Drug Interaction Report

Dasatinib may increase the blood levels of bosutinib. In some cases, this can increase side effects such as nausea, vomiting, abdominal pain, diarrhea, liver problems, fluid retention, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you develop paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Do not consume grapefruit or grapefruit juice during treatment with dasatinib. Grapefruit juice can significantly increase the blood levels and effects of dasatinib, which may result in excessive slowing of heart rate or other conduction disturbances and it may affect your bone marrow function, resulting in low numbers of different types of blood cells. You may be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Talk to your doctor if you have any questions or concerns. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, heart palpitations, paleness, fatigue, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, blood in phlegm, weight loss, pain or burning during urination, red or inflamed skin, or body sores during treatment with dasatinib. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Bosutinib should be taken with a meal to help with its absorption. Do not consume grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with bosutinib unless directed otherwise by your doctor. Grapefruit juice can significantly increase the blood levels of bosutinib. You may be more likely to experience side effects such as nausea, vomiting, abdominal pain, diarrhea, liver damage, and impaired bone marrow function resulting in low numbers of different types of blood cells, which can increase the risk of anemia, bleeding problems, and infections. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

The recommended maximum number of medicines in the 'BCR-ABL tyrosine kinase inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'BCR-ABL tyrosine kinase inhibitors' category:

• bosutinib
• Sprycel (dasatinib)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.