Bosutinib | Side Effects, Dosage, Uses & More
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Generic Name:

bosutinib, Oral tablet

All Brands

  • BOSULIF
SECTION 1 of 5

Highlights for bosutinib

Oral tablet
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Bosutinib is used to treat adults with a certain type of leukemia. It’s called Philadelphia chromosome-positive chronic myelogenous leukemia (Ph+ CML). Bosutinib is used in patients who’ve had other treatment, but it stopped working. It’s also used for patients whose bodies didn’t respond well to other treatment.

2

This drug comes in the form of a tablet you take by mouth.

3

Bosutinib is available as a brand-name drug called Bosulif. It isn’t available as a generic drug.

4

The more common side effects of this drug include rash, fever, tiredness, or weakness.

5

Bosutinib can lower your blood cell counts. Your doctor will monitor your counts to make sure this medication is safe for you.

IMPORTANT INFORMATION

Low blood cell counts

Bosutinib can lower your blood cell counts. This can cause thrombocytopenia (low platelet levels), anemia (low red blood cell levels), or neutropenia (low white blood cell levels). Your doctor will likely do frequent blood tests to check your blood cell counts during your treatment with this drug. Call your doctor right away if you have unexpected bleeding or bruising. Also call if you have blood in your urine or stools, fever, or any signs of infection (such as fever or sore throat).

Liver problems

Bosutinib can cause or worsen liver problems. Your doctor will likely do frequent blood tests to check your liver function during your treatment with this drug. Call your doctor right away if you see signs of jaundice (such as yellowing of your skin or the whites of your eyes). Also call if you have dark, tea-colored urine.

Kidney problems

Bosutinib can cause or worsen kidney problems. Your doctor will likely do frequent blood tests to check your kidney function during your treatment with this drug. Call your doctor right away if you urinate more or less often than normal, or make much larger or smaller amounts of urine than normal.

Pregnancy

Bosutinib can cause serious harm to a pregnancy. Tell your doctor if you’re pregnant or plan to become pregnant. You shouldn’t become pregnant while taking this drug. If you’re a woman who may become pregnant, use effective contraception (birth control). Be sure to use it while you take this drug, and for at least 30 days after you finish treatment. Talk with your doctor about forms of birth control that are right for you.

What is bosutinib?

Bosutinib is a prescription drug. It comes in the form of a tablet you take by mouth.

Bosutinib is only available as a brand-name drug called Bosulif. It’s not available as a generic drug.

Why it's used

Bosutinib is used to treat adults with a certain type of leukemia. It’s called Philadelphia chromosome-positive chronic myelogenous leukemia (Ph+ CML). Bosutinib is used in patients who had other treatment, but it stopped working. It’s also used for patients whose bodies didn’t respond well to other treatment.

How it works

Bosutinib belongs to a class of drugs called tyrosine kinase inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Bosutinib targets certain proteins within cancer cells that promote CML. It blocks the action of these proteins, which stops the cancer from growing and spreading.

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bosutinib Side Effects

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More Common Side Effects

The more common side effects of bosutinib can include:

  • pain in the abdomen (stomach area), joints, or back

  • fever

  • tiredness

  • weakness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Stomach problems. Symptoms can include:

    • stomach pain
    • nausea and vomiting
    • diarrhea
    • blood in your stools
  • Blood cell count problems. Symptoms can include:

    • infection (with symptoms such as sore throat or fever)
    • unexpected bleeding or bruising
    • blood in your urine or stool
  • Liver problems. Symptoms can include:

    • yellowing of your skin or the white part of your eyes
    • dark, tea-colored urine
  • Kidney problems. Symptoms can include:

    • urinating more or less often than normal
    • making larger or smaller amounts of urine than normal
  • Fluid retention (having too much fluid in your body). Fluid may build up in the lining of your lungs, the sac around your heart, or your abdomen (stomach area). Symptoms can include:

    • trouble breathing or shortness of breath
    • cough
    • chest pain
    • swelling (in your hands, ankles, feet, or all over your body)
    • weight gain
  • Severe allergic reaction (anaphylactic shock). Symptoms can include:

    • respiratory tract infections (infections that affect your nose, throat, and airways)
    • loss of appetite
    • headache
    • dizziness
    • back or joint pain
    • rash
    • itching
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Bosutinib may cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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bosutinib May Interact with Other Medications

Oral tablet

Bosutinib can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Food interactions

Don’t eat grapefruit, drink grapefruit juice, or take supplements that contain grapefruit extract if you’re taking bosutinib. Grapefruit can increase the amount of bosutinib in your body. This can lead to serious side effects.

Medications that might interact with this drug

Drugs you should not use with bosutinib

Do not take these drugs with bosutinib. Doing so can cause dangerous effects in the body. Examples of these drugs include:

  • Antibiotics such as erythromycin or clarithromycin.
    • Using these drugs with bosutinib can increase side effects to dangerous levels. This is because the amount of bosutinib in your body may be increased.
  • Antifungals such as posaconazole or voriconazole.
    • Using these drugs with bosutinib can increase side effects to dangerous levels. This is because the amount of bosutinib in your body may be increased.
  • Human immunodeficiency virus (HIV) drugs such as ritonavir or indinavir.
    • Taking certain drugs used to treat HIV (human immunodeficiency virus) with bosutinib can increase side effects to dangerous levels. This is because the amount of bosutinib in your body may be increased.
  • HIV drugs such as efavirenz.
    • Taking certain other drugs used to treat HIV (human immunodeficiency virus) with bosutinib can decrease the amount of bosutinib in your body. This can make it less effective, and it may not work as well to treat your cancer.
  • Antiseizure drugs such as phenytoin or carbamazepine.
    • Using these drugs with bosutinib can decrease the amount of bosutinib in your body. This can make it less effective, and it may not work as well to treat your cancer.
  • TB drugs such as rifampin.
    • Using these drugs with bosutinib can decrease the amount of bosutinib in your body. This can make it less effective, and it may not work as well to treat your cancer.
  • Stimulants such as modafinil.
    • Using these drugs with bosutinib can decrease the amount of bosutinib in your body. This can make it less effective, and it may not work as well to treat your cancer.

Drugs that can make bosutinib less effective

When bosutinib is used with certain drugs, it may not work as well to treat your cancer. This is because the amount of bosutinib in your body may be decreased. Examples of these drugs include:

  • Drugs such as lansoprazole, omeprazole, or pantoprazole.
    • Your doctor may switch you to antacids or histamine-2 (H2) blockers such as ranitidine or famotidine. You should take them at least 2 hours before or after taking bosutinib.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Bosutinib warnings
kidney problems
People with kidney problems

If you have kidney problems or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of bosutinib in your body and cause more side effects. This medication may also decrease your kidney function, making your kidney disease worse.

liver problems
People with liver problems

If you have liver problems, your body may not be able to process this drug well. This may increase the levels of bosutinib in your body and cause more side effects. This medication may also decrease your liver function, making your liver disease worse.

heart problems
People with heart problems

Bosutinib can cause fluid build-up in your body, including your heart or lungs. Call your doctor if you have symptoms such as swelling, weight gain, chest pain, cough, or trouble breathing. If your symptoms are severe, call 9-1-1.

pregnant women
Pregnant women

Bosutinib is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases when it's needed to treat a dangerous condition in the mother.

Bosutinib can cause serious harm to a pregnancy. Tell your doctor if you’re pregnant or plan to become pregnant. You shouldn’t become pregnant while taking this drug. If you’re a woman who may become pregnant, use effective contraception (birth control). Be sure to use it while you take this drug, and for at least 30 days after you finish treatment. Talk with your doctor about forms of birth control that are right for you.

breast-feeding
Women who are breast-feeding

Bosutinib may pass into breast milk and cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

for seniors
For seniors

The kidneys and liver of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

for children
For children

This medication hasn’t been approved for use in children. It shouldn’t be used in people younger than 18 years.

call doctor
When to call the doctor

Call your doctor right away if you become pregnant while taking this drug.

allergies
Allergies

Bosutinib can cause a severe allergic reaction. Symptoms can include:

  • respiratory tract infections (infections that affect your nose, throat, and airways)
  • loss of appetite
  • headache
  • dizziness
  • back or joint pain
  • rash
  • itching

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take bosutinib (Dosage)

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All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Philadelphia chromosome-positive chronic myelogenous leukemia (CML)

Brand: Bosulif

Form: Oral tablet
Strengths: 100 mg, 500 mg
Adult dosage (ages 18–64 years)
  • Typical starting dosage: 500 mg once per day.
  • Dosage increases: If needed, your doctor may increase your dosage to 600 mg once per day.
  • Maximum dosage: 600 mg once per day.
Child dosage (ages 0–17 years)

This medication hasn’t been approved for use in children. It shouldn’t be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys and liver of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

Kidney disease: If you have moderate kidney problems, your doctor will likely prescribe 400 mg once per day. If you have severe kidney problems, they’ll likely prescribe 300 mg once per day.

Liver problems: If you have liver disease, your doctor will likely prescribe 200 mg once per day.

If liver function tests show that you have very high levels of liver enzymes, your doctor may stop your treatment with bosutinib for a time. (High levels can be a sign of liver damage.) If your test results improve, your doctor may restart your dose at 400 mg once per day. If your blood tests continue to show high levels, your doctor may stop your treatment with bosutinib completely.

Diarrhea or other side effects: If you have severe diarrhea with bowel movements that are much more frequent than normal, your doctor may stop your treatment with bosutinib for a time. They may also stop your treatment if you have other side effects that aren’t related to blood cell counts. When your symptoms improve, your doctor may restart your treatment at 400 mg once per day.

Decreased blood cell counts: If you have severe or ongoing low white blood cell or platelet counts, your doctor may stop treatment with bosutinib for a time. Depending on your blood cell count levels, your doctor may restart your treatment at lower doses and adjust them by 100 mg at a time.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Bosutinib comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your cancer may worsen, which could lead to death. Don’t change your dose or stop taking bosutinib without first talking with your doctor.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • pain in your abdomen (stomach area), joints, or back
  • fever
  • tiredness
  • weakness

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Take your dose as soon as you remember. If you miss a dose by more than 12 hours, skip that dose and take your next dose at your regular time. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

The growth of your cancer should slow down, or you may start to recover from the cancer. You may still feel ill because cancer treatment can affect healthy cells as well as cancer cells. Your doctor can do tests to find out if the drug is working to treat your cancer.

Bosutinib is used for long-term treatment.

Important considerations for taking bosutinib

Swallow bosutinib tablets whole. Don’t crush or cut the tablets.

If you have crushed or broken tablets, avoid breathing in the dust. Also, don’t touch or handle them. If they touch your skin, wash the skin thoroughly. And if they get on your clothes, remove the clothing and have it washed.

Store this drug carefully

  • Store bosutinib at room temperature between 68°F and 77°F (20°C and 25°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Blood cell counts. Blood tests can check your blood cell counts. If your blood cell counts become too low, your doctor may lower your dose or stop your treatment with this drug.
  • Liver function. Blood tests can check how well your liver is working. If your liver isn’t working well, your doctor may decide to lower your dose or stop your treatment with this drug.
  • Kidney function. Blood tests can check how well your kidney is working. If your kidney isn’t working well, your doctor may decide to lower your dose or stop your treatment with this drug.

Hidden costs

You may need blood tests during your treatment with bosutinib. The cost of these tests will depend on your insurance coverage.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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How Much Does bosutinib Cost?

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These prices represent the lowest priced national pharmacies for bosutinib on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on December 8, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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