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need some guidance on increased dose of tasigna

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#1 Nili_7783


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Posted 11 December 2014 - 05:44 PM

Hi All,

if you have a some time and could read my message and give me your input

My sister was dignosed 2 years and 3 months ago with CML when she was 19.she is in india, she finished her Nursing degree and now she 21. Since the dignosis she is on Tasigna 300mg twice a day, she got green card and immigrating for good to san jose, CA,USA on 23rd december, She had her last visit with her regular oncologist in india 2 days ago, and i found out that her doc increased her tasigna dose to 400mg twice a day. when i called doc to ask why increase in dose? his answer was
1)she had gained weight since her dignosis and now she 112
2)he is still waiting for her PCR report, which in india takes 5-7 days to come back, till the last visit she was PCRU
3)also her WBC counts were 14000 at this visit. Doc said none out of these was leukamatic cells

i am worried on why he needed to increase dosage now when she is leaving the country and not being monitored by any oncologist for few months

because of different countries and time difference, it's very hard for me to communicate with her doc and see the reports etc.

now situation here is i am applying for her medi-cal insurance as an individual with covered california(obamacare), if all the parameters qualify under low income (she is/will not be earning any income, she will start insurance from Feb and by the time we find a a good oncologist and lab, it will be at least mid February 2015

Doc (india) at the last visit prescribed 400mg twice a day tasigna for next 6 months, so she will have meds worth of 6 months with her but this is a increased dose and i am worried about how she will respond to it.


i am planning on calling oncologist today, what are some of the questions i should ask him to find out why he feel need to increase dose now?

please advise how should i tackle with whole situation?

Thanks so much


#2 JPD


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Posted 11 December 2014 - 07:37 PM

What were her last PCR results?  Unless her PCR numbers are up, I have no idea why the increase.


That is very strange, indeed.


What side effects did she have (if any) with the 300mg?  The only thing I would be wary of is her WBC getting too low (happened to me at 400mg) but she should be getting regular blood tests with the increase in dosage... I dont think its safe to increase the dosage without having some blood tests to check her numbers.

January 15: .53%

April 15:       .78%

July 15:      1.1% - upped dosage to 400mg after this test

Oct 15:       .85%

December 15:  .28%

March 16: .29%

July 16: .34%

October 16: .11%

January 17: .081%

April 17: .055%

July 17: .135%

Oct 17: .008%

#3 Nili_7783


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Posted 12 December 2014 - 02:41 PM

Thanks JPD for your reply!

#4 Trey


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Posted 12 December 2014 - 05:11 PM

There is no apparent reason for the Onc's actions.  The dosage might be too high for her.  It is higher than the standard 300mg twice per day.  Also, her low weight might increase the side effects. 


The Onc is acting without proper reason.  Such an increase should only be done if there is poor response to the drug.  The Onc does not know her drug response without the PCR report.

#5 Nili_7783


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Posted 12 December 2014 - 08:31 PM

Thanks Trey for your reply! i am going to call this onc again today and convince him not to increase the dose.

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