I was curious how many people in this Forum are taking (or have taken) a Sprycel Dose under 50 mg. I have lobbied, unsuccessfully, for a dose reduction to 40 mg or less. My oncologist is adamant that there are no studies to support a reduction under 50 mg. I am struggling with side effects, but have responded well to Sprycel, so I do not want to change medications unless it becomes absolutely necessary. I realize this would just be anecdotal evidence, but I would still be very interested in knowing. Thank you.
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Sprycel Dose under 50 mg?
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I take 20mg daily.
I don’t know of any studies going below 50mg, but studies aren’t the be all and end all. There are lots of stop-studies, so it stands to reason a small dose is going to be more successful than a stop regime.
My doctor is great, we have always agreed on the plan but a the end of the day you can do you own thing and just tell your doctor. If you wanted you could do 50mg every two days, and ask for more frequent PCR testing. Or your doctor could play ball and give you 20mg once a day and increased testing too.
My doctor prescribed 20 mg in response to my severe myelosuppression which occurred at a higher starting dose. He is an expert in the field and one of the top researchers in the world who helped write the protocol guidelines. It was his research (and others) that suggested 50 mg be a better starting dose for sprycel for many patients. He observed in his clinic that many patients do very well on low dose sprycel.
Once I was prescribed 20 mg, my PCR levels plummeted and I achieved "undetected" status. I then reduced my dose further to 20 mg every other day and remained undetected. I am now in treatment free remission (> one year) - drug free.
Depending on your CML status (PCR = ? %), you have plenty of time to experiment with lower dose and see how you respond after 3 months. There is a fair chance your side effects will lessen and your response either remain the same or actually improve.