Bosutinib is an anti-cancer medication that belongs to tyrosine kinase inhibitors. The drug was first approved in September 2012 for treating patients with chronic, accelerated, or blast-phase Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML) who are resistant or can no longer benefit from other medications for CML. Later on, FDA approved bosutinib for the treatment of patients with newly-diagnosed chronic phase (CP) Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML) in December 19, 2017.

It is used to treat three stages of chronic myelogenous leukemia (CML) called ‘chronic phase’, ‘accelerated phase’, and ‘blast phase’ in patients who have already been treated with one or more tyrosine kinase inhibitors (medicines for CML which work in a similar way to Bosutinib) and became intolerant (no longer being benefited) to it. It is also used to treat newly-diagnosed chronic phase (CP) Philadelphia chromosome-positive chronic myelogenous leukemia (Ph+ CML). 

Bosutinib is available as oral tablets in 100 mg, 400 mg, and 500 mg. The drug will be prescribed by the healthcare professional. Your physician will decide on the dose and frequency based on the severity of the disease, weight, and height. For Newly-diagnosed chronic phase (Ph+) CML, 400 mg orally once daily with food will be prescribed initially. For managing Chronic, accelerated, or blast phase (Ph+) CML with resistance or intolerance to prior therapy, 500 mg orally once daily with food is given. The doctor may increase the dose up to 600 mg once a day or reduce it or interrupt treatment according to how the medicine works for you and based on the side effects.

The common side effects of bosutinib are abdomen pain, anemia (low red blood cell counts), low platelet counts, nausea, diarrhea, vomiting, blood in your stools, tiredness, fever, cough, rash, headache, decreased platelet counts, tiredness, increased levels of liver enzymes, swelling of the ankles or swelling around the eyes,  joint or muscle pains,  bitter or metal taste in your mouth. This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you will likely get an infection. 

The drug may cause allergic reactions; notify your doctor if you see any signs of rash, itchy skin, redness, Swelling of your lips or tongue, sudden cough, and low blood pressure. Bosutinib causes infection. Inform your doctor immediately if you face any symptoms of infection or bleeding. Report the symptoms of decreased liver function, chest pain, and fluid buildup in the abdomen, face, and ankle areas to your doctor. It is not safe to take this medicine during pregnancy. It may harm an unborn baby. Tell your doctor immediately if you become pregnant, breastfeeding, or planning for pregnancy. This medicine may cause liver damage and kidney and heart problems; hence if you have any existing conditions, inform your doctor. 

Do not take PPIs (Proton pump inhibitors such as pantoprazole, omeprazole, and lansoprazole) while using this medication because this will reduce the effectiveness of bosutinib. Consider talking with your physician about all the other prescribed, over-the-counter or herbal medications you take. If you take antacids or H2 blockers (such as famotidine and ranitidine), take these medications at least 2 hours before or after bosutinib. Inform your physician if you are allergic to bosutinib, its ingredients, or other medications. Bosutinib may increase your chances of getting infected. To lower the chances of getting infected, avoid contact with people affected by infections such as cold or flu.

Take this medication by mouth with food as directed by your doctor, usually once daily. Swallow the medication whole. Do not crush, chew, or split the tablets. Use this medication regularly to get the most benefit from it. Remember to use it at the same time each day. This drug may make you dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely.

1. HIGHLIGHTS OF PRESCRIBING INFORMATION. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/203341s009lbl.pdf (Accessed on 20 December 2022)

2. Bosutinib: MedlinePlus Drug Information. medlineplus.gov. https://medlineplus.gov/druginfo/meds/a613005.html (Accessed on 20 December 2022)

3. Bosulif (bosutinib) dosing, indications, interactions, adverse effects, and more. reference.medscape.com. (Accessed December 20, 2022) https://reference.medscape.com/drug/bosulif-bosutinib-999770#91 

4. Micromedex Products: Micromedexsolutions.com. Published 2019. (Accessed December s://www.micromedexsolutions.com/micromedex2/librarian/PFDefaultActionId/evṭidencexpert.DoIntegratedSearch?navitem=topHome&isToolPage=true# 

The drug information on this page is not a substitute for medical advice. It is meant for educational purposes only. For further details, consult your doctor about your medical condition to know if you can receive this treatment.