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Bosulif

bosutinib
Used for Leukemia
Used for Leukemia

Bosulif (bosutinib) is a tyrosine kinase inhibitor that's used to treat certain adults and children with Philadelphia chromosome-positive chronic myelogenous leukemia (Ph+ CML). This medication comes as tablets and capsules that are conveniently taken by mouth once a day. Bosulif (bosutinib) is one of the recommended options for CML in certain adults, but it can commonly cause bothersome side effects like diarrhea and other stomach issues.

Reviewed by:
reviewer
Jenny Zhang, PharmD, BCOP
reviewer
Cydnee Ng, PharmD
Last reviewed on January 10, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Bosulif (bosutinib)?

What is Bosulif (bosutinib) used for?

  • Philadelphia chromosome-positive chronic myelogenous leukemia (Ph+ CML)

How Bosulif (bosutinib) works

Bosulif (bosutinib) is a tyrosine kinase inhibitor (TKI). It blocks a certain protein in your body called BCR-ABL tyrosine kinase. This protein is only found on cancer cells like those of CML and typically causes the cancer cells to grow and multiply. By blocking BCR-ABL from working, Bosulif (bosutinib) stops the cancer from growing and spreading.

Are you looking for information on Sprycel (dasatinib) or Iclusig (ponatinib) instead?

Drug Facts

Common BrandsBosulif
Drug ClassBCR-ABL tyrosine kinase inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
basics-icon

What are the side effects of Bosulif (bosutinib)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Other Side Effects

  • Constipation
  • Lower appetite
  • Joint pain
  • Back pain
  • Cough
  • Shortness of breath
  • Fluid buildup or swelling
  • Dizziness
  • Itching
Note: Side effects were reported by adults. Side effects for children might differ.

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Infections: repeated fevers, chills, cough, trouble breathing, severe diarrhea, vomiting, painful or frequent urination
  • Serious bleeds: bleeding or bruising that doesn’t stop or go away, large amount of bleeding, throwing up blood, blood in the urine, bloody or black and tarry stool
  • Liver damage: dark urine, right-sided stomach pain, yellowing of the eyes or skin, tiredness, loss of appetite, nausea, vomiting
  • Heart problems: chest pain, racing heartbeat, shortness of breath that usually worsens with activity or while lying flat, swelling of your legs or feet, sudden weight gain, fatigue, dizziness

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Black, tarry stools

bleeding gums

blood in the urine or stools

chills

cough

difficult or labored breathing

fever

lower back or side pain

painful or difficult urination

pale skin

pinpoint red spots on the skin

sore throat

swelling of the hands, ankles, feet, or lower legs

tightness in the chest

troubled breathing with exertion

ulcers, sores, or white spots in the mouth

unusual bleeding or bruising

unusual tiredness or weakness

Less common

Agitation

chest pain or discomfort

clay-colored stools

cough with mucus

confusion

dark urine

decreased appetite

decreased urination

depression

diarrhea

dizziness

dry mouth

fainting

fast or irregular heartbeat

general feeling of discomfort or illness

headache

hives, itching, or skin rash

hoarseness

hostility

increased sweating

increased thirst

irritation

joint pain, stiffness or swelling

lightheadedness

loss of appetite

muscle aches, pains, or twitching

nausea

numbness or tingling in the hands, feet, or lips

rapid breathing

rapid weight gain

redness of the skin

runny nose

seizures

shivering

sneezing

stomach pain or tenderness

sunken eyes

swelling of the eyelids, face, lips, hands, or feet

thirst

trouble sleeping

trouble swallowing

vomiting

weakness or heaviness of the legs

wrinkled skin

Rare

Blistering, peeling, or loosening of the skin

bloating

blue lips, fingernails, or skin

chest pain, possibly moving to the left arm, neck, or shoulder

constipation

coughing that sometimes produces a pink frothy sputum

difficult, noisy breathing

indigestion

irregular, fast or slow, or shallow breathing

pains in the stomach, side, or abdomen, possibly radiating to the back

puffiness or swelling of the eyelids or around the eyes, face, lips or tongue

red, irritated eyes

vomiting of blood or material that looks like coffee grounds

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Back pain

difficulty with moving

lack or loss of strength

muscle stiffness

stuffy nose

Less common

Blemishes on the skin

burning feeling in the chest or stomach

change in taste

hearing loss

loss of taste

muscle cramping

pimples

ringing, buzzing, or other unexplained noise in the ears that continues

stomach upset

Rare

Flaking and falling off of the skin

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Bosulif (bosutinib)

thumbs-up

Pros

A pill that’s swallowed once a day

Recommended treatment option for CML in certain adults

More precise in treating CML than traditional chemotherapy because it specifically targets CML cancer cells

thumbs-down

Cons

Can cause diarrhea, nausea, vomiting, and stomach pain

Requires regular blood tests so your provider can check for side effects

Might not be safe while pregnant or breastfeeding

Available as brand only

pharmacist-tips

Pharmacist tips for Bosulif (bosutinib)

pharmacist

  • Take Bosulif (bosutinib) with food. Swallow the tablets or capsules whole; don’t cut, dissolve, or chew them.

    • If you can't swallow pills whole, you can open the Bosulif (bosutinib) capsule(s) for your dose and mix the contents with room-temperature applesauce or yogurt in a clean container. The amount of applesauce or yogurt to use depends on your dose. Take the entire mixture right away without chewing and have a full meal with your dose. Don't save the mixture for later. Don't take an extra dose if the whole thing wasn't swallowed; continue with your usual dosing schedule the next day.

      • If you miss a dose of Bosulif (bosutinib) by more than 12 hours, skip your missed dose. Take your next dose at your next regularly scheduled time. Don't take two doses at the same time.

        • Bosulif (bosutinib) can cause stomach troubles, such as diarrhea, nausea, vomiting, and stomach pain. This usually happens in the first few days of taking the medication and can last throughout treatment. Be sure to drink plenty of fluids to stay hydrated. Talk to your provider for suggestions on how to manage these issues if they’re bothersome.

          • Avoid grapefruit and grapefruit juice while you're taking Bosulif (bosutinib). It can raise the levels of the medication in your body and put you at risk for more side effects.

            • Tell your provider and pharmacist about all the medications you take, including supplements and over-the-counter medications. Before starting any new medications, be sure your provider knows that you're taking Bosulif (bosutinib). Some drug interactions can affect how safe your medications are for you or how well Bosulif (bosutinib) works to treat CML (like with proton pump inhibitors or PPIs). Your provider can suggest safer alternatives or how to best take your medications.

              • If you’re able to become pregnant, use reliable birth control while you're taking Bosulif (bosutinib) and for at least 2 weeks after your last dose. It’s possible that the medication can harm an unborn baby.

                • Ask your provider or pharmacist about the best way to safely handle and throw away Bosulif (bosutinib). Anticancer medications can be very harmful to people who handle or come into contact with them.

                  faqs

                  Frequently asked questions about Bosulif (bosutinib)

                  Is Bosulif (bosutinib) chemotherapy?
                  Bosulif (bosutinib) isn't considered traditional chemotherapy. Traditional chemotherapy are medications that kill fast-growing cells in the body. These medications can kill cancer cells, but also other normal, healthy cells in the body that grow fast (causing side effects commonly linked to chemotherapy). Instead, Bosulif (bosutinib) is called targeted therapy. It only targets and affects cells in the body that have a specific protein called BCR-ABL. And this protein is only found on CML cancer cells. By blocking BCR-ABL on CML cancer cells, Bosulif (bosutinib) stops the cancer from growing and spreading.
                  Does Bosulif (bosutinib) cause hair loss?
                  In clinical studies, people who took Bosulif (bosutinib) didn't report hair loss. Speak with your provider if you notice hair thinning or hair loss while you're taking this medication. Your provider can examine you for other possible causes of hair loss and suggest ways to prevent more hair loss.
                  When is the best time to take Bosulif (bosutinib)?
                  You should take Bosulif (bosutinib) once a day with food, so it might be helpful to pair when you take the medication with a meal that you consistently have. For example, you can take Bosulif (bosutinib) with lunch or with dinner. Be sure to stick to a routine and be consistent with when you take Bosulif (bosutinib) so that the medication works as best it can for you.
                  Can I drink alcohol with Bosulif (bosutinib)?
                  It's best to avoid drinking alcohol while you're taking Bosulif (bosutinib). In general, alcohol can raise the risk for certain other cancers besides CML. In addition, both alcohol and Bosulif (bosutinib) can cause liver injury. So drinking alcohol with the medication can put you at higher risk for liver damage. Speak with your provider about lowering how much you drink and stopping drinking if you need guidance doing so.
                  How long do I need to take Bosulif (bosutinib) for?
                  Take Bosulif (bosutinib) for as long as your provider instructed you to. In general, you'll continue taking the medication as long as it's working well to treat your CML and as long as any side effects you have are mild and tolerable. Your provider might decide to stop treatment if your lab work suggests that the medication isn't working well or if side effects, like diarrhea, nausea, low blood cell counts, and liver damage, become serious. Don’t stop taking Bosulif (bosutinib) without first talking with your provider.
                  Can I take Bosulif (bosutinib) if I have liver or kidney problems?
                  You can take Bosulif (bosutinib) if you have liver or kidney problems, but you'll probably need to start the medication at a lower dose and follow up with your provider more often. Your liver and kidneys help break down Bosulif (bosutinib) in your body. Having liver or kidney problems can mean that your body might have a harder time getting rid of the medication. This can make the medication build up in your body, which can raise your risk for side effects from it. Tell your providers if you have problems with your liver or kidneys so they can adjust your treatment plan accordingly.
                  Can I take Bosulif (bosutinib) while pregnant?
                  It isn’t recommended to take Bosulif (bosutinib) if you're pregnant because it's possible that the medication can cause harm to your unborn baby. If you can get pregnant, you should use reliable birth control while you're taking Bosulif (bosutinib) and for 2 weeks after the last dose. Tell your provider right away if you become pregnant while you're taking this medication.
                  Is Bosulif (bosutinib) safe while breastfeeding?
                  Breastfeeding isn't recommend while you're taking Bosulif (bosutinib) and for 2 weeks after your last dose. We don’t know whether the medication can pass into human breast milk, but there’s a risk of serious harm to nursing infants if it does. Talk with your provider about other ways to feed your baby during treatment.
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                  warings-icon

                  What are the risks and warnings for Bosulif (bosutinib)?

                  Bosulif (bosutinib) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                  risk-warning

                  Low blood cell counts

                  Bosulif (bosutinib) can cause the levels of your red blood cells, white blood cells, and platelets to drop. When these cell counts are lower than normal, you can feel more tired. You can also have a higher risk of bleeding, bruising, and developing infections. Your provider will check your blood counts often while you’re taking Bosulif (bosutinib). Let your provider know right away if you experience fevers, chills, or bleeding and bruising that doesn’t stop or go away. You might need to stop this medication.

                  risk-warning

                  Liver damage

                  Bosulif (bosutinib) can cause liver injury. Signs of liver injury generally appeared within the first 3 months of taking the medication during clinical studies, but it can happen at any time during treatment. Your provider will regularly check your liver through blood work while you’re taking Bosulif (bosutinib). Let your provider know if you experience tiredness, loss of appetite, nausea or vomiting, dark urine, right-side stomach pain, or yellowing of the eyes or skin. These can be signs of liver problems.

                  risk-warning

                  Kidney damage

                  • Risk factors: History of kidney problems | At risk for kidney problems

                    Bosulif (bosutinib) can damage your kidneys and affect how well they work, especially if you already have kidney problems. Your provider will regularly check your kidneys through lab work during treatment. Talk to your provider if you notice any changes in how often you urinate (more or less) or any blood in your urine. Your provider can check for kidney issues.

                    risk-warning

                    Heart problems

                    • Risk factors: Older age | History of heart failure or other heart problems | Diabetes | Considered obese | High blood pressure

                      Bosulif (bosutinib) can cause new or worsening heart problems. These heart problems can happen when not enough oxygen reaches your heart or when your heart can’t pump blood well enough. Though rare, these problems can lead to serious complications, including heart attacks or heart failure.

                      Your provider might follow up with you more regularly while you’re taking Bosulif (bosutinib) if you currently have heart problems or have a higher risk for heart problems. Tell your provider right away or seek medical help if you have chest pain, arm or shoulder pain, sweating, dizziness, a racing heartbeat, shortness of breath, or swelling of your legs or feet.

                      risk-warning

                      Fluid buildup or swelling in the body

                      Bosulif (bosutinib) can cause new or worsening swelling in the arms or legs (peripheral edema) or fluid buildup in the heart or lungs. Some symptoms of fluid buildup include shortness of breath during rest or exercise, weight gain, swelling of the legs or ankles, fatigue, and poor appetite. Let your provider know if you develop any of these symptoms during treatment. You might need to stop taking Bosulif (bosutinib) or have your dose changed.

                      risk-warning

                      Harm to unborn baby

                      Based on animal studies, Bosulif (bosutinib) can harm an unborn baby or raise the risk for miscarriage (pregnancy loss) when it's taken during pregnancy. If you can get pregnant, you might need to take a pregnancy test before you start treatment. You should use birth control while you're taking Bosulif (bosutinib) and for at least 2 weeks after the last dose. Let your provider know right away if you become pregnant during this time.

                      dosage

                      Bosulif (bosutinib) dosage forms

                      Typical dosing for Bosulif (bosutinib)

                      Adults

                      • Newly diagnosed with Ph+ CML: The typical dose is 400 mg by mouth once daily.

                      • Previously treated with a similar medication: The typical dose of Bosulif (bosutinib) is 500 mg by mouth once daily.

                      Children aged 1 year and older

                      • The dose is based on your child's body surface area or body size, which takes into account weight and height.

                      • Newly diagnosed with Ph+ CML: The typical dose ranges from 150 mg to 400 mg by mouth once daily, depending on your child's body size.

                      • Previously treated with a similar medication: The typical dose of Bosulif (bosutinib) ranges from 200 mg to 500 mg by mouth once daily, depending on your child's body size.

                      Your dose might differ if you have kidney or liver problems. Your provider will also adjust your dose if you have bothersome or severe side effects.

                      interactions

                      Interactions between Bosulif (bosutinib) and other drugs

                      Bosulif (bosutinib) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Bosulif (bosutinib). Please note that only the generic name of each medication is listed below.

                      Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                      Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                      alternatives

                      What are alternatives to Bosulif (bosutinib)?

                      There are a number of medications that your doctor can prescribe in place of Bosulif (bosutinib). Compare a few possible alternatives below.
                      Bosulif (bosutinib)
                      Used for:

                      • Philadelphia chromosome-positive chronic myelogenous leukemia (Ph+ CML)

                      View Prices
                      Sprycel (dasatinib)
                      Used for:

                      • Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML)

                      • Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL)

                      $1004.00 Lowest GoodRx priceView Prices
                      Tasigna (nilotinib)
                      Used for:

                      • Philadelphia chromosome-positive chronic myelogenous leukemia (Ph+ CML)

                      $21565.27 Lowest GoodRx priceView Prices
                      images

                      Bosulif (bosutinib) images

                      Yellow Oval 100 And Pfizer - Bosulif 100mg Tablet
                      This medicine is Yellow, Oval Tablet Imprinted With "Pfizer" And "100".Yellow Oval 100 And Pfizer - Bosulif 100mg Tablet

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                      References

                      Best studies we found

                      American Cancer Society.(2018). What causes chronic myeloid leukemia?

                      American Cancer Society. (2019). Chemotherapy safety.

                      American Cancer Society. (2019). How is chemotherapy used to treat cancer?

                      View All References (10)

                      American Cancer Society. (2021). Targeted therapies for chronic myeloid leukemia.

                      American Cancer Society. (2024). Anemia (low red blood cell counts).

                      American Cancer Society. (2024). Neutropenia (low white blood cell counts).

                      American Cancer Society. (2024). Thrombocytopenia (low platelet count).

                      Leukemia & Lymphoma Society. (n.d.). Tyrosine kinase inhibitor (TKI) therapy.

                      National Cancer Institute. (2021). Alcohol and cancer risk.

                      National Cancer Institute. (2022). Targeted therapy to treat cancer.

                      National Comprehensive Cancer Network. (2023). Chronic myeloid leukemia.

                      Pfizer Inc. (n.d.). Overview of Ph+ CML.

                      Pfizer Laboratories Div Pfizer Inc. (2023). Bosulif- bosutinib tablet, film coated; bosutinib capsule [package insert]. DailyMed.

                      GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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