In November 2014, the MHRA had issued an update on the risk of risk of vascular occlusive events with ponatinib, noting that this risk is likely to be dose-dependent. However, the data are insufficient to recommend reducing the ponatinib dose. Also, there is a risk that a lower dose might not be as effective as the current dose in all patients and in long-term treatment. Therefore, the recommended starting dose of ponatinib remains at 45 mg once a day but the product literature would contain strengthened warnings.