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BOSULIF
Leukemias, lymphomas, and other hematologic cancers
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Drug Name:

BOSULIF Rx

BOSULIF (bosutinib) 500mg tablets by Pfizer

Generic Name and Formulations:
Bosutinib 100mg, 500mg; tabs.

Company:
Pfizer Inc.

e-Prescribe this drug via Surescripts


Therapeutic Use:

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Indications for BOSULIF:

Treatment of chronic, accelerated, or blast phase Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML) with resistance or intolerance to prior therapy.

Adult Dose for BOSULIF:

500mg once daily with food. Continue until disease progression or patient intolerance. Consider dose escalation to 600mg once daily in patients who do not reach complete hematological response (CHR) by week 8 or a complete cytogenetic response (CCyR) by week 12, who did not have Grade 3 or higher adverse reactions. Adjust dose for hematologic and non-hematologic toxicity: see literature. Hepatic impairment: 200mg daily.

Children's Dose for BOSULIF:

<18yrs: not established.

Pharmacological Class:

Tyrosine kinase inhibitor.

Warnings/Precautions:

Monitor and manage GI toxicity, fluid retention; withhold, reduce dose, or discontinue as necessary. Perform CBC weekly for first month, then monthly; hepatic enzyme tests monthly for first three months (more frequently if transaminase elevations occur); withhold, reduce dose, or discontinue as necessary. Pregnancy (Cat.D), nursing mothers: not recommended.

Interactions:

Potentiated by concomitant strong or moderate CYP3A and/or P-gp inhibitors (eg, ritonavir, indinavir, nelfinavir, saquinavir, ketoconazole, boceprevir, telaprevir, itraconazole, voriconazole, posaconazole, clarithromycin, telithromycin, nefazodone, conivaptan, fluconazole, darunavir, erythromycin, diltiazem, atazanavir, aprepitant, amprenavir, fosamprenavir, crizotinib, imatinib, verapamil, grapefruit products, ciprofloxacin); avoid. Antagonized by concomitant strong or moderate CYP3A inducers (eg, rifampin, phenytoin, carbamazepine, St. John’s Wort, rifabutin, phenobarbital, bosentan, nafcillin, efavirenz, modafinil etravirine); avoid. Antagonized by proton pump inhibitors (eg, lansoprazole); consider short-acting antacids or H2 blockers instead; separate dosing by more than 2hrs. May potentiate drugs that are P-gp substrates (eg, digoxin).

Adverse Reactions:

Diarrhea, nausea, thrombocytopenia, vomiting, abdominal pain, rash, anemia, pyrexia, fatigue; fluid retention (monitor), hepatic toxicity.

Metabolism:

Hepatic (CYP3A4); 94% protein bound.

Elimination:

Fecal (primary), renal.

Generic Availability:

NO

How Supplied:

Tabs 100mg—120; 500mg—30