Nodriga (Dasatinib)

Dasatinib is a targeted tyrosine‑kinase inhibitor used in hematologic malignancies that involve BCR‑ABL or SRC family kinases.

• Chronic Myeloid Leukemia (CML): helps achieve cytogenetic and molecular remission by blocking proliferative signaling in BCR‑ABL‑positive cells.
• Philadelphia chromosome‑positive Acute Lymphoblastic Leukemia (Ph+ ALL): contributes to disease control by inhibiting the same oncogenic kinase pathways, supporting remission induction and maintenance.

• Dasatinib binds competitively to the ATP‑binding site of BCR‑ABL and SRC family tyrosine kinases, preventing phosphorylation of downstream substrates. This inhibition disrupts signaling cascades that drive malignant cell proliferation, survival, and migration, leading to apoptosis of leukemic cells and reduced tumor burden.

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

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Diarrhea: watery stools often occurring early in therapy.
• Fatigue: persistent tiredness affecting daily activities.
• Rash: skin erythema or pruritus.

Serious or Rare Side Effects

• Pleural effusion: accumulation of fluid around the lungs requiring medical evaluation.
• Pulmonary hypertension: elevated pressure in pulmonary arteries, potentially life‑threatening.
• Severe bleeding: hemorrhage due to platelet dysfunction or thrombocytopenia.

Patients receiving Dasatinib should be monitored closely for safety concerns.

• Blood counts: perform regular CBC to detect myelosuppression.
• Liver function: assess hepatic enzymes periodically.
• Cardiac monitoring: evaluate for signs of pulmonary hypertension or heart failure.
• Drug interactions: avoid strong CYP3A4 inhibitors that may increase exposure.
• Storage: Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Dasatinib interacts with several medication classes that can alter its efficacy or safety.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may raise dasatinib plasma levels.
• Proton pump inhibitors: can reduce absorption of the oral tablet.
• Anticoagulants (e.g., warfarin): increased risk of bleeding.

Moderate Interactions (Monitor Closely)

• Moderate CYP3A4 inhibitors (e.g., erythromycin): may modestly increase exposure.
• CYP3A4 inducers (e.g., rifampin, carbamazepine): may lower drug concentrations.
• QT‑prolonging agents (e.g., quinidine): monitor cardiac rhythm.