Pepsi® or Coke®? Influence of acid on dasatinib absorption

Dasatinib is a second generation ABL kinase inhibitor used in the management of chronic myeloid leukemia or Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL). Dasatinib's bioavailability is highly dependent on gastric pH. When proton-pump inhibitors (PPIs) are co-administe...

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Bibliographic Details
Published in:Journal of oncology pharmacy practice 2018-03, Vol.24 (2), p.156-158
Main Authors: Knoebel, Randall W, Larson, Richard A
Format: Article
Language:English
Subjects:
Absorption
Acute lymphoblastic leukemia
Bioavailability
Carbonation
Chronic myeloid leukemia
Enzyme inhibitors
Leukemia
Lymphatic leukemia
Myeloid leukemia
pH effects
Philadelphia chromosome
Protease inhibitors
Proton pump inhibitors
Soft drinks
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Summary:Dasatinib is a second generation ABL kinase inhibitor used in the management of chronic myeloid leukemia or Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL). Dasatinib's bioavailability is highly dependent on gastric pH. When proton-pump inhibitors (PPIs) are co-administered with dasatinib, absorption is significantly reduced. Cola intake at the time of drug administration has been demonstrated to lead to relevant increases in the bioavailability for other acid labile drugs during PPI treatment. This manuscript reviews the relevant literature supporting a strategy of temporarily lowering the gastric pH with a carbonated beverage at the time of drug administration. The use of cola provides an easy to implement way to significantly improve dasatinib bioavailability, especially during concomitant use of a PPI.
ISSN:1078-1552
1477-092X
DOI:10.1177/1078155217692152