Nilotinib Heart Risks: What You Need to Know About Cardiac Side Effects

Nilotinib, a targeted cancer drug used to treat chronic myeloid leukemia (CML). Also known as Tasigna, it works by blocking abnormal proteins that make leukemia cells grow. But for all its power against cancer, nilotinib carries real risks to the heart — risks that aren’t always talked about until it’s too late.

Doctors prescribe nilotinib when other treatments fail or when patients have a specific genetic mutation. But behind the scenes, studies show it can cause QT prolongation, a heart rhythm disorder that can lead to sudden cardiac arrest. This isn’t rare — clinical data from the FDA and European regulators point to it happening in up to 10% of long-term users. It’s not just about rhythm, either. Peripheral arterial occlusive disease, a condition where blood flow to the arms and legs gets blocked has been reported in patients on nilotinib, sometimes leading to amputations. These aren’t side effects you can ignore. They’re serious, measurable, and often preventable with the right checks.

Who’s most at risk? People over 60, those with existing heart disease, high blood pressure, or diabetes. Even people who’ve never had heart problems before can develop issues if they’re on nilotinib for years. That’s why regular ECGs and blood pressure checks aren’t optional — they’re life-saving. Your doctor should monitor your heart before you start, every few months during treatment, and anytime you feel chest pain, dizziness, or unusual fatigue. And if you’re taking other drugs that affect heart rhythm — like certain antibiotics or antidepressants — the risk goes up fast. It’s not just the drug. It’s the combo.

There’s no way around it: nilotinib saves lives. But it doesn’t come without trade-offs. The same mechanism that kills cancer cells can tighten arteries and slow down your heart’s electrical signals. That’s why knowing the signs matters more than ever. If you’ve been on this drug for more than a year, ask your doctor for a recent ECG. Check your cholesterol. Watch your feet for coldness or pain when walking. These aren’t alarmist suggestions — they’re standard care for anyone on nilotinib.

Below, you’ll find real patient stories, clinical breakdowns, and comparisons with other leukemia drugs that carry similar heart risks. You’ll learn how to talk to your doctor about monitoring, what tests to demand, and when it might be time to switch. This isn’t about scaring you. It’s about giving you the facts so you can stay in control — and stay alive.