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dasatinib side effect


Hi all,

Have been here for quite a while but never posted.

I was dx at Feb 2019 and start Imatinib since then. My number drop signifcantly the first year but got slower in 2020, around 0.1% level PCR. My doctor advice me to an hemotolgist in Nov 2020. Then the new CML specialist took over my case and ask me to switch Dasatinib 100mg starting in Dec 2020. ECG and X ray results normal. But moderate LA enlargement was reported in my Echocardiography exam, done about one month into taking dasatinib. 

Now I am in three month with dasatinib but feel some serious side effects that not experienced with imatinib. The most alarming one is the heart palpitations that really concerns me. I never have any heart disease before but feel heart beats very strong, especially when lying down. And sometimes I felt chest pain and shortness of breath. Because I am living in cold climate, the whole winter I didn't go outdoor much just to avoid any risk of heart failure. And I also see my blood pressure rise to over 130, used to be at 110 level. 

So I see a lot of people sharing the same experience with Dasatinib. Waiting to see my three month PCR after Dasatinib. And will talk to Dr next week. Shall I ask for lower dosage or back to imatinib?



Hi, sorry you are feeling so bad .0.1% is great don't know why your doctor would change your TKI ,some are in just too much of a hurry .As for 100 mg Dasatinib  you don't need to be on such a high dose being so low Insist on lowering to 50 mg to get rid of those awful side effects and you will feel so much better .There are research papers you can download here to take into your doctor explaining about lower dose being better with Dasatinib.Good Luck, Denise.

Thanks Denise.

I also have doubt for such a hurry switch. Now I don't get 50 mg pills and only 100 mg. I wish to try lower the doses by one and other day.

Is there anyone do this before?

And the dizziness also worries me when I need driving the car.

Hi, I was on Imatinib 400 mg and changed to Dasatinib 50 mg no way would I take 100 mg too toxic  and felt so much better ,I am gradually lower my dose  ,on 40 mg now  will lower to 20 mg soon .

I forgot to mentioned that moderate LA enlargement was reported in my Echocardiography exam, done about one month into taking dasatinib.

Also make me wonder if that's the sign of more severe heart problems.

Just got my PCR back at 0.049 after 3 months of Dasatinib. Doctor insist I should keep 100mg until deeper response. 

Good that I have milder side effects with 100mg recently.  Wonder what level of response needed to justify a dosage reduction.


I too have had similar side effects to yours on Sprycel. I have been taking it a little over a year. I have heart palpitations controlled by beta blocker and blood pressure controlled by other medicine. I am currently on 40 mg and still experience these side effects. I do not want that to be discouraging for you, we are all different. Dose reduction has reduced the intensity of my side effects. I also had mild left atrium emlargement and see a cardiologist. The cardiologist hasnt found damage from my side effects. My doctor has been more willing to change due to my side effects, he was not so sure early on. My latest PCR came back higher then the previous one but still in a good place. It was 0.034. I would encourage you to have a serious conversation with your doctor about your side effects and ask for dose reduction. Sprycel can be quite effective at lower doses and there is research that proves it.


Thank you Shawn. Can you please share the research of lower dosage reaching same efficacy?

You can cut the 100 mg pills with a pill cutter to get 50.  My doctor had me do that until the 50s arrived.

Can you share what PCR level did you reach so that your doctor allow lowering the dosage?