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Please advise on Bosutinib 100mg Starting Sept 5 after failing on 100mg and 50mg Dasatinib

I was excited to be on the dasatinib and the first night of my 50mg pill at 9pm was awake at 12:30am with slight fever that eventually went to 103.7 within a hour.  I felt like I was going to pass out and had my Sister call an ambulance instead of driving me to MD Anderson.  My Doctor and the head of the leukemia dept decided after two attempts on dasatinib resulting in fevers it was time to try a different TKI.  

Bosutinib 100mg was the choice.  The guy that sat up the prescription said it could be taken with or without food but the pharmacy advisor said take with dinner.  They did WHOLLY concur that the diarrhea was going to be an issue (both said wide eyed).  I was advised to always have a change of clothes and a way to clean up and bag soiled clothing if I had to go out.

Anyone here that can help me with their experience like what food seemed to help you best...what food STAY away from.....How long did the diarrhea affect you and does it still.  I am trying to prepare for the worse and hope for the best it can be.  Hearing from people that have actually went through this means a lot to me.

I would also be very interested in any other side affects this drug caused you and what you did to help yourself through it. 

Very down about failing on the dasatinib after reading the success with so many people.

Onekayaker

 

 

 

Good luck with bosutinib. The diarrhea tends to last only a short time - a handful of weeks at most, usually. 

I can only give you general advice on this, since I have not taken bosutinib but you would want to avoid highly fatty foods as this makes diarrhea particularly unpleasant. Pizza is probably not great! Big rich meals like a rib-eye steak best avoided too for a while.

Some other people on bosutinib have said that little-and-often of fairly simple food is a good strategy in the early days. Once it resolves after a while, you're back to normal business. 

David.

Hi Onekayaker,

I was too switched from Dasatinib to Bosutinib. It has been 5 months and I have been experienced very few side effects- even the dreaded diarrhea!

I have had a couple of bouts but did before as well.  I take my dose at 4:00 with a light snack and then have dinner at 6:00  I try to eat healthy anyways so not sure if that factors in as well. 

Give it a chance, it may not be as bad as they say.  And on a posited note, my numbers are the best they have ever been.

 

Best of luck and keep us posted.

 

 

 

 

 

Thank you David.   I appreciate the information.   I think I will eat a Brat  diet for the first few weeks.  Looks like white rice and maybe boiled chicken and boiled eggs toast

 

Steff

Crossing my fingers I follow your path.   May I ask why you were switched to Bosutinib from Dasatinib?

Steff

I was having breathing issues that pointed to PAH but it was never confirmed. I was actually first switched to Gleevic but my numbers started to climb pretty aggressively. They then switched me to Bosutanib. They started me on 300 and I am currently on 400. I have asked if we might lower the dosage but my doctor feels that is a ways away. She would prefer me to stay the course for a while and then try stopping. As long as my numbers look good, and I have few side effects, I will try it her way. 

Smoody,

 

Hope you see this before I start the new pills.   What does your light snack consist of and what do your meals include?   Researching on my own but would like to hear from you personally please.

Thank you!

Stephanie

Hi Stephanie

how Are you coming along on Bosutinib?

i was on Sprycel for 5 years and all of a sudden developed pleural effusions at all dosage levels. Saddened by that as it worked so well for me. I switched to 10g Bosutinib a few weeks ago and still having gastro issues and fluid retention (to the point that its impacting breathing).

how have you adapted to it ?

Chigi - Sorry to bust in here - I know you are waiting to hear from Stephanie - but I'm interested in Bosutinib and pleural effusions, since I MAY be headed there.  Were you completely free of pleural effusion before you started bosutinib?  Have they checked to see if your impacted breathing/fluid retention is another pleural effusion?  I would have switched to bosutinib (after my 4th pleural effusion on dasatinib) but I'm terrified by the stories about diarrhea and nausea, plus it seems that many people continue to have pleural effusions on bosutinib anyway.  So, I'm going along right now on 20 mg Sprycel (PCR 0.005% IS) and a small, mostly stable, symptomless pleural effusion.  Bosutinib may be in my future so I'm interested in everyone's story on it.

Back to you, Stef -

chigi,

you mean 100g yes?   I have been on the 100g for 8 days.   So far so good.  It is a low dose and I will not see my doctor till next Wednesday and i will follow up a post for you.  i did not have the hideous diarrhea at all.  I have stuck to a diet that includes boiled chicken, white breads if toasted I spread regular apple sauce on it, greek yogurt fage brand, bananas, peeled apples at first then I knew I needed a little roughage, chicken breast cut thin and cook in a little olive oil, steam  spinach, boiled eggs, boost, blueberries, eggs fried in Pam and salad no dressing a few times.  I ate some wheat thins without issue just for something crunchy.  My protein intake needs to be 84-100g per day.  My stomach makes noise when I lay down but no pain.  I do get a pain in my right side rib.  It is a sharp pain if I move a certain way.  The rib pain starts late early evenings to sleep time.  It is gone when I get up then comes again later in day.  It is not a pain that I would want to try something else though.  When I lay down without moving, the pain is neutralized.   I drink 3 quarts of water a day.  This is my routine so far.  WHICH sucks because food was my vice.  Spicy, hot, party in your mouth, rainbow of flavors.   Write down what you eat.   Show it to your doctor.  Could something you are eating add to your side effects?  I do not use much salt.  Just enough to barely flavor the chicken and fried eggs.  If you are in the states, you can contact a Bosutinib "advisor" at 877-983-5618.  Also on google "bosutinib diet"  a 2-4 minute video on youtube with be one of the first things to pop up.  

What is your diet?  I am very interested in what other people eat while taking this pill.  

Onekayaker

 

Chigi,

I take the pill in the morning after eating about 3/4 of my breakfast and wash it down with a bottle of filtered water.  I only drink filtered water.

Onekayaker

Yes meant 100mg.

Glad to know so far so good. I haven’t focused a lot on changing my diet except reduced salt intake. spicy food and ensuring I get good amount of protein and nutritious food. 

Will keep you posted if I learn of anything new / interesting 

Hi Kat73

i had traces of pleural effusion when I switch. My PCR came back positive from undetected thus the rush to not wait.

Recent x-rays show no pleural effusion increases on Bosutinib

I fully agree with you - stay with 20mg Dasatinib if you can tolerate the side effects. I wish I would have but my effusion was severe on 20mg as well.

good luck 

 

chigi,

do you eat chocolate and if so does it affect you at all?  i loved dark chocolate just 2 squares but i stay away from it now.  i never over indulged even before diagnosed

onekayaker

@onekayaker could you please update on how you are doing?  still on 100 mg Bosulif?  or have you titrated up?

how are the side effects?  I see you are taking it at breakfast, while others have recommended dinner?  Thanks for any updated info.

Are you still on 100 mg, I am starting tomorrow having been on Spyrcel 100 for 5 years just start getting pleural effusion. 
all blood work perfect, only side effect, I was a little exhausted from tge time I woke up. I took it at night. 

Awe, this is good news I start tomorrow on Bosutinib after being on Spyrcel for 5 years. Both is 100 mg. 
only side effect from Spyrcel was tiredness but recently pleural effusion.

@sueR my husband has been on Bosulif 100 for two years with no side effects. He had lots of problems with shortness of breath on Sprycel 70 and then 50. 
bosulif 100 is VERY low dose whereas Sprycel 100 is very high dose. 
my husband started on Bosulif 100 with expectation of going higher but has remained in MMR usually at about .004 on lowest dose so never increased. 

best of luck to you. 

Thanks, that good to hear. Yes it’s the shortness of breath is the reason.