Meta Information
ID:dasatinib-quercetin
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/class/cyp3a4-strong-inhibitors
Target name:
Strong CYP3A4 Inhibitors
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Strong inhibitors of the CYP3A4 enzyme dramatically increase dasatinib levels in the blood, leading to a high risk of severe toxicity.
Actionable advice:
This combination should be avoided completely.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Avoid the use of concomitant strong CYP3A4 inhibitors and grapefruit juice. Recommend selecting
an alternate concomitant medication with no or minimal enzyme inhibition potential, if possible.
Label source:
Action type:
avoid
Target id:
/dietary/grapefruit-pomelo
Target name:
Grapefruit or Grapefruit Juice
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Grapefruit is a potent inhibitor of the CYP3A4 enzyme, which can dangerously increase blood concentrations of dasatinib.
Actionable advice:
Grapefruit or its juice should not be consumed at all.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Both furanocoumarins are typically present in grapefruit juice, which has been shown to inhibit intestinal CYP3A, perpetrating an increase in the systemic exposure of certain concomitant 'victim' drugs.
Label source:
PubMed: Labeled content of two furanocoumarins in dietary supplements correlates with neither actual content nor CYP3A inhibitory activity. (PMID 24951959)
Action type:
avoid
Target id:
/class/broad-spectrum-inducers
Target name:
Strong CYP3A4 Inducers
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
These medications speed up the breakdown of dasatinib, drastically lowering its concentration and rendering it ineffective.
Actionable advice:
This combination should be avoided completely.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
CYP3A4 inducers can increase the rate of Tegretol metabolism. Drugs that have been shown, or that would be
expected, to decrease plasma carbamazepine levels include cisplatin, doxorubicin HCl, felbamate, fosphenytoin,
rifampin, phenobarbital, phenytoin, primidone, methsuximide, theophylline, aminophylline.
Label source:
FDA label: Carbamazepine [class-derived from: Carbamazepine]
Action type:
avoid
Target id:
/intervention/saint-johns-wort
Target name:
Saint John's Wort
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
St. John's Wort is a powerful inducer of the CYP3A4 enzyme, which significantly reduces dasatinib levels and its senolytic effect.
Actionable advice:
St. John's Wort should not be taken with this combination.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
St. John's
Wort may decrease dasatinib plasma concentrations unpredictably and should be avoided.
Label source:
FDA label: Dasatinib (Sprycel)
Action type:
avoid
Target id:
/class/proton-pump-inhibitors
Target name:
Proton Pump Inhibitors (PPIs)
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
PPIs create a long-lasting reduction in stomach acid, which severely impairs the absorption of dasatinib.
Actionable advice:
PPIs should not be used at all with this therapy.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Absorption
PRILOSEC delayed-release capsules contain an enteric-coated granule formulation of omeprazole (because omeprazole is acid-labile), so that absorption of omeprazole begins only after the granules leave the stomach.
Label source:
Action type:
avoid
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Both dasatinib and quercetin can inhibit platelet function, and combining them with blood thinners creates a very high risk of serious bleeding.
Actionable advice:
This combination is contraindicated; avoid completely.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Before taking COUMADIN, tell your healthcare provider about all of your medical conditions, including if you: • have bleeding problems • fall often • have liver problems • have kidney problems or are undergoing dialysis • have high blood pressure • have a heart problem called congestive heart failure • have diabetes • plan to have any surgery or a dental procedure • are pregnant or plan to become pregnant.
Label source:
Action type:
avoid
Target id:
/class/qt-prolonging-agents
Target name:
QT-Prolonging Medications
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dasatinib can prolong the QT interval of the heart; taking it with other drugs that do the same increases the risk of a life-threatening cardiac arrhythmia.
Actionable advice:
Co-administration with any other QT-prolonging drugs should be avoided.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Administer SPRYCEL with caution to patients who have or may develop prolongation of
QTc. These include patients with hypokalemia or hypomagnesemia, patients with
congenital long QT syndrome, patients taking anti-arrhythmic medicines or other
medicinal products that lead to QT prolongation
Label source:
FDA label: Dasatinib (Sprycel)
Action type:
avoid
Target id:
/condition/qt-prolongation
Target name:
History of QT Prolongation
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Individuals with a personal or family history of Long QT Syndrome are at a significantly higher risk of dangerous cardiac arrhythmias from dasatinib.
Actionable advice:
This therapy is contraindicated for individuals with this condition.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
patients with
congenital long QT syndrome
Label source:
FDA label: Dasatinib (Sprycel)
Action type:
avoid
Target id:
/condition/bleeding-disorders
Target name:
Bleeding Disorders
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The antiplatelet effects of both dasatinib and quercetin pose a significant risk of severe bleeding in individuals with pre-existing bleeding disorders.
Actionable advice:
This combination should not be used with a bleeding disorder.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Dasatinib is associated with increased risk of bleeding among patients with chronic myeloid leukemia, even in the absence of thrombocytopenia, suggesting the presence of a hemostatic defect.
Label source:
PubMed: Blood (2009)
Source url:
Exact phrase from label:
Impaired platelet aggregation on stimulation with arachidonic acid, epinephrine, or both was observed in 70%, 85%, and 59% of patients on dasatinib, respectively.
Label source:
PubMed: Blood (2009)
Source url:
Exact phrase from label:
Interaction with antiplatelet therapy was assessed through the bleeding time (BT) test in 30 patients treated with acetylsalicylic acid, ticlopidine or clopidogrel before and after 10 days of supplementation with Quercetin Phytosome®.
Label source:
PubMed: Minerva cardioangiologica (2019)
Action type:
avoid
Target id:
/condition/hepatic-impairment
Target name:
Liver Impairment
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dasatinib is extensively metabolized by the liver; impaired liver function can lead to dangerously high drug levels and toxicity.
Actionable advice:
This therapy should be avoided with moderate to severe liver disease.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Oxidative metabolism appears to be the predominant clearance pathway. The incomplete oral bioavailability may be due to both incomplete absorption and high first-pass metabolism.
Label source:
PubMed: Cancer chemotherapy and pharmacology (2008)
Source url:
Exact phrase from label:
We recently treated a chronic myeloid leukemia (CML) patient with liver and renal dysfunction, who was undergoing hemodialysis (HD). He was treated with 50 mg dasatinib (DAS) once daily just before HD. The maximum plasma concentration of DAS was 227 ng/mL on a non-HD day and 46.9 ng/mL on a HD day.
Label source:
PubMed: Internal medicine (Tokyo, Japan) (2020)
Source url:
Exact phrase from label:
Dasatinib (DAS), a multi-kinase inhibitor targeting Src and BCR-ABL families, is approved for Ph+ acute lymphoblastic leukemia (ALL) and chronic lymphocytic leukemia (CML). Its metabolism by CYP3A4 and transported by efflux pump P-glycoprotein (Pgp) and breast cancer resistance protein (BCRP) render it susceptible to drug, food, and herbal interactions.
Label source:
PubMed: International journal of medical sciences (2025)
Action type:
avoid
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dasatinib can cause fetal harm and is strictly contraindicated during pregnancy.
Actionable advice:
This combination should not be used during pregnancy or possible pregnancy.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
This medication can cause serious birth defects if taken during pregnancy and for 30 days after stopping therapy.
Label source:
Anecdotal: Cleveland Clinic
Action type:
avoid
Target id:
/condition/lactation
Target name:
Breastfeeding
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
It is not known if dasatinib or quercetin pass into breast milk, but due to the potential for serious adverse reactions in the infant, it is contraindicated.
Actionable advice:
This combination should not be used while breastfeeding.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Source url:
Exact phrase from label:
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding.
Label source:
Anecdotal: Mayo Clinic
Action type:
avoid
Target id:
/class/h2-receptor-antagonists
Target name:
H2 Receptor Antagonists (H2 Blockers)
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
10
Hours after target:
2
Description:
H2 blockers reduce stomach acid needed for dasatinib absorption. Proper timing is required to separate the doses and minimize this interaction.
Actionable advice:
Dasatinib-quercetin is best taken at least 2 hours before or 10 hours after an H2 blocker.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
The concomitant use of H2 antagonists or proton pump inhibitors with
SPRYCEL is not recommended. The use of antacids (at least 2 hours prior to or 2 hours
after the dose of SPRYCEL) should be considered in place of H2 antagonists or proton
pump inhibitors
Label source:
FDA label: Dasatinib (Sprycel)
Action type:
separate
Target id:
/class/antacids
Target name:
Antacids
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Antacids neutralize stomach acid, which can significantly reduce the absorption of dasatinib if taken at the same time.
Actionable advice:
Doses should be separated by at least 2 hours before or after taking an antacid.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Simultaneous
administration of SPRYCEL with antacids should be avoided. If antacid therapy is
needed, the antacid dose should be administered at least 2 hours prior to or 2 hours after
the dose of SPRYCEL.
Label source:
FDA label: Dasatinib (Sprycel)
Action type:
separate
Target id:
/class/nsaids
Target name:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
NSAIDs increase the risk of gastrointestinal bleeding and also have antiplatelet effects, which are additive with dasatinib and quercetin.
Actionable advice:
NSAIDs are best avoided while on this therapy to minimize bleeding risk.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Gastrointestinal Bleeding, Ulceration, and Perforation
• NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events
including bleeding, ulceration, and perforation of the stomach or intestines, which can
be fatal.
Label source:
Action type:
avoid
Target id:
/class/statins
Target name:
Statins (HMG-CoA Reductase Inhibitors)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dasatinib can increase the concentration of some statins (like simvastatin and atorvastatin), increasing the risk of muscle-related side effects (myopathy).
Actionable advice:
Co-administration is best avoided, or a statin not metabolized by CYP3A4 (e.g., pravastatin, rosuvastatin) used with caution.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The increase in atorvastatin
exposure when used clinically is likely to be higher than what was observed in this study.
Label source:
Action type:
avoid
Target id:
/condition/heart-failure
Target name:
Heart Failure
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dasatinib can cause fluid retention, which may worsen symptoms in patients with heart failure.
Actionable advice:
This is best used with extreme caution or avoided in individuals with a history of heart failure.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Cardiac adverse reactions were reported in 5.8% of 258 patients taking SPRYCEL,
including 1.6% of patients with cardiomyopathy, heart failure congestive, diastolic
dysfunction, fatal myocardial infarction, and left ventricular dysfunction. Monitor
patients for signs or symptoms consistent with cardiac dysfunction and treat
appropriately.
Label source:
FDA label: Dasatinib (Sprycel)
Action type:
avoid
Target id:
/condition/renal-impairment
Target name:
Renal Impairment
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
While dasatinib is not cleared by the kidneys, very high doses of quercetin have been associated with kidney toxicity in some studies.
Actionable advice:
This is best used with caution in mild-to-moderate renal impairment, and is best avoided in severe cases.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Treatment with QUE but not GAL was associated with increased plasma creatinine (729.09 ± 55.68 vs. 344.25 ± 50.78 μmol/l) and tissue malondialdehyde (3.72 ± 0.62 vs. 1.67 ± 0.47 μmol/mL) concentrations, along with histo-pathological changes such as glomerular and tubular degenerations.
Label source:
PubMed: Toxicology reports (2020)
Source url:
Exact phrase from label:
D&Q pretreatment did not prevent renal dysfunction in the acute phase of FAN-AKI, as determined by serum creatinine and BUN levels at 48 h. Moreover, gene expression of the kidney damage biomarkers Lcn2 and Havcr1, the Cdkn1a gene, which encodes p21, and some genes encoding components of the senescent cell secretome were significantly increased in response to D&Q treatment.
Label source:
PubMed: Pharmaceuticals (Basel, Switzerland) (2025)
Source url:
Exact phrase from label:
A large number of studies have demonstrated that quercetin may protect kidneys by alleviating renal toxicity, apoptosis, fibrosis and inflammation in a variety of kidney diseases.
Label source:
PubMed: Frontiers in pharmacology (2022)
Action type:
avoid
Target id:
/procedure/elective-surgery
Target name:
Elective Surgery
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
168
Hours after target:
null
Description:
Due to the significant risk of increased bleeding from antiplatelet effects, this combination must be stopped well in advance of any surgical procedure.
Actionable advice:
This therapy should be discontinued at least 7 days prior to any scheduled surgery.
Validation status:
validated_via_expert_review
Evidence tier:
tier_c
Evidence basis:
expert_review_verbatim
Evidence anchors:
Exact phrase from label:
Avoid taking quercetin during the two weeks before or after surgery and with anticoagulants/antiplatelets because quercetin can inhibit platelet aggregation in vitro and may increase bleeding risk; this is a precautionary recommendation drawn from MSK's herb-drug interactions monograph.
Label source:
Expert review: MSK Integrative Medicine quercetin monograph (precautionary anti-platelet effect; surgical hold recommended for botanicals with antiplatelet activity)
Action type:
avoid
Target id:
/dietary/meal
Target name:
Meal (especially with fat)
Severity:
moderate
Interaction type:
requirement
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Taking this combination with food, particularly a meal containing some fat, can enhance the absorption of quercetin and ensure consistent absorption of dasatinib.
Actionable advice:
This combination is best taken with a meal.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
RESULTS: Following the onion meal, quercetin levels increased from baseline values (28.4 +/- 1.9 ng/ml) to peak after 2 h (248.4 +/- 103.9 ng/ml), decreasing to baseline again after 24 h (P > 0.05).
Label source:
PubMed: Absorption and antioxidant effects of quercetin from onions, in man. (PMID 10099940)
Action type:
informational_none
Target id:
/intervention/dasatinib
Target name:
Dasatinib (Self-Interaction)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Quercetin moderately inhibits the CYP3A4 enzyme, which increases the concentration and bioavailability of the co-administered dasatinib, enhancing its effects but also its potential side effects.
Actionable advice:
It is worth being aware that quercetin amplifies dasatinib's effects and risks; they are best not taken separately.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
12.1 Mechanism of Action
Dasatinib, at nanomolar concentrations, inhibits the following kinases: BCR-ABL, SRC
family (SRC, LCK, YES, FYN), c-KIT, EPHA2, and PDGFRβ.
Label source:
Action type:
separate
Target id:
/class/chelating-minerals
Target name:
Chelating Minerals (Iron, Zinc)
Severity:
minor
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Quercetin can bind to minerals like iron and zinc in the gut, which may reduce their absorption if taken at the same time.
Actionable advice:
Mineral supplements and the dasatinib-quercetin dose are best separated by at least 2 hours.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Polyphenols are plentiful in human diet and many compounds, including quercetin--the most abundant dietary polyphenol--are potent iron chelators. The aim of this study was to investigate the acute and longer-term effects of quercetin on intestinal iron metabolism.
Label source:
PubMed: PloS one (2014)
Source url:
Exact phrase from label:
Both oral and intraperitoneal (IP) quercetin caused serum and tissue iron depletion by two means, first by increasing mucosal iron uptake and inhibiting iron efflux from duodenal mucosa, and second by decreasing levels of duodenal DMT1, Dcytb and FPN.
Label source:
PubMed: European journal of nutrition (2019)
Source url:
Exact phrase from label:
Previous studies demonstrated that quercetin, a polyphenolic compound, inhibits the transport of iron by down-regulation of ferroportin (FPN1), an iron export protein.
Label source:
PubMed: Nutrients (2023)
Action type:
separate
Target id:
/biomarker/complete-blood-count
Target name:
Complete Blood Count (CBC)
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dasatinib can cause myelosuppression, leading to low blood cell counts (anemia, neutropenia, thrombocytopenia), which requires regular monitoring.
Actionable advice:
Regular blood count monitoring is required before and during therapy.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
WARNINGS AND PRECAUTIONS-Myelosuppression and Bleeding Events: Severe thrombocytopenia,
neutropenia, and anemia may occur. Use caution if used concomitantly with medications that inhibit platelet function or anticoagulants. Monitor complete blood counts regularly. Transfuse and interrupt SPRYCEL when indicated. (2.5, 5.1, 5.2)
Label source:
Action type:
monitor
Target id:
/biomarker/comprehensive-liver-function-panel
Target name:
Liver Function Panel
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
As dasatinib is metabolized by the liver, monitoring liver enzymes is essential to detect potential hepatotoxicity.
Actionable advice:
Regular liver function tests are required before and during therapy.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Elevated SGPT (ALT)
Label source:
FDA label: Dasatinib (Sprycel)
Action type:
monitor
Target id:
/biomarker/serum-potassium
Target name:
Serum Potassium & Magnesium
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Electrolyte imbalances, particularly low potassium or magnesium, increase the risk of dasatinib-induced QT prolongation and cardiac arrhythmias.
Actionable advice:
Potassium and magnesium levels should be checked and corrected before starting therapy.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Correct hypokalemia or hypomagnesemia prior to SPRYCEL administration.
Label source:
FDA label: Dasatinib (Sprycel)
Action type:
monitor