BOSULIF is a kinase inhibitor indicated for the treatment of adult patients with

• Newly-diagnosed chronic phase Ph+ chronic myelogenous leukemia (CML). This indication is approved under accelerated approval based on molecular and cytogenetic response rates. Continued approval for this indication may be contingent upon verification and confirmation of clinical benefit in an ongoing long-term follow up trial. (1, 14)
• Chronic, accelerated, or blast phase Ph+ CML with resistance or intolerance to prior therapy. (1)

• Newly-diagnosed chronic phase Ph+ CML: 400 mg orally once daily with food. (2.1)
• Chronic, accelerated, or blast phase Ph+ CML with resistance or intolerance to prior therapy: 500 mg orally once daily with food. (2.1)
• Consider dose escalation by increments of 100 mg once daily to a maximum of 600 mg daily in patients who do not reach complete hematologic, cytogenetic, or molecular response and do not have Grade 3 or greater adverse reactions. (2.2)
• Adjust dosage for toxicity and organ impairment (2)

Tablets: 100 mg, 400 mg, and 500 mg. (3)

Hypersensitivity to BOSULIF. (4)

• Gastrointestinal Toxicity: Monitor and manage as necessary. Withhold, dose reduce, or discontinue BOSULIF. (2.3, 5.1)
• Myelosuppression: Monitor blood counts and manage as necessary. (2.4, 5.2)
• Hepatic Toxicity: Monitor liver enzymes at least monthly for the first 3 months and as needed. Withhold, dose reduce, or discontinue BOSULIF. (2.3, 5.3)
• Cardiac Failure: Monitor and manage as necessary. (5.4)
• Fluid Retention: Monitor patients and manage using standard of care treatment. Withhold, dose reduce, or discontinue BOSULIF. (2.3, 5.5)
• Renal Toxicity: Monitor patients for renal function at baseline and during therapy with BOSULIF. (5.6)
• Embryo-Fetal Toxicity: BOSULIF can cause fetal harm. Advise patients of potential risk to a fetus and to use effective contraception. (5.7)

Most common adverse reactions in patients with newly-diagnosed CML (incidence ≥20%) are diarrhea, nausea, thrombocytopenia, rash, increased alanine aminotransferase, abdominal pain, increased aspartate aminotransferase. (6)

Most common adverse reactions in patients with CML who were resistant or intolerant to prior therapy (incidence ≥20%) are diarrhea, nausea, abdominal pain, rash, thrombocytopenia, vomiting, anemia, fatigue, pyrexia, cough, headache, alanine aminotransferase, and edema. (6)

To report SUSPECTED ADVERSE REACTIONS, contact Pfizer Inc. at 1-800-438-1985 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

• Strong and Moderate CYP3A Inhibitors: Avoid concomitant use with BOSULIF. (7.1)
• Strong CYP3A Inducers: Avoid concomitant use with BOSULIF. (7.1)
• Proton Pump Inhibitors: Use short-acting antacids or H2 blockers as an alternative to proton pump inhibitors. (7.1)

• Lactation: Advise women not to breastfeed. (8.2)