that drives malignant cell proliferation and survival, leading to apoptosis of leukemic cells and interruption of disease progression.

Dasatinib may cause a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Myelosuppression: decreased white blood cells, neutrophils, or platelets.
• Gastrointestinal upset: nausea, diarrhea, or abdominal pain.
• Fluid retention: peripheral edema or pleural effusion.
• Fatigue or generalized weakness.

Serious or Rare Side Effects

• Pulmonary arterial hypertension.
• Severe bleeding or hemorrhage.
• Cardiac dysfunction, including left ventricular failure.
• Severe infections such as sepsis.
• Liver toxicity with elevated transaminases.

• Patients should be monitored regularly for hematologic and organ‑specific toxicities.
• Baseline assessment: obtain complete blood count and liver function tests before initiating therapy.
• Infection risk: monitor for signs of infection and manage promptly.
• Bleeding tendency: avoid concomitant anticoagulants unless medically necessary.
• Cardiac monitoring: assess for symptoms of pulmonary hypertension or heart failure.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, and protect from moisture.

Dasatinib metabolism and transport can be affected by other medicines, requiring careful review.

Major Interactions (Avoid)

• Strong CYP3A4 inducers (e.g., rifampin, carbamazepine): may markedly reduce dasatinib exposure.
• Antacids containing aluminum or magnesium: can decrease oral absorption.
• Proton‑pump inhibitors: may lower bioavailability.

Moderate Interactions (Monitor Closely)

• Moderate CYP3A4 inhibitors (e.g., erythromycin, fluconazole): may increase plasma levels.
• P‑glycoprotein inhibitors (e.g., verapamil): can raise dasatinib concentrations.
• Concomitant anticoagulants: heightened bleeding risk warrants close observation.