Meta Information
ID:dasatinib
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 CYP3A4 inhibitors block the primary enzyme that breaks down dasatinib, causing its levels to rise to potentially toxic concentrations and increasing the risk of severe side effects.
Actionable advice:
This combination should be avoided; if medically necessary, a significant dose reduction of dasatinib is required under strict medical supervision.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
For current labeling information, please visit https://www.fda.gov/drugsatfda
Concomitant Strong CYP3A4 inhibitors: CYP3A4 inhibitors (eg, ketoconazole,
itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir,
saquinavir, telithromycin, and voriconazole) may increase dasatinib plasma
concentrations.
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 contains compounds that strongly inhibit the CYP3A4 enzyme in the gut, which can dramatically increase dasatinib absorption and blood levels, raising toxicity risk.
Actionable advice:
Grapefruit, its juice, or Seville oranges should not be consumed at all while taking dasatinib.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Grapefruit juice may also increase plasma concentrations of dasatinib and
should be avoided.
Label source:
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 agents speed up the enzyme that metabolizes dasatinib, causing it to be cleared from the body too quickly, which can render the treatment ineffective.
Actionable advice:
This combination should be avoided; if medically necessary, a significant dose increase of dasatinib may be required under strict medical supervision.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
2.1 Dose Modification
Concomitant Strong CYP3A4 inducers: The use of concomitant strong CYP3A4
inducers may decrease dasatinib plasma concentrations and should be avoided (eg,
dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, phenobarbital).
Label source:
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 potent inducer of the CYP3A4 enzyme, which can dramatically lower dasatinib blood levels and compromise its therapeutic effect.
Actionable advice:
St. John's Wort should be avoided completely while taking dasatinib.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
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 profoundly suppress stomach acid for an extended period. Dasatinib requires an acidic environment to dissolve and be absorbed, so PPIs can severely reduce its effectiveness.
Actionable advice:
PPIs should not be used concurrently; alternatives like H2 blockers or antacids with appropriate timing may be considered.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
H2 Antagonists/Proton Pump Inhibitors: Long-term suppression of gastric acid
secretion by H2 antagonists or proton pump inhibitors (eg, famotidine and omeprazole) is
likely to reduce dasatinib exposure.
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; combining it with other drugs that do the same increases the risk of a serious and potentially fatal heart rhythm disorder.
Actionable advice:
Co-administration with other QT-prolonging drugs should be avoided; close cardiac monitoring is required if unavoidable.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
5.4 QT Prolongation
In vitro data suggest that dasatinib has the potential to prolong cardiac ventricular
repolarization (QT interval).
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:
Dasatinib can impair platelet function. When combined with other blood-thinning medications (e.g., warfarin, apixaban, clopidogrel, aspirin), it significantly increases the risk of serious bleeding.
Actionable advice:
This combination should be used only with extreme caution and under close medical supervision, with monitoring for any signs of bleeding.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
5.2 Bleeding Related Events
In addition to causing thrombocytopenia in human subjects, dasatinib caused platelet
dysfunction in vitro.
Label source:
Action type:
monitor
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:
Based on its mechanism and animal studies, dasatinib is expected to cause harm to a developing fetus.
Actionable advice:
Dasatinib is contraindicated in pregnancy; effective contraception must be used during treatment and for 30 days after the final dose.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
17.4 Pregnancy
Patients should be informed that dasatinib may cause fetal harm when administered to a
pregnant woman.
Label source:
Action type:
avoid
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
It is unknown if dasatinib passes into breast milk, but due to the potential for serious adverse reactions in a nursing infant, it is not recommended.
Actionable advice:
Breastfeeding should not be done while taking dasatinib and for at least 2 weeks after the final dose.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Because many drugs are
excreted in human milk and because of the potential for serious adverse reactions in
nursing infants from SPRYCEL, a decision should be made whether to discontinue
nursing or to discontinue the drug, taking into account the importance of the drug to the
mother.
Label source:
Action type:
informational_none
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 (e.g., famotidine) reduce stomach acid, which can decrease the absorption of dasatinib. Spacing the doses apart can mitigate this interaction.
Actionable advice:
Dasatinib 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:
Source url:
Exact phrase from label:
H2 Antagonists/Proton Pump Inhibitors: Long-term suppression of gastric acid secretion by H2 antagonists or proton pump inhibitors (eg, famotidine and omeprazole) is likely to reduce dasatinib exposure.
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 (e.g., Tums, Maalox) neutralize stomach acid on contact, which can interfere with the dissolution and absorption of dasatinib if taken at the same time.
Actionable advice:
Administration of dasatinib and any antacids should be separated by at least 2 hours.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
For current labeling information, please visit https://www.fda.gov/drugsatfda
Antacids: Nonclinical data demonstrate that the solubility of dasatinib is pH dependent.
Label source:
Action type:
separate
Target id:
/class/cyp3a4-moderate-inhibitors
Target name:
Moderate CYP3A4 Inhibitors
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Moderate CYP3A4 inhibitors (e.g., diltiazem, verapamil) slow the breakdown of dasatinib, leading to increased blood levels and a higher risk of side effects.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for side effects; a dose reduction of dasatinib may be needed under medical guidance.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
For current labeling information, please visit https://www.fda.gov/drugsatfda
Concomitant Strong CYP3A4 inhibitors: CYP3A4 inhibitors (eg, ketoconazole,
itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir,
saquinavir, telithromycin, and voriconazole) may increase dasatinib plasma
concentrations.
Label source:
Action type:
adjust_with_prescriber
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 (e.g., ibuprofen, naproxen) also have antiplatelet effects and can cause gastrointestinal irritation, increasing the risk of bleeding when taken with dasatinib.
Actionable advice:
Long-term or high-dose NSAID use is best avoided; NSAIDs are best used with caution for short periods if necessary, and it is a good idea to monitor for bleeding.
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 (CYP3A4-metabolized)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dasatinib can inhibit CYP3A4, potentially increasing the concentration of statins metabolized by this enzyme (e.g., simvastatin, atorvastatin, lovastatin), which elevates the risk of muscle-related side effects.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for muscle pain; statins not metabolized by CYP3A4 like pravastatin or rosuvastatin may be worth considering.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
7.3 Drugs That May Have Their Plasma Concentration
Altered By Dasatinib
CYP3A4 Substrates: Single-dose data from a study of 54 healthy subjects indicate that
the mean Cmax and AUC of simvastatin, a CYP3A4 substrate, were increased by 37% and
20%, respectively, when simvastatin was administered in combination with a single
100-mg dose of SPRYCEL.
Label source:
Action type:
monitor
Target id:
/condition/hepatic-impairment
Target name:
Hepatic Impairment
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Since dasatinib is extensively metabolized by the liver, impaired liver function can lead to increased drug levels and a higher risk of toxicity.
Actionable advice:
This is best used with caution and at a reduced dose in patients with moderate to severe hepatic impairment, under medical supervision.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
8.6 Hepatic Impairment
The effect of hepatic impairment on the pharmacokinetics of dasatinib was evaluated in
healthy volunteers with normal liver function and patients with moderate (Child-Pugh
class B) and severe (Child-Pugh class C) hepatic impairment.
Label source:
Action type:
informational_none
Target id:
/intervention/quercetin
Target name:
Quercetin
Severity:
major
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dasatinib and quercetin work together as a senolytic combination to clear senescent (aged) cells, which is the basis for its use in longevity protocols.
Actionable advice:
For senolytic purposes, dasatinib and quercetin should be taken together at the same time as directed by a protocol.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Senotherapeutics, such as the combination of dasatinib and quercetin (DQ), are being increasingly used to improve the clinical outcomes of chronic disorders and promote a healthy life span through the reduction of senescent cell burden and senescence-associated secretory phenotype (SASP).
Label source:
PubMed: Dasatinib and Quercetin Limit Gingival Senescence, Inflammation, and Bone Loss. (PMID 39797437)
Action type:
informational_none
Target id:
/dietary/meal
Target name:
Food/Meal
Severity:
minor
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dasatinib can be taken with or without food, but its absorption can be slightly altered by meals. Taking it in a consistent manner helps maintain stable drug levels.
Actionable advice:
Dasatinib is generally best taken at the same time each day, either consistently with a meal or consistently on an empty stomach.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
• Take SPRYCEL with or without food.
Label source:
Action type:
separate