Nilotinib — practical guide for patients and caregivers
Nilotinib (brand name Tasigna) is a targeted cancer drug used mainly for Philadelphia chromosome–positive chronic myeloid leukemia (CML). It blocks the BCR‑ABL tyrosine kinase, which helps control the leukemia cells. If you or someone you care for is starting nilotinib, here’s what matters most in plain language.
How it's taken and why timing matters
Doctors usually prescribe nilotinib as pills taken twice a day. It must be taken on an empty stomach — at least 1 hour before or 2 hours after eating. Food increases absorption and can raise side effect risks. Swallow the capsules whole; do not chew or crush. Stick to the same schedule every day to keep steady drug levels.
Typical doses vary by situation, but the common starting dose is twice daily. Your oncologist will tell you the exact amount based on disease stage and prior treatments. Never change dose or stop the drug without talking to your healthcare team.
Watch these side effects and how to monitor safely
Most people have some mild side effects like nausea, rash, headache, constipation, or tiredness. But nilotinib can also cause serious problems. It can lengthen the QT interval on the ECG (a heart rhythm risk), damage the liver, raise blood sugar and cholesterol, and increase the chance of blood clots or heart issues. Pancreatitis and low blood counts are possible too.
Before starting nilotinib your doctor will usually check a baseline ECG, complete blood count (CBC), liver tests, fasting glucose and lipids, and electrolytes (potassium, magnesium). Expect frequent blood tests at first — then less often if things are stable. If you notice chest pain, fainting, extreme belly pain, sudden shortness of breath, or yellowing of the skin, get medical help right away.
Nilotinib interacts with many drugs. Avoid grapefruit and grapefruit juice. Strong CYP3A4 inhibitors (like some antifungals and antibiotics) and inducers can change nilotinib levels and cause danger. Also avoid other drugs that prolong the QT interval. Tell every doctor and pharmacist you see that you take nilotinib.
Nilotinib is not safe in pregnancy. Use reliable birth control during treatment and for a time after stopping — ask your doctor how long. Breastfeeding is generally not recommended while on this drug.
If treatment stops working, there are other TKIs (imatinib, dasatinib, bosutinib, ponatinib) and other strategies. Resistance testing can help choose the next step. Talk with your specialist about options if response is incomplete or side effects are hard to manage.
Small practical tips: set phone alarms for doses, carry a medication card, keep follow‑up appointments, and check with your team before starting any new medicine or supplement. With the right monitoring and support, nilotinib can be a very effective option for managing CML.
Apr, 26 2025