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Why is Bosulif prescribed?

Bosulif (Bosutinib) is a kinase inhibitor used to treat adults and certain children aged 1 year and older with Chronic Myelogenous Leukemia (CML), also known as chronic myeloid leukemia.

What does it do?

Bosulif is a targeted therapy that works by inhibiting BCR-ABL kinase, a protein that is often overproduced in CML cells, helping to slow or stop their growth. In addition to targeting BCR-ABL, it also inhibits Lyn, Src, and Hck—members of the Src family of kinases. Bosulif is classified as a tyrosine kinase inhibitor.

How should I take it?

Take this medication by mouth with food as prescribed by your doctor, usually once daily. Your dose may be adjusted if you have any existing liver or kidney disease or any unwanted side effects.

What if I missed a dose?

Take the medication as soon as possible, but if you are more than 12 hours late, skip the missed dose. Do not double dose.

What are the special precautions before taking Bosulif?

Inform your doctor about all the medications you are taking, your current and previous medical history.

Before starting Bosulif, inform your doctor if you have a history of:

• Breastfeeding
• Diabetes
• Heart disease
• High blood pressure
• Liver or kidney disease

Bosulif may cause severe diarrhea and other digestive issues. Inform your doctor if these side effects become intolerable, as they may need to adjust your dose, pause treatment, or discontinue the medication and can lower blood cell counts, reducing your ability to fight infections and clot blood properly. Contact your doctor immediately if you experience unusual bruising, bleeding, fever, chills, or body aches.

Do not break or crush Bosulif tablets. If a tablet is broken, avoid direct contact with the medicine, as it may be harmful if it touches your skin. Consult your doctor or pharmacist on how to safely handle and dispose of broken tablets.

Does it have any side effects?
It is important to note that all drugs have corresponding side effects and adverse reactions. Additional information may be obtained when you ask your doctor or pharmacist.
Common side effects may include:
• Constipation
• Diarrhea
• Rash
• Fatigue
• Fever
• Nausea
• Abdominal pain
• Liver issues
• Headache
• Decreased appetite
• Respiratory infections (throat, nose, or lung infections)
• Changes in blood test results (your doctor will monitor these)
• Vomiting
Serious side effects may include:
• Stomach issues: Bosulif may lead to abdominal pain, nausea, diarrhea, vomiting, or blood in the stool. Seek medical attention immediately if you experience these symptoms.
• Low blood cell counts: This medication can reduce red blood cells (anemia), platelet levels (thrombocytopenia), and white blood cells (neutropenia). Your doctor will monitor your blood counts regularly. Contact your doctor if you notice unexpected bruising, bleeding, blood in your urine or stool, fever, or signs of infection.
• Liver problems: Routine liver function tests are recommended. Call your doctor if you notice yellowing of the skin or eyes (jaundice) or dark-colored urine.
• Heart complications: Bosulif may cause heart failure or reduced blood flow to the heart, potentially leading to a heart attack. Seek immediate medical help if you experience chest pain, shortness of breath, swelling in your feet, hands, or ankles, or unexplained weight gain.
• Fluid retention: Excess fluid may accumulate in the lining of the lungs, around the heart, or in the abdominal cavity.
• Kidney problems: Your doctor will monitor kidney function throughout your treatment.

Your doctor may adjust your dose, temporarily stop, or permanently discontinue Bosulif if certain side effects occur.

Report any bothersome or persistent side effects to your doctor. This is not a complete list of possible side effects. Contact your doctor for medical advice regarding side effects.

Is it safe to take it with another drug?
Some drug interactions may cause serious or life-threatening reactions when administered together. Immediately inform your doctor if you are taking Bosulif with any of the following medications:
• Antacids and Acid Reducers: such as famotidine or cimetidine
• Proton Pump Inhibitors: including Omeprazole
• Strong and Moderate CYP3A Inhibitors: such as Diltiazem, Erythromycin, Clarithromycin, Itraconazole, Ketoconazole, Ritonavir, and Verapamil
• Strong CYP3A Inducers: including Carbamazepine, Phenobarbital, Glucocorticoids, Rifampin, and Phenytoin
• Live Vaccines: including ,Measles, Mumps, Rotavirus and Varicella

Avoid grapefruit, grapefruit juice, and supplements containing grapefruit extract, as they may interact with Bosutinib. Many other medications may interact with Bosutinib. Always inform your doctor about any new or discontinued medications to ensure safe and effective treatment.

How should I store it?
Keep your medication in its original, labeled container at room temperature in a dry place, unless otherwise instructed by your healthcare provider or pharmacist. Do not store this medication in a pillbox. Keep the container out of reach of children and pets.
What action should I take in case of overdose?
If someone has overdosed and is experiencing severe symptoms such as unconsciousness or difficulty breathing, seek immediate medical attention or contact a poison control center right away.
Is it safe for pregnant or breastfeeding women?

Inform your doctor if you are pregnant or planning to become pregnant. Avoid pregnancy while using Bosutinib, as it may harm an unborn baby. Your doctor may require a pregnancy test before starting this medication. Discuss reliable birth control options to use during treatment and for 2 weeks after your last dose. If you become pregnant, contact your doctor immediately to discuss the potential risks and benefits.

It is unknown whether Bosutinib passes into breast milk. Due to the potential risk to the infant, breastfeeding is not recommended during treatment and for 2 weeks after the final dose. Consult your doctor before breastfeeding.

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