Comprehensive medication guide to Phyrago including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$500 per month for commercially insured patients enrolled in the Cycle Vita copay assistance program; specialty tier requiring prior authorization on most plans. Medicare patients are not eligible for the manufacturer copay card and should apply to independent foundations such as the LLS Co-Pay Assistance Program.
Estimated Cash Pricing
$4,000–$14,000+ per 30-day supply at list price depending on dose; Phyrago is a brand specialty oncology drug available exclusively through Onco360 specialty pharmacy. Commercially insured patients may pay as little as $0 with Cycle Vita copay assistance (888-360-8482).
Medfinder Findability Score
55/100
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Phyrago (dasatinib) is a prescription oral tablet used to treat Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML) and Ph+ acute lymphoblastic leukemia (ALL). It is a BCR-ABL tyrosine kinase inhibitor (TKI) — a class of targeted cancer drugs that work by blocking the abnormal BCR-ABL protein produced by the Philadelphia chromosome, which drives uncontrolled leukemia cell growth.
Phyrago was developed by Handa Therapeutics and commercially launched in the United States in October 2025 by Cycle Pharmaceuticals. It is FDA-approved for newly diagnosed adults with Ph+ CML in chronic phase, adults with Ph+ CML in any phase who are resistant or intolerant to prior therapy including imatinib, adults with Ph+ ALL resistant or intolerant to prior therapy, and pediatric patients 1 year of age and older with Ph+ CML or newly diagnosed Ph+ ALL.
Phyrago is bioequivalent to Sprycel (Bristol-Myers Squibb) under fasted conditions but has a clinically important advantage: it is the first and only dasatinib formulation that can be taken concomitantly with proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs) without losing effectiveness. Standard dasatinib loses 40–60% of its absorption when taken with these common acid-suppressing medications.
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Phyrago works by inhibiting BCR-ABL tyrosine kinase — the overactive enzyme produced by the Philadelphia chromosome (BCR-ABL1 fusion gene) that drives the uncontrolled growth of leukemia cells. By fitting into the active site of the BCR-ABL enzyme, dasatinib physically blocks it from functioning, turning off the molecular "on" switch for cancer cell proliferation.
Phyrago also inhibits multiple additional kinases including SRC family kinases (SRC, LCK, YES, FYN), c-KIT, EPHA2, and PDGFRβ. This multi-kinase inhibition contributes to its broad efficacy against most BCR-ABL mutations that cause resistance to first-generation inhibitors like imatinib. Phyrago is approximately 325-fold more potent than imatinib against BCR-ABL in laboratory studies.
Phyrago's novel formulation addresses a known limitation of standard dasatinib: pH-dependent absorption. Standard dasatinib requires an acidic gastric environment to dissolve properly for absorption. Phyrago's formulation technology allows it to maintain full bioavailability regardless of stomach pH, meaning patients who need acid suppression therapy (PPIs or H2RAs) receive the full intended dose of their leukemia treatment.
20 mg — tablet
50 mg — tablet
70 mg — tablet
80 mg — tablet
100 mg — tablet
Standard starting dose for adults with chronic phase CML
140 mg — tablet
Starting dose for adults with accelerated/blast phase CML or Ph+ ALL
Phyrago is not available at retail pharmacies. It is exclusively distributed through Onco360 specialty pharmacy, with wholesale distribution through McKesson, Cencora, and Cardinal Health. As of 2026, there is no FDA-listed shortage of Phyrago. However, patients frequently experience access delays due to the specialty pharmacy enrollment process, prior authorization requirements, and step therapy requirements imposed by some insurance plans.
The Cycle Vita hub program (888-360-8482) provides dedicated support to help patients navigate the access process, including benefit verification, prior authorization submission, and a free starter supply for commercially insured patients while authorization is pending. This program is the fastest path to accessing Phyrago for newly diagnosed patients.
For patients who need help locating pharmacies that can fill their prescription or checking availability of generic dasatinib as a bridge, medfinder calls pharmacies in your area and texts you the results — saving hours on hold.
Phyrago is an oncology specialty medication that is not a controlled substance. Any licensed prescriber can technically write a prescription, but in practice it is prescribed by oncology specialists who have the expertise to diagnose and manage Ph+ CML and Ph+ ALL. A diagnosis of Ph+ CML or Ph+ ALL requires specialized blood and bone marrow testing that must be performed and interpreted by a specialist.
Types of providers who prescribe Phyrago:
Hematologist-oncologists (primary prescribers for CML and Ph+ ALL)
Medical oncologists at comprehensive cancer centers
Nurse practitioners (NPs) and physician assistants (PAs) in oncology practices under physician oversight
Academic medical center leukemia specialists
Telehealth: Telehealth cannot be used to initiate Phyrago treatment, as the underlying diagnosis of Ph+ CML or Ph+ ALL requires in-person bone marrow biopsy and cytogenetic testing. Established patients may use telehealth for follow-up visits, lab review, and prescription refills with their existing oncologist.
No. Phyrago (dasatinib) is not a controlled substance and is not scheduled by the DEA. It does not have abuse or dependence potential. However, it is a prescription-only medication — it requires a valid prescription from a licensed oncologist or hematologist and cannot be purchased over the counter.
Unlike controlled substances, Phyrago prescriptions are not subject to DEA prescription limitations (e.g., no 30-day supply cap, no Schedule II restrictions on refills). However, it is an oncology specialty medication that requires the infrastructure of a specialty pharmacy (Onco360) for dispensing, and most insurance plans require prior authorization before covering it.
The following side effects occurred in 15% or more of patients in clinical trials:
Myelosuppression (low blood cell counts: anemia, neutropenia, thrombocytopenia)
Fluid retention, including pleural effusion (fluid around lungs)
Diarrhea
Headache
Skin rash
Hemorrhage (bleeding)
Dyspnea (shortness of breath)
Fatigue
Nausea
Musculoskeletal pain
Serious side effects requiring immediate medical attention:
Severe bleeding, including CNS hemorrhage
Pulmonary arterial hypertension (PAH)
QT interval prolongation / cardiac arrhythmia
Hepatotoxicity (liver toxicity)
Tumor lysis syndrome
Severe dermatologic reactions (Stevens-Johnson syndrome)
Embryo-fetal toxicity (do not use during pregnancy)
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Generic dasatinib
Same active ingredient as Phyrago; significantly lower cost but cannot be safely co-administered with PPIs or H2RAs. Appropriate for patients not on acid suppression therapy.
Sprycel (dasatinib)
Original brand-name dasatinib from Bristol-Myers Squibb; same indications and limitations regarding PPI/H2RA interaction as generic dasatinib.
Imatinib (Gleevec)
First-generation BCR-ABL inhibitor; generic available at low cost (~$30-50/month with discounts). Less potent than dasatinib but still highly effective for newly diagnosed chronic phase CML in lower-risk patients.
Tasigna (nilotinib)
Second-generation TKI; more potent than imatinib, must be taken on empty stomach twice daily; associated with cardiovascular risks including peripheral arterial occlusive disease.
Scemblix (asciminib)
Third-generation STAMP inhibitor; effective against many TKI-resistant mutations; FDA-approved for CML after two or more prior TKIs and for T315I mutation.
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Strong CYP3A4 inhibitors (ketoconazole, clarithromycin, ritonavir)
majorIncrease dasatinib plasma concentrations; dose reduction may be necessary. Avoid if possible.
Strong CYP3A4 inducers (rifampin, carbamazepine, apalutamide, St. John's Wort)
majorDecrease dasatinib plasma concentrations, potentially reducing efficacy. Avoid if possible; dose increase may be required.
QT-prolonging drugs (antipsychotics, ondansetron, azithromycin, antiarrhythmics)
majorAdditive risk of QT interval prolongation. Use with caution; ECG monitoring may be required.
Aluminum/magnesium antacids (Tums, Rolaids, Maalox)
moderateReduce Phyrago absorption; administer antacid at least 2 hours before or after Phyrago.
Anticoagulants and antiplatelet drugs (warfarin, apixaban, aspirin, clopidogrel)
majorIncreased bleeding risk due to Phyrago-induced thrombocytopenia and platelet dysfunction. Use with caution and monitor closely.
Grapefruit juice
moderateInhibits CYP3A4, increasing dasatinib levels. Avoid entirely during treatment.
Phyrago represents a meaningful clinical advance for patients with Ph+ CML and Ph+ ALL who require concurrent acid suppression therapy. By solving the long-standing drug-drug interaction problem between dasatinib and PPIs/H2RAs, it ensures that patients who need both a TKI and an acid-reducing medication receive the full efficacy of their cancer treatment without compromise.
The primary access challenge for Phyrago in 2026 is not supply — it is the complexity of the specialty pharmacy and insurance access pathway. Patients who work closely with their oncologist and the Cycle Vita support team can navigate this system effectively. Commercially insured patients may pay as little as $0 per month with copay assistance. Medicare and uninsured patients have other resources available through independent foundations and patient assistance programs.
If you are struggling to fill a Phyrago prescription or find a pharmacy that can help, medfinder calls pharmacies near you to check which ones can fill your prescription and texts you the results — taking the burden of phone calls off your plate while you focus on your treatment.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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