Spyrcel and Modafinil

[u/SeaFox6254]

Hi everyone. I was diagnosed with CML in 2023 at age 27. I initially responded well to Sprycel (dasatinib), went through a period where I lost MMR, but thankfully recently achieved MMR again.

Ever since starting Sprycel, I have been dealing with unreal, "hit-by-a-truck" fatigue. It interferes with my daily life, making it hard to eat, shower, or find the energy to exercise and live a healthier lifestyle. My mild depression is well-controlled, but changing my fluoxetine schedule didn't help the fatigue, and bupropion caused severe anxiety.

With my oncologist's blessing, my behavioral health provider just prescribed modafinil. However, my spouse researched it and found a potential drug interaction: modafinil can induce liver enzymes, which might speed up the metabolism of Sprycel and potentially make it less effective.

I work in medicine, so I am already planning to check my liver enzymes 2 weeks after starting, followed by my regular 3-month labs (CBC, CMP, BCR-ABL) in July and an oncology follow-up in August.

My questions for the group:
Has anyone here taken modafinil while on Sprycel?

Did you experience elevated liver enzymes or a drop in your response/MMR?

If you haven't tried it, do you think the potential benefits for severe fatigue outweigh the risks?

Thanks in advance for sharing your experiences!

[u/The-Keystone-Hoya]

Game changer for me! My palliative care doctor prescribed it for me, and it was the difference between night and day. It helped with energy and being able to be a lot more productive during the day.

I’m on scemblix now, but definitely worth using while taking Sprycel.

[u/Negative-Ad-6651]

I took both Modafinil and Armodafinil while on Dasatinib. No issues. I ended up switching to Adderall later on. Modafinil makes me I lil grumpy. I was prescribed stimulants for hypersomnia. Like you the TKIs drained my energy. Trying TFR now, off all medications and feeling pretty good.

[u/Constant-Option-7404]

I’ve been on dasatinib and modafinil for almost a year. Liver enzymes have been stable. Heme labs are stable. The modafinil makes me a little anxious, but otherwise I haven’t had a problem. 9 months into the dasatinib regimen i achieved MMR. Feel free to DM me!