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changing from Imatinib 400mg to Dasatinib due to intolerence/side effects

Hi, I am due to see my consultant again in a couple of weeks as at my last clinic appointment, switching to Dasatinib from Imatinib 400mg was discussed due to some of the side effects that I have on Imatinib.

I feel worried and anxious to make the switch when my side effects are.. Anemia previously transfusion dependent. Nausea and vomiting. Arthralgias with a raised creatine Kinase (I have no idea what this is??) fluctuating BCR-ABL ratio IVC obstruction July 2005 secondary to dehydration premature menopause, Bilateral hallux rigidus.

My bone marrow shows 0% positivity my BCR-ABL levels do vary from 0.01 (i.e.%) to 0.004 (i.e. 0.4%) positivity which borders on a major molecular response. I suffer from bad cramps. My creatinine runs at 92 and CK midly elevated at 192. My calcium is low at 2.1.

I feel that I am able to manage my side effects as I have become used to them. I know that when  my dosage was increased  to 600mg a few years ago I became intolerant at that level of dosage as i was having blood transfusions every 2nd week. So I understand that this would not be an option.

I have been advised that the side effects of Dasatinib may be fewer and although my response is ok, it may be even better at a molecular level on Dasabinib than I have been able to reach on Imatinib. I have been advised to take vitamin D supplement to see if that helps with the cramps and low calcium levels and be reviewed for the possible switch now or to watch the situation a little longer.

I would appreciate your feedback for any of you that have made the switch and feel better from taking Dasatinib from Imatinib.

I was diagnosed in Nov 03.

Thanks

Michelle

darren, my husband switched a few weeks back due to developing resistance after 18months of treatment. He always felt tired and sick on the gleevec but since switching to Dasatinib he has been so much better. So far he has had no side effects at all and feels great. We dont know if its working yet but certainly the side effects have disappearred.

Hope this helps

Lisa

Hi Michelle


I switched to dasatanib from imatanib because of intolerance and have found I have far fewer side effects. Still some such as abdominal cramps/pain/bloating, muscle/bone pain in my legs, and these side effects come and go without obvious rhyme and reason. This gets me down at times (although that of course may also be another side effect...) and I just have to take painkillers and buscopan. I also had pleural effusion last year so now have been on a dose of 70mg per day. PE hasn't come back and PCR still remains undectable (so far). I too was worried about switching but I don't have the slew of side effects I had before (and I don't have to take steroids to tolerate it). You can also take dasatanib without a meal and it isn't quite so hard on your stomach. Problem of course is that everyone is different so the effects are difficult to predict. All I can say is that I'm better off on dasatanib and I hope that you will be too.

Sarah