"First of all, the drug has no restrictions in prescribing, just warnings on the label. Two years ago when I started the drug we all thought that 45 mg would be the right dose. It wasn't. I developed serious side effects and we dropped the dose to 15 mg to control the side effects. Nonetheless, my leukemia quickly became undetectable and remains so today. Now, as part of the trials, I am cutting my dose in half and taking 15 mg every other day. This is possible because the drug has a half life in your system in excess of 20 hours. On an interesting side note, 15 years ago, when I started the clinical trials for Gleevec, the first TKI, my doctor thought that the "hot ticket" would be Gleevec in combination with low dose conventional chemo. It made me sick as a dog and didn't work. That doctor was Brian Druker, the inventor of Gleevec. He is still my doctor today and is considered THE leading authority on CML."
The drug has demonstrated very good results with dosages as low as 8 mg. all of the significant adverse effects were at dosages of 45 mg or more. Study data correlates that for every 15 mg reduction in dose, there is a 40% reduction in adverse effects. Most patients are being converted to a 15 mg a day regimine - that is, for a "typical" patient a 80% reduction in adverse effects bringing the drug in line with other TKIs on the market.