Which four groups of people are not suitable for taking dasatinib?

Dasatinib (Dasatinib) is a potent oral tyrosine kinase inhibitor, mainly used to treat chronic myelogenous leukemia (CML) and Ph+acute lymphoblastic leukemia (Ph+ALL), which blocks the activity of BCR-ABL fusion protein and interferes with the signal transduction of tumor cells, thereby inhibiting the growth and proliferation of leukemia cells. However, not all patients are suitable for dasatinib treatment. Some people have higher risks in using the drug due to underlying health problems or different drug metabolism characteristics, and must be treated with caution or even banned.

The first category of prohibited persons is those who are allergic to dasatinib or any of its excipients. This allergic reaction may manifest as rash, itching, laryngeal edema, or difficulty breathing, and is classified as a serious adverse reaction. Once a drug allergy is diagnosed, further contact with the drug should be avoided.

The second category is patients with severe liver dysfunction. Dasatinib is mainly metabolized by the liver. Impaired liver function will slow down the clearance of the drug, increase its concentration in the body, and increase the risk of toxic reactions. In particular, serious consequences such as bone marrow suppression, bleeding, or infection may occur. Therefore, liver enzyme levels and bilirubin indicators should be assessed before treatment, and dose adjustment or discontinuation should be considered in the event of liver injury.

The third category of patients for whom it is not recommended to use this drug is those who have obvious bleeding tendencies or are receiving anticoagulant therapy. Dasatinib has been shown to affect platelet function and weaken the integrity of the vascular endothelium, resulting in an increased risk of bleeding, especially when combined with aspirin, heparin or other antiplatelet drugs. The benefits and risks should be weighed in patients with active peptic ulcers, thrombocytopenia, or a history of severe bleeding.

The fourth category is women who are pregnant or may be pregnant. Although human data are limited, dasatinib has demonstrated toxicity to embryonic development, including teratogenesis and fetal death, in animal studies and therefore carries a high risk for use during pregnancy. All women of childbearing potential should take a pregnancy test before using this drug and use effective contraception until several weeks after stopping the drug before considering pregnancy.

Reference materials:https://go.drugbank.com/drugs/DB01254