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May switch to Bosulif -- Advice please


My husband has been on 4-month drug holiday from Sprycel 50 mg due to shortness of breath.  Because SOB has diminished but not gone away entirely, he will likely switch to 300 mg Bosulif if/when his PCR goes above .1.  It is at .026.  Would like to hear from others on Bosulif with advice for how best to take drug, what to avoid, etc.  For example, time of day, what kind of food/water amounts, etc.  And he does enjoy beer or wine with dinner.  Has this been a problem?

Our hope is that on this "lower" dose of 300 there will not be severe side effects.  My husband has been very responsive to TKI's since diagnosis 2012 and in MMR the whole time.  A previous TFR failed after 3 months and he returned to MMR almost immediately.

I plan to also post this on the LLS community forum since I'm a bit confused about the level of activity on the two forums at this time.  As always, am extremely thankful to others who share experience and advice on this journey.

TTT  this was posted right before the forum went offline for a day or two, so hoping may get some responses.

UPDATE:  He will start on 100 mg Bosulif and perhaps titrate up, NOT on 300 mg as I had originally posted.

Bosutinib is a powerful TKI. The 100mg dose seems low. I was on it for a while at a starting dosage of 400mg and felt good. But had to change off it recently due to my liver enzymes (ALT/AST) being to high. I think I was an exception that couldn’t work through that issue. No alcohol while the liver values were high. It should be taken with food. No grapefruit. I took it in the morning with breakfast. Otherwise Bosutinib is usually well tolerated.

The thing to know is it can give some very bad  diarrhea issues at the start, but if you can ride that out it usually gets better.

Best wishes!

Hi Alison 

similar situation as your husband. Severe PEs on Sprycel after 5 very successful years. Intolerable at lower doses as well.

just switched to 200mg Bosulif 3 days ago. Going to 400mg by adding 100 every week. 

First day was diarrhea. Took Imodium and now the opposite issue and cramps. Need to find the balance. Will keep you updated 

Thanks, Mike B.  I am being moved over to Bosulif in a few weeks after not being able to tolerate Gleevec, Tasigna or Sprycel.  I can deal with the gastro issues so if that's all I have to deal with I'll consider myself lucky!  Have a great day.