[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Kinase inhibitors (targeted oncology)](https://durgical.com/en/pharmacology/classes/kinase-inhibitors/) › Asciminib # Asciminib ## Kinase inhibitors (targeted oncology)? Kinase inhibitors (targeted oncology) ## High alert? An error with this medicine can cause serious harm: double checks and protocols are used. ## Pregnancy: avoid? Avoid in pregnancy. Asciminib may harm the fetus: contraception is used during treatment and for a week after, and breastfeeding is stopped. A BCR-ABL inhibitor that binds outside the ATP site (the myristoyl pocket); works in chronic myeloid leukaemia, including T315I. Updated Nov 12, 2026 ## Quick facts **Group** [Kinase inhibitors (targeted oncology)](https://durgical.com/en/pharmacology/classes/kinase-inhibitors/) **Target** BCR-ABL1 tyrosine kinase (myristoyl pocket of ABL1) **Key effects** Muscle · Fatigue · Nausea **Monitor** Complete blood count · Lipase and amylase **ATC** L01EA06 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Clinical What the labels mean - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action ✂**BCR-ABL1 tyrosine kinase (myristoyl pocket of ABL1)**Asciminib ⓘ The crystal shows asciminib in the myristoyl pocket of the human ABL1 kinase domain, with nilotinib in the ATP site at the same time; the protein carries two mutations. **Target in 3D:** BCR-ABL1 tyrosine kinase (myristoyl pocket of ABL1). PDB structure 5MO4 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/5MO4) · Drag to rotate · pinch to zoom Normal ABL1 is kept switched off when a myristoyl group folds into a pocket of its kinase domain. BCR-ABL loses that brake. Asciminib fills the empty myristoyl pocket and locks the kinase in its inactive shape. Because it does not use the ATP site, it works when ATP-site mutations, such as T315I, cause resistance to other inhibitors. - Asciminib fills the myristoyl pocket of BCR-ABL - The kinase is locked in its inactive shape - CML cells lose their growth signal, even with T315I ## Indications - Philadelphia chromosome-positive chronic myeloid leukaemia in chronic phase: newly diagnosed, after two or more kinase inhibitors, or with the T315I mutation. [Chronic myeloid leukaemia →](https://durgical.com/en/conditions/chronic-myeloid-leukaemia/) ## Adverse effects ### Common - Muscle, bone and joint pain - Fatigue, headache - Nausea, diarrhoea - Rash ### Serious (rare, important) - Myelosuppression: thrombocytopenia, neutropenia, anaemia - Pancreatitis - High blood pressure - Heart and blood vessel events: heart failure, ischaemia, thrombosis - Hypersensitivity ## Contraindications - Hypersensitivity to asciminib ## Key interactions **St John's wort** Can lower asciminib levels; avoided. **Other medicines and supplements** Many interact; the full list is reviewed before starting. ## What is monitored - Complete blood count, often at first - Lipase and amylase - Blood pressure - BCR-ABL molecular response ## Administration and safety - Oral tablets swallowed whole on an empty stomach, not split, crushed or chewed. - Taken at the same time each day; it is not stopped without the treating team. ## Pregnancy and breastfeeding Avoid in pregnancy. Asciminib may harm the fetus: contraception is used during treatment and for a week after, and breastfeeding is stopped. ## Nursing care - Check blood counts and teach to report bleeding, bruising or fever. - Teach the signs of pancreatitis: abdominal pain spreading to the back, nausea, vomiting. - Measure blood pressure at visits. - Contraception during treatment and for a week after; breastfeeding is stopped. ## Pharmacokinetics **Absorption** Oral tablets on an empty stomach (before or well after a meal). ## Memory aid «STAMP on the back door»: asciminib Specifically Targets the ABL Myristoyl Pocket, away from the ATP front door that T315I blocks. ## Test yourself Think of the answer, then tap the question to see it. ## Where does asciminib bind BCR-ABL? In the myristoyl pocket, an allosteric site away from the ATP site. ## Why does asciminib work against T315I? T315I changes the ATP site, which asciminib does not use. ## Which pancreatic test is followed on asciminib? Lipase and amylase (pancreatitis). [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/asciminib/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## What the labels mean **High alert** An error with this medicine can cause serious harm: double checks and protocols are used. **Pregnancy: avoid** Avoid in pregnancy. Asciminib may harm the fetus: contraception is used during treatment and for a week after, and breastfeeding is stopped. ## Connections ## Related drugs 3 - [Imatinib](https://durgical.com/en/pharmacology/imatinib/) - [Dasatinib](https://durgical.com/en/pharmacology/dasatinib/) - [Nilotinib](https://durgical.com/en/pharmacology/nilotinib/) ## Related conditions 1 - [Chronic myeloid leukaemia](https://durgical.com/en/conditions/chronic-myeloid-leukaemia/) [← Back to the class: Kinase inhibitors (targeted oncology)](https://durgical.com/en/pharmacology/classes/kinase-inhibitors/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Asciminib: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a621055.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [Asciminib Hydrochloride - NCI](https://www.cancer.gov/about-cancer/treatment/drugs/asciminib-hydrochloride) (National Cancer Institute, 2024); [RCSB PDB - 5MO4: ABL1 kinase (T334I_D382N) in complex with asciminib and nilotinib](https://www.rcsb.org/structure/5MO4) (RCSB Protein Data Bank, 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01EA06) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/asciminib/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/asciminib/