Michelle,  I am curious why your doctor would want you on more than the 
manufacturer's recommended dose?  The higher the dose the more likely that 
side effects will occur, and with Sprycel having the risk of Pulmonary 
Arterial Hypertension (PAH), a potentially fatal side effect, it seems 
reckless to exceed the recommended dose unless absolutely necessary.    The 
recommended dose is 100mg a day...140 is only recommended for patients with 
AML or CML is blast crisis, which, with a zero PCR you are light years away 
from either of those!  Even with the recommended dose at 100mg there are 
plenty of folks taking far less.  I have seen dosing as little as 20mg 
daily or 70 - 100mg 2-3 times weekly.  I consult with one of the research 
docs who helped develop Sprycel and he believes that the current data shows 
that CML response to the level of each dose better, as opposed to the 
quantity of doses, so with patients with severe side effects he will drop 
the number of doses per week before dropping the amount of each dose.  But 
a dose higher than 100mg is still never recommended as a maintenance dose, 
that is just risking plural effusions and PAH.  Not clear why your doctor 
would risk that, especially with your history!  

Personally, I have been on Sprycel for two years now and am thinking I am 
going to ask for a change to  a low dose of Tasigna.  I have been mostly 
PCRU for that entire time but have never found a dose of Sprycel low enough 
that will work but not put me in bed for the entire day each time I take 
it, not just fluish, but *severe* headache and body pain.  At 50mg twice a 
week my PCR went up to trace, and when we upped it to 70mg twice a week a 
few weeks ago the side effects started escalating...don't know yet if that 
dose is even effective, but the longer I am on it the worse the side 
effects are with each dose.  I think I am done with Sprycel.  

I personally don't think any of these drugs have been around long enough 
for doctors to realize that no one should be on a larger dose than 
absolutely necessary, and that each person's dose will be different.  Don't 
let your doc OD you on Sprycel...PAH can be deadly, and most Sprycel 
patients who develop PAH don't even know they have it until it is nearly 
too late...patients are not screened nearly enough. I have a CML friend who 
almost died!  Even on the low dose I have been on my cardiologist did a 
baseline angiogram and does an Echo Cardiogram every six months.  

Only you know your body, do what works for you, and question everything!

Peg

On Monday, September 16, 2013 12:36:57 PM UTC-7, Michele, Loves to Dance! 
wrote:
>
> Hi All,
> So, I began taking Sprycel again after pleural effusion. Taking a poll of 
> what YOU think my dosage should be! Here are the facts: http://
> www.leukemiasurvivor.co/2013/09/back-on-sprycel-side-effects-return.html
>
> Thanks, hope you all are having a great day,
> Michele
>
> -- 
> [email protected]
> www.LearntoBallroomDanceOnline.com 
>

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