If you have Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML), your doctor might suggest Bosulif (bosutinib) as a treatment option. It’s a prescription medication used in adults to treat Ph+ CML that is:

  • in the chronic phase* and newly diagnosed, or
  • in the chronic, accelerated, or blast phase,* and didn’t respond to past treatments†

* To learn about phases of CML, see this article.
† For this use, Bosulif can also be used if past treatments caused side effects that required stopping the treatment.

Bosulif comes as a tablet you swallow. It contains the active drug bosutinib. This drug belongs to a group of cancer medications called tyrosine kinase inhibitors.

You’ll likely take Bosulif long-term, unless your CML gets worse, or you have bothersome side effects. For more information about Bosulif, including details about its uses, see this in-depth article on the drug.

Like other drugs, Bosulif can cause mild or serious side effects. Keep reading to learn more.

Some people may experience mild or serious side effects during their Bosulif treatment. Examples of Bosulif’s commonly reported side effects include:

Not everyone who takes Bosulif will have these side effects. In studies, diarrhea was the most common side effect, and was reported by most people who took Bosulif.

These aren’t all the side effects Bosulif may cause. To learn more, see the “Mild side effects” and “Serious side effects” sections below. You can also check out Bosulif’s full prescribing information to see a full list of side effects reported in the drug’s studies.

* To learn more about this side effect, see the “Side effects explained” section below.

Like most medications, treatment with Bosulif can cause mild side effects. Some are more common than others.

For example, most people who took Bosulif in studies had at least one digestive side effect. This may have included nausea, vomiting, diarrhea, or belly pain. In many cases, these side effects are mild. And they typically go away on their own or with treatment, without needing to stop Bosulif.

Mild side effects that have been reported with Bosulif include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And don’t stop using Bosulif unless your doctor recommends it.

Bosulif may cause mild side effects other than the ones listed above. See the Bosulif prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Bosulif, visit MedWatch.

Serious side effects that have been reported with Bosulif include:

If you develop serious side effects while taking Bosulif, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.

Learn more about some of the side effects Bosulif may cause.

Diarrhea

Diarrhea is a common side effect of Bosulif. Specifically, in studies of the drug:

  • For people with newly diagnosed Ph+ CML, diarrhea occurred starting about 4 days after beginning treatment. The diarrhea lasted an average of about 3 days.
  • For people taking Bosulif after trying other CML treatments, diarrhea began about 2 days after starting Bosulif. Diarrhea symptoms typically lasted about 2 days.

It’s possible for diarrhea to happen multiple times during Bosulif treatment. People have 3 episodes of diarrhea with Bosulif, on average.

Diarrhea caused by Bosulif can be severe. In studies, severe diarrhea was defined as having seven or more bowel movements per day, and trouble controlling these movements.

What might help

Contact your doctor if you have diarrhea while taking Bosulif. They can recommend a treatment to help with this side effect, such as a medication to treat diarrhea.

If you have severe diarrhea, your doctor will likely have you stop taking Bosulif until your diarrhea goes away. If they have you start taking Bosulif again, they’ll likely lower your dose. Or your doctor might advise permanently stopping Bosulif and may recommend other treatments for your condition.

Changes in certain lab test results

Taking Bosulif can cause changes in certain lab tests. These may be mild, or they can be severe in some cases. This is also called myelosuppression.

If you have changes in your lab results, you might not have any noticeable symptoms. But you may notice certain symptoms if these changes become severe. The following table describes possible lab test changes with Bosulif, and possible symptoms in severe cases:

Test resultPossible symptoms
high creatinine levels*• changes in the amount of urine you produce and how often you urinate

• fatigue (low energy)
high liver enzyme levels• jaundice (yellowing of your skin or the whites of your eyes)
low platelet levels• unusual bleeding or bruising

• blood in your urine or stool
low red blood cell levels• fatigue

• weakness
low white blood cell levels• frequent infections, which might take longer than usual to get better

• fever

* This can be a sign of kidney problems, which are described under “Kidney problems” just below.

Your doctor will have you get tests throughout your treatment with Bosulif, to monitor for these changes.

What might help

If you have changes in any test results, you doctor will determine the next steps based on how serious the changes are.

If you have low blood cell levels, your doctor will likely have you stop taking Bosulif until the levels return to normal. They may also lower your Bosulif dose. Or your doctor might have you permanently stop taking Bosulif.

Heart problems

Treatment with Bosulif can cause heart problems. These may include heart failure (inability of the heart to pump enough blood) or decreased blood flow to the heart, which can cause a heart attack.

Symptoms of heart problems, such as heart failure, can include:

People taking Bosulif after other chronic myeloid leukemia (CML) treatments had a higher risk of heart failure than people taking it for newly diagnosed CML. Older adults are also more likely to have heart failure with Bosulif.

You may also be at higher risk of heart problems if you have other risk factors, such as diabetes, obesity, or high blood pressure.

What might help

If you have symptoms of heart problems while taking Bosulif, contact your doctor right away. Call 911 or go to the nearest emergency room if your symptoms feel life-threatening.

Depending on the severity of your heart problems, your doctor may have you temporarily stop taking Bosulif to see if your symptoms go away. Or they might reduce your dose, or have you permanently stop taking Bosulif.

Your doctor can also recommend treatment if needed. For example, if they confirm you have heart failure, they’ll likely prescribe medications to treat your symptoms.

Kidney problems

Treatment with Bosulif may cause kidney problems. These include acute (sudden) kidney injury and kidney failure. Symptoms can include:

  • urinating more or less often than usual
  • producing more or less urine than usual
  • swelling in your feet or legs

Bosulif can also make existing kidney problems worse. See “Warnings for Bosulif” below for details.

What might help

Before you start taking Bosulif, your doctor will order a blood test to check your kidney function. You’ll also have this test occasionally while you’re taking Bosulif. If these tests show changes in your kidney function, your doctor will likely lower your Bosulif dose.

Allergic reaction

Like most drugs, Bosulif can cause an allergic reaction in some people.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter antihistamine, such as Benadryl (diphenhydramine). Or they might recommend a product you apply topically (to your skin), such as hydrocortisone cream, to manage your symptoms.

If your doctor confirms you had a mild allergic reaction to Bosulif, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Bosulif, they may have you switch to a different treatment.

Keeping track of side effects

During your Bosulif treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how Bosulif affects you. And your doctor can use this information to adjust your treatment plan if needed.

Get answers to some frequently asked questions about Bosulif’s side effects.

Does Bosulif cause bone pain?

No, Bosulif isn’t known to cause bone pain. This side effect wasn’t reported in studies.

But, bone pain can be a symptom of chronic myeloid leukemia (CML), the condition Bosulif is used to treat. And, other CML medications may cause bone pain, such as Sprycel (dasatinib).

Also, Bosulif is approved to treat CML after other medications have been tried. So, it’s possible that previous medications you’ve taken could still cause bone pain until they’re completely out of your body. But this side effect isn’t known to be caused by Bosulif.

Talk with your doctor if you have concerns about bone pain and your CML treatment plan.

Can Bosulif cause long-term side effects?

Yes, taking Bosulif can cause long-term side effects. This can include side effects that happen even after taking the drug for a long time. It also includes side effects that last for a long time or may not go away.

Long-term side effects reported with Bosulif use include:

More information about Bosulif and heart or kidney problems is above in the “Side effects explained” section. If you’d like to learn more about Bosulif and long-term side effects, talk with your doctor or pharmacist.

Does Bosulif cause hair loss?

It’s not likely. Hair loss wasn’t reported as a side effect by people taking Bosulif in studies.

Some other medications used to treat CML may cause hair loss, such as Gleevec (imatinib). Bosulif is approved to treat CML after other medications have been tried. So, it’s possible that previous medications you’ve taken could cause hair loss until they’re completely out of your system. But Bosulif isn’t known to cause hair loss.

Talk with your doctor if you have concerns about hair loss and your CML treatment plan.

Bosulif may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Bosulif. The list below includes factors to consider.

Diabetes or heart problems, including high blood pressure. Rarely, treatment with Bosulif can cause heart problems. People with diabetes, heart problems (such as coronary artery disease), obesity, or high blood pressure may be at higher risk of heart problems with Bosulif. Your doctor can help determine whether taking Bosulif is safe for you.

Kidney problems. Treatment with Bosulif can result in kidney problems as a side effect. Existing kidney problems, such as chronic (long-term) kidney disease, may get worse if you take Bosulif. Your doctor can help determine whether taking Bosulif is safe for you. If they prescribe Bosulif for you, they might prescribe a lower starting dose than usual. They might also monitor your kidney function closely during treatment.

Liver problems. Liver problems, such as liver damage, are possible side effects of Bosulif. You may be at higher risk for this if you already have liver problems, such as hepatitis (liver infection). Your doctor can help determine whether taking Bosulif is safe for you. They may prescribe a lower Bosulif dose than usual and monitor your liver function closely while you take the medication.

Allergic reaction. If you’ve had an allergic reaction to Bosulif or any of its ingredients, your doctor will likely not prescribe Bosulif. Ask your doctor what other medications are better options for you.

Alcohol use and Bosulif

You should talk with your doctor about whether alcohol is safe for you to drink during your treatment. Drinking alcohol could raise your risk of certain side effects from Bosulif.

These include mild side effects such as fatigue (low energy), headache, and diarrhea. But alcohol use may also raise your risk of serious side effects, such as liver problems. This is because both Bosulif and alcohol can damage your liver.

Be sure to talk with your doctor about how much alcohol, if any, is safe for you to have during your treatment.

Pregnancy and breastfeeding while taking Bosulif

Your doctor likely won’t prescribe Bosulif if you’re pregnant. And it’s not recommended to breastfeed while taking Bosulif, or for at least 2 weeks after your last dose.

If you can become pregnant, your doctor will have you take a pregnancy test to check that you’re not pregnant before prescribing Bosulif. They’ll also recommend using birth control while taking Bosulif, and for at least 2 weeks after your last dose.

If you’re pregnant, breastfeeding, or planning either, talk with your doctor. They can recommend a cancer treatment plan that’s safe for you. And they can help determine safe feeding options for your child while you’re taking Bosulif, if needed.

Taking Bosulif can cause mild or serious side effects. If you’re considering treatment with Bosulif, talk with your doctor. You can ask questions that help you feel more comfortable about your treatment options. Some examples to get you started include:

  • How do Bosulif’s side effects compare with other medications for treating my condition?
  • If I have side effects while taking Bosulif, could a lower dose help?
  • Are there steps I can take to lower my risk of side effects from Bosulif?

Q:

Do any medications raise my risk of side effects if I take them with Bosulif?

Anonymous

A:

Yes. For example, drugs that affect an enzyme (a type of protein) in your body called CYP3A can increase the level of Bosulif in your body. This can increase your risk of side effects from Bosulif.

Examples of these drugs include certain antibiotics (such as clarithromycin), and medications used to treat fungal and viral infections. Your doctor can determine whether you’re taking any medications that might increase your risk of side effects with Bosulif. They’ll likely recommend not taking these drugs with Bosulif.

Grapefruit and grapefruit juice can also increase levels of Bosulif in your body and increase your risk of side effects.

For information about other drugs that interact with Bosulif, see this article. And talk with your doctor about all the over-the-counter and prescription medications you take. Also tell them about any herbal supplements and vitamins. Keep a list of your medications with you and discuss it with your doctor and pharmacist any time a new medication is added.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.