6 replies to this topic

[CMLParent]

Is there any data to support breaking up a dose to twice a day vs once a day is less effective? For example if your dose was 40mg of Sprycel and instead of taking both pills at the same time everyday you took one in the morning and one at night.

Thanks in advance

[Marnie]

Splitting Sprycel is not recommended.  It can increase the risk of pleural effusion. 

[Trey]

Here is the summary info about Sprycel once daily dosage:

http://www.ncbi.nlm....pubmed/18541900

 

However, there is very little info about children taking Sprycel, so I would not automatically assume this would be the same recommendation for your child.  But no one will tell you it is OK to split dosage for a child since they have no data.  Lower dosage Sprycel is done regularly in CML patients, so lower dosage twice daily would not be an automatic issue for your child.  It might help with his other side effects.  As the info says in the link above the issue was pleural effusion in the study group, but studies are not exact representations of all real world scenarios, and may even be skewed.  Many people taking once daily Sprycel get pleural effusion, also. 

 

No one knows the answer to this and many other issues.  If you try it then you will know, otherwise you will not know.

[scuba]

This was an interesting paper ... it was one of the reasons that led me to shift taking my dose to the evening. 

 

.. from the paper,

 

"Once-daily treatment resulted in less toxicity, suggesting that toxicity results from continuous inhibition of unintended targets. "

 

One of those unintended targets is melanin production necessary for sun protection (via tan generation). I found that when I moved taking my dose from daytime to the evening, I was able to tan again (like now during this summer) when out in the sun without burning. The half-life of Sprycel is about 5 hours - so by mid-day, the inhibition of secondary sites by Sprycel is largely gone. Of course inhibition of CML is gone too, but the potency of Sprycel is dramatic (from the paper, "Dasatinib is a BCR-ABL inhibitor, 325-fold more potent than imatinib against unmutated BCR-ABL in vitro").

 

... of course, I'm just shifting what is getting targeted by Sprycel from daytime biochemistry to night time biochemistry. I do have more interesting dreams now that I take Sprycel at bed time (don't go there Trey ... I know you want to ...)

[beno]

I've always taken my Sprycel at bed time and I'm extremely more sensitive to the Sun than I was before.

[scuba]

I've always taken my Sprycel at bed time and I'm extremely more sensitive to the Sun than I was before.

 

I'm sure dose has something to do with it as well. I only take 20mg vs 100.

[JohnFromChicago]

I'm sure dose has something to do with it as well. I only take 20mg vs 100.

 

 

I've always taken my Sprycel at bed time and I'm extremely more sensitive to the Sun than I was before.

 

I am on 100mg and I have not noticed any more sensitivity to the sun and I take my Sprycel in the morning, I guess it may just be one of those things that affects everyone differently. I do wear SPF after being outside for an hour or a little longer. I spend many hours in the sun outside at least 2-3 days a week. Im sure 20mg vs 100mg makes a huge difference for those who it does affect as well.