Dosing & Uses
Dosage Forms & Strengths
tablet
- 20mg
- 50mg
- 70mg
- 80mg
- 100mg
- 140mg
Chronic Myeloid Leukemia
Also see Administration
Newly diagnosed
- Indicated for newly diagnosed adults with Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML) in chronic phase
- Start 100 mg PO qDay (morning or evening)
- May increase to 140 mg qDay if inadequate response
Advanced CML
- Indicated for treatment of chronic, accelerated, or myeloid or lymphoid blast phase Ph+ CML with resistance or intolerance to prior therapy including imatinib
- Start 140 mg PO qDay
- May increase to 180 mg qDay if inadequate response
Acute Lymphoblastic Leukemia
Indicated for Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) with resistance or intolerance to prior therapy
Start 140 mg PO qDay
May increase to 180 mg PO qDay if inadequate response
Dosage Modifications
Hepatic Impairment
- Mild-to-moderate (Child Pugh A to B): No dosage adjustment necessary
- Severe (Child Pugh C): Decreases mean Cmax by 43% and in mean AUC by 28% compared to normal liver function subjects
Gastric acid reducing agents
- Do not administer H2 antagonists or proton pump inhibitors with dasatinib; consider the use of antacids in place of H2 antagonists or proton pump inhibitors
- Administer the antacid at least 2 hr prior to or 2 hr after dasatinib dose
- Avoid simultaneous administration of dasatinib with antacids
Concomitant strong CYP3A4 inducers
- Avoid use
- If coadministration of strong CYP3A4 inducer is unavoidable, consider increasing dasatinib dose and monitor for toxicity
Concomitant strong CYP3A4 inhibitors
- Avoid use
- Recommend an alternate concomitant medication with no or minimal enzyme inhibition potential, if possible
Recommended dosage adjustment if concomitant strong CYP3A4 inhibitors must be administered
- Patient currently taking 140 mg PO qDay: Decrease to 40 mg PO qDay
- Patient currently taking 100 mg PO qDay: Decrease to 20 mg PO qDay
- Patient currently taking 70 mg PO qDay: Decrease to 20 mg PO qDay
- Patients currently taking 40 or 60 mg PO qDay: Hold treatment until inhibitor is discontinued
- If therapy is not tolerated after dose reduction, either discontinue strong CYP3A4 inhibitor or interrupt dasatinib until inhibitor is discontinued; allow a washout period of ~1 week after inhibitor is stopped before increasing dose of dasatinib
Dose adjustments for neutropenia and thrombocytopenia
- ANC <0.5 X 10^9 or platelets <10 X 10^9
Chronic Phase CML
- Hold treatment until ANC ≥1.0 X 10^9/L and platelets ≥50 X 10^9/L
- Resume treatment at original starting dose if recovery occurs in ≤7 days
- If platelets <25 x 10^9/L or recurrence of ANC <0.5 x 10^9/L for >7 days, hold treatment until ANC ≥1.0 X 10^9/L and platelets ≥50 X 10^9/L and resume at a reduced dose of 80 mg PO qDay for second episode
- For third episode, further reduce dose to 50 mg PO qDay (for newly diagnosed patients) or discontinue dasatinib (for patients resistant or intolerant to prior therapy including imatinib)
Accelerated phase CML, blast phase CML and Ph+ ALL
- Check if cytopenia is related to leukemia (marrow aspirate or biopsy)
- If cytopenia is unrelated to leukemia, hold dasatinib until ANC ≥1 X 10^9/L and platelets ≥20 X 10^9/L and resume at original starting dose
- Recurrence of cytopenia, check if cytopenia is related to leukemia and resume dasatinib at a reduced dose of 100 mg PO qDay (second episode) or 80 mg PO qDay (third episode)
- If cytopenia is related to leukemia, consider dose escalation to 180 mg PO qDay
Dosing Considerations
In clinical studies, dasatinib in adults, children, and adolescents patients was continued until disease progression or unacceptable toxicity
The effect of stopping treatment on long-term disease outcome after the achievement of a cytogenetic response or major molecular response has not been established
Dosage Forms & Strengths
tablet
- 20mg
- 50mg
- 70mg
- 80mg
- 100mg
- 140mg
Acute Lymphoblastic Leukemia
Indicated for patients (≥1 year) with newly diagnosed Ph+ ALL in combination with chemotherapy
Begin therapy on or before day 15 of induction chemotherapy, when diagnosis is confirmed and continue for 2 years
Recommended initial dosage based on body weight
- <10 kg: Not recommended
- 10 to <20 kg: 40 mg PO qDay
- 20 to <30 kg: 60 mg PO qDay
- 30 to <45 kg: 70 mg PO qDay
- ≥45 kg: 100 mg PO qDay
Chronic Myeloid Leukemia
Indicated for patients (≥1 year) with Ph+ CML in chronic phase
Recommended initial dosage based on body weight
- <10 kg: Not recommended
- 10 to <20 kg: 40 mg PO qDay
- 20 to <30 kg: 60 mg PO qDay
- 30 to <45 kg: 70 mg PO qDay
- ≥45 kg: 100 mg PO qDay
Recommended dose escalation if hematological or cytogenetic response is not achieved
- Starting dose 40 mg PO qDay: May increase 50 mg PO qDay
- Starting dose 60 mg PO qDay: May increase 70 mg PO qDay
- Starting dose 70 mg PO qDay: May increase 90 mg PO qDay
- Starting dose 100 mg PO qDay: May increase 120 mg PO qDay
Also see Administration
Dosage Modifications
Hepatic impairment
- Mild-to-moderate (Child Pugh A to B): No dosage adjustment necessary
- Severe (Child Pugh C): Decreases mean peak plasma concentration by 43% and in mean AUC by 28% compared to normal liver function subjects
Gastric acid reducing agents
- Do not administer H2 antagonists or proton pump inhibitors with dasatinib; consider the use of antacids in place of H2 antagonists or proton pump inhibitors
- Administer the antacid at least 2 hr prior to or 2 hr after dasatinib dose
- Avoid simultaneous administration of dasatinib with antacids
Concomitant strong CYP3A4 inducers
- Avoid use
- If coadministration of strong CYP3A4 inducer is unavoidable, consider increasing dasatinib dose and monitor for toxicity
Concomitant strong CYP3A4 inhibitors
- Avoid use
- Recommend an alternate concomitant medication with no or minimal enzyme inhibition potential, if possible
Recommended dosage adjustment if concomitant strong CYP3A4 inhibitors must be administered
- Patient currently taking 140 mg PO qDay: Decrease to 40 mg PO qDay
- Patient currently taking 100 mg PO qDay: Decrease to 20 mg PO qDay
- Patient currently taking 70 mg PO qDay: Decrease to 20 mg PO qDay
- Patients currently taking 40 or 60 mg PO qDay: Hold treatment until inhibitor is discontinued
- If therapy is not tolerated after dose reduction, either discontinue strong CYP3A4 inhibitor or interrupt dasatinib until inhibitor is discontinued; allow a washout period of ~1 week after inhibitor is stopped before increasing dose of dasatinib
Dose adjustments for neutropenia and thrombocytopenia
- Cytopenia persists for >3 weeks, check if cytopenia is related to leukemia (marrow aspirate or biopsy)
- Cytopenia is unrelated to leukemia, stop treatment until ANC ≥1 X 10^9/L and platelets ≥75 X 10^9/L and resume at original starting dose or at a reduced dose
- Cytopenia recurs, repeat marrow aspirate/biopsy and resume at a reduced dose
- Patients with chronic phase CML: If Grade ≥3 neutropenia or thrombocytopenia recurs during complete hematologic response (CHR), interrupt treatment and resume at a reduced dose; implement temporary dose reductions for intermediate degrees of cytopenia and disease response as needed
- Patients with Ph+ ALL: Neutropenia and/or thrombocytopenia delays next block of treatment by > 14 days; interrupt dose and resume at the same dose level once the next block of treatment is started
- Patients with Ph+ ALL: Neutropenia and/or thrombocytopenia persist and next block of treatment is delayed another 7 days; perform a bone marrow assessment to assess cellularity and percentage of blasts; if marrow cellularity <10%, interrupt treatment until ANC >500/mcL; if marrow cellularity >10%, consider resumption of treatment
One-level dose reduction
- Starting dose 40 mg PO qDay: May increase 20mg PO qDay
- Starting dose 60 mg PO qDay: May increase 40 mg PO qDay
- Starting dose 70 mg PO qDay: May increase 60 mg PO qDay
- Starting dose 100 mg PO qDay: May increase 80 mg PO qDay
Two-level dose reduction
- Starting dose 40 mg PO qDay: Lower tablet dose not available
- Starting dose 60 mg PO qDay: May increase 20 mg PO qDay
- Starting dose 70 mg PO qDay: May increase 50 mg PO qDay
- Starting dose 100 mg PO qDay: May increase 70 mg PO qDay
Dose adjustments for nonhematologic adverse reactions
- Ph+ CML: Severe nonhematologic adverse reaction develops: Withhold treatment until the event resolves or improves; resume as appropriate at a reduced dose depending on severity and recurrence of the event
- Ph+ ALL: Interrupt treatment for cases of Grade >3 nonhematologic adverse reactions with the exception of liver function test abnormalities, and resume at a reduced dose when resolved to Grade ≤1; if direct bilirubin is >5x ULN or AST/ALT >15x ULN, interrupt therapy until recovery to Grade ≤1 and then resume treatment at original starting dose or at a reduced dose for recurrent events
One-level dose reduction
- Starting dose 40 mg PO qDay: May increase 20mg PO qDay
- Starting dose 60 mg PO qDay: May increase 40 mg PO qDay
- Starting dose 70 mg PO qDay: May increase 60 mg PO qDay
- Starting dose 100 mg PO qDay: May increase 80 mg PO qDay
Two-level dose reduction
- Starting dose 40 mg PO qDay: Lower tablet dose not available
- Starting dose 60 mg PO qDay: May increase 20 mg PO qDay
- Starting dose 70 mg PO qDay: May increase 50 mg PO qDay
- Starting dose 100 mg PO qDay: May increase 70 mg PO qDay
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (3)
- lefamulin
lefamulin will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.
- pimozide
dasatinib increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation.
- saquinavir
saquinavir will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
Serious - Use Alternative (80)
- abametapir
abametapir will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.
- aluminum hydroxide
aluminum hydroxide will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- amiodarone
amiodarone and dasatinib both increase QTc interval. Avoid or Use Alternate Drug.
- amitriptyline
dasatinib will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- apalutamide
apalutamide will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.
- arsenic trioxide
arsenic trioxide and dasatinib both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
artemether and dasatinib both increase QTc interval. Avoid or Use Alternate Drug.
- calcium carbonate
calcium carbonate will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- carbamazepine
carbamazepine will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- chloramphenicol
chloramphenicol will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- cimetidine
cimetidine will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
cimetidine will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. - clarithromycin
clarithromycin will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- clomipramine
dasatinib will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- colchicine
dasatinib will increase the level or effect of colchicine by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Avoid use of colchicine with P-gp inhibitors. If coadministration is necessary, decrease colchicine dose or frequency as recommended in prescribing information. Use of any colchicine product in conjunction with P-gp inhibitors is contraindicated in patients with renal or hepatic impairment.
- deferiprone
deferiprone, dasatinib. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis; if an alternative is not possible, monitor absolute neutrophil count more frequently.
- desipramine
dasatinib will increase the level or effect of desipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- dexlansoprazole
dexlansoprazole will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- dihydroergotamine
dasatinib will increase the level or effect of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- dihydroergotamine intranasal
dasatinib will increase the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- disopyramide
dasatinib and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.
- dronedarone
dasatinib will increase the level or effect of dronedarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- enzalutamide
enzalutamide will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- ergotamine
dasatinib will increase the level or effect of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- erythromycin base
dasatinib will increase the level or effect of erythromycin base by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
erythromycin base will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. - erythromycin ethylsuccinate
erythromycin ethylsuccinate will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
dasatinib will increase the level or effect of erythromycin ethylsuccinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. - erythromycin lactobionate
erythromycin lactobionate will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
dasatinib will increase the level or effect of erythromycin lactobionate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. - erythromycin stearate
erythromycin stearate will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
dasatinib will increase the level or effect of erythromycin stearate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. - esomeprazole
esomeprazole will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- everolimus
dasatinib will increase the level or effect of everolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- famotidine
famotidine will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- fexinidazole
fexinidazole and dasatinib both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
fexinidazole will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates. - hydroxychloroquine sulfate
hydroxychloroquine sulfate and dasatinib both increase QTc interval. Avoid or Use Alternate Drug.
- ibuprofen/famotidine
ibuprofen/famotidine will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- ibutilide
dasatinib and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.
- idelalisib
idelalisib will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates
- imipramine
dasatinib will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- indapamide
dasatinib and indapamide both increase QTc interval. Avoid or Use Alternate Drug.
- itraconazole
itraconazole will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Not recommended during and 2 weeks after itraconazole.
- ivosidenib
ivosidenib and dasatinib both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.
ivosidenib will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. - ketoconazole
ketoconazole will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- lansoprazole
lansoprazole will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- lonafarnib
dasatinib will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.
lonafarnib will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling. - lopinavir
lopinavir will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- lovastatin
dasatinib will increase the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- mefloquine
mefloquine increases toxicity of dasatinib by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.
- mifepristone
mifepristone will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration necessary, concomitant use of mifepristone not recommended in patients receiving dasatinib 40-60 mg daily; consider a dasatinib dose reduction to 40 mg PO daily if original dose was 140 mg daily, 20 mg PO daily if original dose was 100 mg daily, or 20 mg PO daily if original dose was 70 mg daily; If dasatinib is not tolerated after dose reduction, consider alternative therapies; if mifepristone stopped, wait approximately 1 week before increasing dasatinib dose
- nefazodone
nefazodone will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- nizatidine
nizatidine will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- omeprazole
omeprazole will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- ondansetron
dasatinib and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.
- palifermin
palifermin increases toxicity of dasatinib by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hrbefore, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.
- panobinostat
dasatinib and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.
- pantoprazole
pantoprazole will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- pazopanib
dasatinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day
- pentamidine
dasatinib and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.
- pimozide
dasatinib and pimozide both increase QTc interval. Avoid or Use Alternate Drug.
- procainamide
dasatinib and procainamide both increase QTc interval. Avoid or Use Alternate Drug.
- quinidine
quinidine and dasatinib both increase QTc interval. Avoid or Use Alternate Drug.
- rabeprazole
rabeprazole will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- ranolazine
dasatinib will increase the level or effect of ranolazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- ribociclib
ribociclib increases toxicity of dasatinib by QTc interval. Avoid or Use Alternate Drug.
- rifabutin
rifabutin will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- rifampin
rifampin will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- ritonavir
ritonavir will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. May require decreased dasatinib dose or adjustment of dosing interval. Both ritonavir and dasatinib are CYP3A4 inhibitor, however, ritonavir is a strong CYP3A4 inhibitor and more likely to increase dasatinib levels and increase risk for toxicity including prolonged QT interval.
- silodosin
dasatinib will increase the level or effect of silodosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- simvastatin
dasatinib will increase the level or effect of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- sirolimus
dasatinib will increase the level or effect of sirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- sodium bicarbonate
sodium bicarbonate will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- sodium citrate/citric acid
sodium citrate/citric acid will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- sotalol
dasatinib and sotalol both increase QTc interval. Avoid or Use Alternate Drug.
- St John's Wort
St John's Wort will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- tipranavir
tipranavir will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- tolvaptan
dasatinib will increase the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- toremifene
dasatinib and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.
- tucatinib
tucatinib will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.
- umeclidinium bromide/vilanterol inhaled
dasatinib increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
- vandetanib
dasatinib, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.
- vemurafenib
vemurafenib and dasatinib both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.
- vilanterol/fluticasone furoate inhaled
dasatinib increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
- voxelotor
voxelotor will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.
Monitor Closely (231)
- acalabrutinib
acalabrutinib, dasatinib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.
- albuterol
albuterol and dasatinib both increase QTc interval. Use Caution/Monitor.
- alfuzosin
dasatinib and alfuzosin both increase QTc interval. Use Caution/Monitor.
alfuzosin and dasatinib both increase QTc interval. Use Caution/Monitor. - almotriptan
dasatinib will increase the level or effect of almotriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- alprazolam
dasatinib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- amiodarone
dasatinib will increase the level or effect of amiodarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- amitriptyline
amitriptyline and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- amobarbital
amobarbital will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- amoxapine
amoxapine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- apomorphine
apomorphine and dasatinib both increase QTc interval. Use Caution/Monitor.
- aprepitant
aprepitant will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- arformoterol
arformoterol and dasatinib both increase QTc interval. Use Caution/Monitor.
- aripiprazole
dasatinib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
aripiprazole and dasatinib both increase QTc interval. Use Caution/Monitor. - armodafinil
armodafinil will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- artemether/lumefantrine
dasatinib will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely. - atazanavir
atazanavir will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- atomoxetine
atomoxetine and dasatinib both increase QTc interval. Use Caution/Monitor.
- atorvastatin
dasatinib will increase the level or effect of atorvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- avanafil
dasatinib will increase the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inhibitors may reduce avanafil clearance increasing systemic exposure to avanafil; increased levels may result in increased associated adverse events; the maximum recommended dose of STENDRA is 50 mg, not to exceed once every 24 hours for patients taking concomitant moderate CYP3A4 inhibitors
- avapritinib
dasatinib will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- axitinib
dasatinib increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- bazedoxifene/conjugated estrogens
dasatinib will increase the level or effect of bazedoxifene/conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- bedaquiline
dasatinib and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely
- belzutifan
belzutifan will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.
- bexarotene
dasatinib will increase the level or effect of bexarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- bosentan
bosentan will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- budesonide
dasatinib will increase the level or effect of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
budesonide will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - buspirone
dasatinib will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- butabarbital
butabarbital will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- butalbital
butalbital will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- carbamazepine
dasatinib will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cenobamate
cenobamate will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.
- chloroquine
chloroquine increases toxicity of dasatinib by QTc interval. Use Caution/Monitor.
- chlorpromazine
chlorpromazine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- cilostazol
dasatinib will increase the level or effect of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cinacalcet
dasatinib will increase the level or effect of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- citalopram
citalopram and dasatinib both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- clarithromycin
clarithromycin and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- clobetasone
dasatinib will increase the level or effect of clobetasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- clomipramine
clomipramine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- clopidogrel
dasatinib will decrease the level or effect of clopidogrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Inhibition of CYP3A4 will reduce clopidogrel bioactivation
- clozapine
dasatinib will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cobicistat
cobicistat will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Dosage adjustment of dasatinib may be necessary upon coadministration with cobicistat coadministered with atazanavir or darunavir. Refer dasatinib prescribing information for dosing instructions.
- conivaptan
conivaptan will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- conjugated estrogens
dasatinib will increase the level or effect of conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- conjugated estrogens, vaginal
dasatinib will increase the level or effect of conjugated estrogens, vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cortisone
dasatinib will increase the level or effect of cortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
cortisone will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - crizotinib
crizotinib increases levels of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- crofelemer
crofelemer increases levels of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.
- cyclosporine
cyclosporine will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- dabrafenib
dabrafenib will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
- darifenacin
darifenacin will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib will increase the level or effect of darifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - darunavir
darunavir will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Dasatinib may require adjustment of dose or dosing interval if coadministered.
- deferasirox
deferasirox will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- desipramine
desipramine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- dexamethasone
dasatinib will increase the level or effect of dexamethasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dexamethasone will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - DHEA, herbal
DHEA, herbal will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- diazepam
dasatinib will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- dichlorphenamide
dichlorphenamide and dasatinib both decrease serum potassium. Use Caution/Monitor.
- didanosine
didanosine will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- dienogest/estradiol valerate
dasatinib will increase the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for potential adverse effects such as nausea, irregular uterine bleeding, breast tenderness and headache.
- diltiazem
diltiazem will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- dofetilide
dasatinib and dofetilide both increase QTc interval. Modify Therapy/Monitor Closely.
dofetilide increases toxicity of dasatinib by QTc interval. Use Caution/Monitor. - dolasetron
dasatinib and dolasetron both increase QTc interval. Use Caution/Monitor.
- doxepin
doxepin and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- doxorubicin
dasatinib will increase the level or effect of doxorubicin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- doxorubicin liposomal
dasatinib will increase the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- dronedarone
dronedarone will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and dronedarone both increase QTc interval. Modify Therapy/Monitor Closely. - droperidol
dasatinib and droperidol both increase QTc interval. Modify Therapy/Monitor Closely.
- duvelisib
duvelisib will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. will increase the level or effect of
- efavirenz
efavirenz will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- elagolix
elagolix will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.
- eletriptan
dasatinib will increase the level or effect of eletriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.
- encorafenib
encorafenib, dasatinib. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.
- erlotinib
dasatinib will increase the level or effect of erlotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- erythromycin base
dasatinib and erythromycin base both increase QTc interval. Modify Therapy/Monitor Closely.
- erythromycin ethylsuccinate
dasatinib and erythromycin ethylsuccinate both increase QTc interval. Modify Therapy/Monitor Closely.
- erythromycin lactobionate
dasatinib and erythromycin lactobionate both increase QTc interval. Modify Therapy/Monitor Closely.
- erythromycin stearate
dasatinib and erythromycin stearate both increase QTc interval. Modify Therapy/Monitor Closely.
- escitalopram
escitalopram increases toxicity of dasatinib by QTc interval. Use Caution/Monitor.
- eslicarbazepine acetate
eslicarbazepine acetate will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- estradiol
dasatinib will increase the level or effect of estradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- estrogens conjugated synthetic
dasatinib will increase the level or effect of estrogens conjugated synthetic by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- estrogens esterified
dasatinib will increase the level or effect of estrogens esterified by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- estropipate
dasatinib will increase the level or effect of estropipate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ethinylestradiol
ethinylestradiol will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- etonogestrel
dasatinib will increase the level or effect of etonogestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- etoposide
dasatinib will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- etravirine
dasatinib will increase the level or effect of etravirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
etravirine will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - ezogabine
ezogabine, dasatinib. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.
- fedratinib
fedratinib will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.
- felodipine
dasatinib will increase the level or effect of felodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fesoterodine
dasatinib will increase the level or effect of fesoterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- finerenone
dasatinib will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.
- flecainide
dasatinib and flecainide both increase QTc interval. Use Caution/Monitor.
- flibanserin
dasatinib will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.
- fluconazole
fluconazole will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and fluconazole both increase QTc interval. Modify Therapy/Monitor Closely. - fludrocortisone
dasatinib will increase the level or effect of fludrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fluoxetine
dasatinib and fluoxetine both increase QTc interval. Use Caution/Monitor.
- fluphenazine
fluphenazine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- fluvoxamine
fluvoxamine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- formoterol
dasatinib and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.
- fosamprenavir
dasatinib will increase the level or effect of fosamprenavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- foscarnet
dasatinib and foscarnet both increase QTc interval. Use Caution/Monitor.
- fosphenytoin
fosphenytoin will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fostemsavir
dasatinib and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- grapefruit
grapefruit will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- green tea
green tea, dasatinib. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of bleeding.
- griseofulvin
griseofulvin will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- haloperidol
dasatinib and haloperidol both increase QTc interval. Modify Therapy/Monitor Closely.
- hydrocortisone
dasatinib will increase the level or effect of hydrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- hydroxyprogesterone caproate
dasatinib will increase the level or effect of hydroxyprogesterone caproate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- hydroxyurea
dasatinib, hydroxyurea. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of myelosuppression.
- iloperidone
dasatinib will increase the level or effect of iloperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and iloperidone both increase QTc interval. Use Caution/Monitor.
iloperidone increases levels of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. - imipramine
imipramine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- indacaterol, inhaled
indacaterol, inhaled, dasatinib. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.
- indinavir
dasatinib will increase the level or effect of indinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
indinavir will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - isoniazid
isoniazid will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- istradefylline
istradefylline will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.
- ixabepilone
dasatinib will increase the level or effect of ixabepilone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- lapatinib
dasatinib will increase the level or effect of lapatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and lapatinib both increase QTc interval. Use Caution/Monitor. - lemborexant
dasatinib will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.
- lenvatinib
dasatinib and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.
- levofloxacin
dasatinib and levofloxacin both increase QTc interval. Use Caution/Monitor.
- lofepramine
lofepramine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- lomitapide
dasatinib increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.
- lopinavir
dasatinib will increase the level or effect of lopinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- loratadine
dasatinib will increase the level or effect of loratadine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- lorlatinib
lorlatinib will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- lumefantrine
dasatinib will increase the level or effect of lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely. - lurasidone
dasatinib decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concurrent use of weak CYP3A4 inhibitors can theoretically lead to an increased risk of lurasidone-related adverse reactions.
- maprotiline
maprotiline and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- maraviroc
dasatinib will increase the level or effect of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- marijuana
marijuana will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- mestranol
dasatinib will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- methadone
dasatinib will increase the level or effect of methadone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and methadone both increase QTc interval. Use Caution/Monitor. - methylprednisolone
dasatinib will increase the level or effect of methylprednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- metronidazole
metronidazole will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- miconazole vaginal
miconazole vaginal will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- midazolam
dasatinib will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- midazolam intranasal
dasatinib will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.
- mifepristone
mifepristone, dasatinib. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.
- mitotane
mitotane decreases levels of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.
- modafinil
modafinil will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- moxifloxacin
dasatinib and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
- nelfinavir
dasatinib will increase the level or effect of nelfinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
nelfinavir will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - nevirapine
nevirapine will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nicardipine
dasatinib will increase the level or effect of nicardipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nifedipine
nifedipine will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nilotinib
dasatinib will increase the level or effect of nilotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and nilotinib both increase QTc interval. Modify Therapy/Monitor Closely. - nisoldipine
dasatinib will increase the level or effect of nisoldipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nortriptyline
nortriptyline and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- octreotide
dasatinib and octreotide both increase QTc interval. Modify Therapy/Monitor Closely.
- octreotide (Antidote)
dasatinib and octreotide (Antidote) both increase QTc interval. Modify Therapy/Monitor Closely.
- ofatumumab SC
ofatumumab SC, dasatinib. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.
- ofloxacin
dasatinib and ofloxacin both increase QTc interval. Use Caution/Monitor.
- olodaterol inhaled
dasatinib and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias
- osilodrostat
osilodrostat and dasatinib both increase QTc interval. Use Caution/Monitor.
- osimertinib
osimertinib and dasatinib both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.
- oxcarbazepine
oxcarbazepine will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ozanimod
ozanimod and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.
- paliperidone
dasatinib and paliperidone both increase QTc interval. Use Caution/Monitor.
- paroxetine
dasatinib and paroxetine both increase QTc interval. Use Caution/Monitor.
- pasireotide
dasatinib and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.
- pentobarbital
pentobarbital will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- perphenazine
perphenazine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- phenobarbital
phenobarbital will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- phenytoin
phenytoin will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use will lead to decreased dasatinib plasma concentrations. Consider using alternative therapeutic agents with low enzyme induction potential for coadministration with dasatinib. However, if concomitant use with phenytoin is required, consider increasing the dasatinib dose and monitor the patient closely for dasatinib toxicity (myelosuppression, fluid retention, diarrhea, hemorrhage, or skin rash).
- posaconazole
posaconazole will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and posaconazole both increase QTc interval. Use Caution/Monitor. - prednisone
dasatinib will increase the level or effect of prednisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- primidone
primidone will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- prochlorperazine
prochlorperazine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- promazine
promazine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- promethazine
promethazine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- protriptyline
protriptyline and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- quetiapine
dasatinib will increase the level or effect of quetiapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
quetiapine, dasatinib. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT. - quinidine
dasatinib will increase the level or effect of quinidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- quinine
dasatinib and quinine both increase QTc interval. Use Caution/Monitor.
- quinupristin/dalfopristin
quinupristin/dalfopristin will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ranolazine
dasatinib and ranolazine both increase QTc interval. Use Caution/Monitor.
- repaglinide
dasatinib will increase the level or effect of repaglinide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ribociclib
ribociclib will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rifapentine
rifapentine will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rilpivirine
rilpivirine increases toxicity of dasatinib by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes.
- risperidone
dasatinib and risperidone both increase QTc interval. Use Caution/Monitor.
- ritonavir
dasatinib will increase the level or effect of ritonavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- romidepsin
dasatinib will increase the level or effect of romidepsin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and romidepsin both increase QTc interval. Use Caution/Monitor. - rucaparib
rucaparib will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.
- rufinamide
rufinamide will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- saquinavir
dasatinib will increase the level or effect of saquinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- secobarbital
secobarbital will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- selpercatinib
selpercatinib increases toxicity of dasatinib by QTc interval. Use Caution/Monitor.
- siponimod
siponimod and dasatinib both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.
- sodium zirconium cyclosilicate
sodium zirconium cyclosilicate will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate.
- solifenacin
dasatinib will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- sorafenib
sorafenib and dasatinib both increase QTc interval. Use Caution/Monitor.
- stiripentol
stiripentol, dasatinib. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.
- sulfamethoxazole
sulfamethoxazole and dasatinib both increase QTc interval. Use Caution/Monitor.
- sunitinib
dasatinib will increase the level or effect of sunitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tacrolimus
dasatinib will increase the level or effect of tacrolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tadalafil
dasatinib will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tamoxifen
dasatinib, tamoxifen. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inhibition decreases metabolism of tamoxifen to N-desmethyl tamoxifen (active metabolite with similar biologic activity).
- tazemetostat
dasatinib will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tecovirimat
tecovirimat will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.
- telavancin
dasatinib and telavancin both increase QTc interval. Use Caution/Monitor.
- temsirolimus
dasatinib will increase the level or effect of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- theophylline
dasatinib will increase the level or effect of theophylline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- thioridazine
thioridazine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- tinidazole
dasatinib will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tipranavir
dasatinib will increase the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tolterodine
dasatinib will increase the level or effect of tolterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- topiramate
topiramate will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- trastuzumab
trastuzumab, dasatinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .
- trastuzumab deruxtecan
trastuzumab deruxtecan, dasatinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .
- trazodone
dasatinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
trazodone and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely. - triamcinolone acetonide injectable suspension
dasatinib will increase the level or effect of triamcinolone acetonide injectable suspension by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- triazolam
dasatinib will increase the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- trifluoperazine
trifluoperazine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- trimipramine
trimipramine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- tropisetron
dasatinib and tropisetron both increase QTc interval. Use Caution/Monitor.
- vardenafil
dasatinib will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- venlafaxine
dasatinib and venlafaxine both increase QTc interval. Use Caution/Monitor.
- verapamil
dasatinib will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- vilazodone
dasatinib increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dose adjustment needed with mild CYP3A4 inhibitors.
- voclosporin
voclosporin, dasatinib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- voriconazole
voriconazole will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
dasatinib and voriconazole both increase QTc interval. Use Caution/Monitor. - warfarin
dasatinib will increase the level or effect of warfarin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- zafirlukast
zafirlukast will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- zidovudine
dasatinib, zidovudine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of myelosuppression.
- ziprasidone
dasatinib and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.
Minor (50)
- alfentanil
dasatinib will increase the level or effect of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- alfuzosin
dasatinib will increase the level or effect of alfuzosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- alosetron
dasatinib will increase the level or effect of alosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- amlodipine
dasatinib will increase the level or effect of amlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- armodafinil
dasatinib will increase the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- atazanavir
dasatinib will increase the level or effect of atazanavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- azithromycin
azithromycin and dasatinib both increase QTc interval. Minor/Significance Unknown.
- bosentan
dasatinib will increase the level or effect of bosentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- cevimeline
dasatinib will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- clarithromycin
dasatinib will increase the level or effect of clarithromycin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- dapsone
dasatinib will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- disopyramide
dasatinib will increase the level or effect of disopyramide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- docetaxel
dasatinib will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- donepezil
dasatinib will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- dutasteride
dasatinib will increase the level or effect of dutasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- efavirenz
dasatinib will increase the level or effect of efavirenz by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- eplerenone
dasatinib will increase the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- eucalyptus
dasatinib will increase the level or effect of eucalyptus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- finasteride
dasatinib will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- galantamine
dasatinib will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- imatinib
dasatinib will increase the level or effect of imatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- isradipine
dasatinib will increase the level or effect of isradipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ketoconazole
dasatinib will increase the level or effect of ketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- lansoprazole
dasatinib increases levels of lansoprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- montelukast
dasatinib will increase the level or effect of montelukast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- nifedipine
dasatinib will increase the level or effect of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- nimodipine
dasatinib will increase the level or effect of nimodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- nitrendipine
dasatinib will increase the level or effect of nitrendipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- oxybutynin
dasatinib will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- paclitaxel
dasatinib will increase the level or effect of paclitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- paclitaxel protein bound
dasatinib will increase the level or effect of paclitaxel protein bound by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- parecoxib
dasatinib will increase the level or effect of parecoxib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- pazopanib
dasatinib and pazopanib both increase QTc interval. Minor/Significance Unknown.
- pimozide
dasatinib will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- pioglitazone
dasatinib will increase the level or effect of pioglitazone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- propafenone
dasatinib will increase the level or effect of propafenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- quinine
dasatinib will increase the level or effect of quinine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- rabeprazole
dasatinib will increase the level or effect of rabeprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ramelteon
dasatinib will increase the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ruxolitinib
dasatinib will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- saxagliptin
dasatinib will increase the level or effect of saxagliptin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- sufentanil
dasatinib will increase the level or effect of sufentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- vinblastine
dasatinib will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- vincristine
dasatinib will increase the level or effect of vincristine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- vincristine liposomal
dasatinib will increase the level or effect of vincristine liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- vinorelbine
dasatinib will increase the level or effect of vinorelbine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- zaleplon
dasatinib will increase the level or effect of zaleplon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ziprasidone
dasatinib will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- zolpidem
dasatinib will increase the level or effect of zolpidem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- zonisamide
dasatinib will increase the level or effect of zonisamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
Adverse Effects
>10%
Fluid retention, incl CHF, pulm edema, pleural effusion (50%)
Diarrhea (49%)
Headache (40%)
Hemorrhage (40%)
Fatigue (39%)
Pyrexia (39%)
Skin rash (35%)
Infection (34%)
Nausea (34%)
Dyspnea (32%)
Cough (28%)
Pain (26%)
Abdominal pain (25%)
Vomiting (22%)
Anorexia (19%)
Arthralgia (19%)
Asthenia (19%)
Constipation (14%)
Dizziness (14%)
Musculoskeletal pain (14%)
Weight loss (14%)
Chest pain (13%)
Neuropathy (13%)
Myalgia (12%)
Abdominal distention (11%)
Arrhythmia (11%)
Chills (11%)
Pneumonia (11%)
Pruritus (11%)
Weight gain (11%)
1-10% (selected)
Anemia
Febrile neutropenia
Thrombocytopenia
Mucosal inflammation
Postmarketing Reports
Cardiac disorders: Atrial fibrillation/atrial flutter
Vascular disorders: Thrombosis/embolism (including pulmonary embolism, deep vein thrombosis)
Respiratory, thoracic, and mediastinal disorders: Interstitial lung disease, pulmonary arterial hypertension
Dermatologic reactions: Stevens-Johnson syndrome, erythema multiforme
Infections: Hepatitis B virus reactivation
Renal and urinary disorders: Nephrotic syndrome
Blood and lymphatic system disorders: Thrombotic microangiopathy
Warnings
Contraindications
None
Cautions
Use caution in hepatic impairment
Use with caution in patients who have or may develop prolongation of QT interval; may increase risk of prolongation of QTc in patients including those with hypokalemia or hypomagnesemia, patients with congenital long QT syndrome, patients taking antiarrhythmic medicines or other medicinal products that lead to QT prolongation, and cumulative high-dose anthracycline therapy; correct hypokalemia or hypomagnesemia prior to and during therapy
Cardiac adverse reactions were reported in 5.8% of 258 patients including cardiomyopathy (1.6%), congestive heart failure, diastolic dysfunction, fatal myocardial infarction, and left ventricular dysfunction; monitor patients for signs or symptoms and treat appropriately
Tumor lysis syndrome reported; maintain adequate hydration and correct uric acid levels prior to initiating therapy; monitor electrolyte levels; patients with advanced-stage disease and/or high tumor burden may be at increased risk and should be monitored more frequently
Risk of fluid retention and pleural/pericardial effusion; manage with supportive care measures and/or dose modification; evaluate patients who develop symptoms of pleural effusion or other fluid retention, such as new or worsened dyspnea on exertion or at rest, pleuritic chest pain, or dry cough, promptly with a chest x-ray or additional diagnostic imaging as appropriate; fluid retention events were typically managed by supportive care measures that may include diuretics or short courses of steroids; severe pleural effusion may require thoracentesis and oxygen therapy; consider dose reduction or treatment interruption
Embryofetal toxicity reported (see Pregnancy)
In pediatric trials of dasatinib in chronic phase CML after at least 2 years of treatment, adverse reactions associated with bone growth and development were reported, including epiphyses delayed fusion, osteopenia, growth retardation, and gynecomastia; monitor bone growth and development in pediatric patients
Myelosuppression including severe thrombocytopenia, neutropenia and anemia
- May manage by dose interruption, dose reduction, or discontinuation of therapy
- Hematopoietic growth factor has been used with resistant myelosuppression
Patients with chronic phase CML and pediatric Ph+ ALL
- Perform complete blood cell counts (CBCs) every 2 weeks for 12 weeks, then q3Months thereafter, or as clinically indicated
- Perform CBCs weekly for the first 2 months and then monthly thereafter, or as clinically indicated in patients with advanced phase CML or Ph+ ALL
Pediatric patients with Ph+ ALL treated in combination with chemotherapy
- Perform CBCs prior to start of each block of chemotherapy and as clinically indicated
- During consolidation blocks of chemotherapy, perform CBCs every 2 days until recovery
Bleeding
- Can cause serious and fatal bleeding; incidence of Grade 3/4 hemorrhage, most commonly gastrointestinal, reported, requiring treatment interruptions and transfusions
- Most bleeding events associated with severe thrombocytopenia; also shown to cause platelet dysfunction in vitro
- Concomitant medications that inhibit platelet function or anticoagulants may increase risk of hemorrhage
- Severe hemorrhage may require treatment interruption and transfusion
Pulmonary arterial hypertension
- Increased risk of developing pulmonary arterial hypertension (PAH)
- May be reversible upon discontinuation of therapy
- Evaluate patients for signs and symptoms of underlying cardiopulmonary disease prior to initiation and during treatment
- If PAH confirmed permanently discontinue therapy
Severe mucocutaneous dermatologic reactions
- Cases of severe mucocutaneous dermatologic reactions, including Stevens-Johnson syndrome and erythema multiforme, reported
- Discontinue permanently in patients who experience severe mucocutaneous reaction during treatment if no other etiology can be identified
Drug interactions overview
- Avoid concomitant CYP3A4 inducers/inhibitors
- If unavoidable, consider dose modification as appropriate (see Dosage Modifications)
- Coadministration of dasatinib with a gastric acid reducing agent may decrease the concentrations of dasatinib and reduce efficacy (see Dosage Modifications)
Pregnancy & Lactation
Pregnancy
Based on limited human data, dasatinib can cause fetal harm when administered to a pregnant woman; adverse pharmacologic effects (eg, hydrops fetalis, fetal leukopenia, and fetal thrombocytopenia) have been reported with maternal exposure to dasatinib
Animal reproduction studies in rats have demonstrated extensive mortality during organogenesis, the fetal period, and in neonates; skeletal malformations were observed in a limited number of surviving rat and rabbit conceptuses; these findings occurred at dasatinib plasma concentrations below those in humans receiving therapeutic doses of dasatinib
Advise a pregnant woman of the potential risk to a fetus
Transplacental transfer of dasatinib has been reported
Advise females of reproductive potential and males with female partners of reproductive potential to use effective contraception during treatment and for 30 days after last dose
Based on animal data, dasatinib may result in damage to female and male reproductive tissues
Lactation
No data are available regarding the presence of dasatinib in human milk, the effects of the drug on the breastfed child, or the effects of the drug on milk production
However, dasatinib is present in the milk of lactating rats
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Multi-kinase inhibitor that inhibits BCR-ABL, SRC family (SRC, LCK, YES, FYN), c-Kit, EPHA2 and PDGFR-beta kinases; tyrosine kinase inhibition possibly blocks angiogenesis and cellular proliferation
Absorption
Peak plasma time: 0.5-6 hr
Peak plasma concentration: 82.2 ng/mL (100 mg PO qDay)
AUC: 397 ng/mL·hr (100 mg PO qDay)
High-fat meal increased mean AUC of dasatinib following a single dose of 100 mg by 14%
Distribution
Protein Bound: 96% (dasatinib); 93% (active metabolites)
Vd: 2505 L
Metabolism
Metabolism: extensively metabolized primarily by CYP3A4
Enzymes inhibited: CYP3A4 (weak)
Dasatinib is a P-gp substrate
Elimination
Half-Life: 3-5 hr
Clearance: 363.8 l/hr
Excretion: Feces (85%); urine (4%)
Pharmacogenomics
Tyrosine kinase inhibitors (TKIs) inhibit activity of BCR-ABL fusion protein, resulting in both hematologic response (ie, normal cell counts in the peripheral blood and normal bone marrow morphology), as well as cytogenetic response (ie, disappearance or reduction of the Philadelphia [Ph] chromosome)
NCCN clinical practice guidelines recommends TKIs in CML with confirmed BCR-ABL transcripts in bone marrow or evidence of translocation on cytogenetics
Genetic testing laboratories
- The following companies currently offer FISH and/or transcript quantification testing for BCR-ABL
- Asuragen (http://www.asuragen.com/)
- Dako (http://www.dakousa.com/)
- Invitrogen (http://www.invitrogen.com/)
- Ipsogen (http://www.ipsogen.com)
Administration
Oral Administration
Take with or without meals, either in the morning or evening
Swallow tablet whole; do not cut, crush, or chew
Follow special handling and disposal procedures
Personnel who are pregnant should avoid exposure to crushed or broken tablets
Storage
Tablets: Store at room temperature at 20-25°C (68-77°F); excursions permitted between 15-30°C (59-86°F)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Sprycel oral - | 100 mg tablet |  | |
| Sprycel oral - | 50 mg tablet |  | |
| Sprycel oral - | 20 mg tablet |  | |
| Sprycel oral - | 70 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
dasatinib oral
DASATINIB - ORAL
(da-SA-ti-nib)
COMMON BRAND NAME(S): Sprycel
USES: This medication is used to treat certain types of cancer (chronic myeloid leukemia-CML, acute lymphoblastic leukemia-ALL). It works by slowing or stopping the growth of cancer cells.
HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start taking dasatinib and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually once daily. Swallow the tablets whole. Do not crush, chew, or break the tablets.The dosage is based on your medical condition, response to treatment, lab tests, and other medications you may be taking. Children's dosage is also based on weight. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of serious side effects will increase.Avoid taking antacids (such as aluminum/magnesium hydroxide, calcium carbonate) within 2 hours before or after taking this medication because they will prevent your body from fully absorbing this drug.Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.Since this drug can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the tablets.
SIDE EFFECTS: See also Precautions section.Diarrhea, nausea/vomiting, muscle/joint pain, stomach/abdominal pain, and headache may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.People using this medication may have serious side effects. However, you have been prescribed this drug because your doctor has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.Tell your doctor right away if you have any serious side effects, including: dry cough, swelling/pain in the hands/ankles/feet, sudden/unexplained weight gain, shortness of breath.Get medical help right away if you have any very serious side effects, including: vomit that looks like coffee grounds, black/bloody stools, severe dizziness, fainting, fast/slow/irregular heartbeat, chest pain, confusion, weakness on one side of the body.Dasatinib sometimes causes side effects due to the rapid destruction of cancer cells (tumor lysis syndrome). To lower your risk, your doctor may add a medication and tell you to drink plenty of fluids. Tell your doctor right away if you have symptoms such as: low back/side pain (flank pain), signs of kidney problems (such as painful urination, pink/bloody urine, change in the amount of urine), muscle spasms/weakness.This medication decreases bone marrow function, an effect that may lead to a low number of blood cells such as red cells, white cells, and platelets. This effect can cause anemia, decrease your body's ability to fight an infection, or cause easy bruising/bleeding. Tell your doctor right away if you develop any of the following symptoms: unusual tiredness, pale skin, signs of infection (such as sore throat that doesn't go away, fever, chills), easy bruising/bleeding.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking dasatinib, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as lactose), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems, current/recent infection, heart problems (such as irregular heartbeat), liver problems (such as hepatitis B).Dasatinib may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using dasatinib, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using dasatinib safely.Dasatinib can make you more likely to get infections or may worsen any current infections. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.This medication may affect a child's bone growth and development. Consult the doctor or pharmacist for more details.Older adults may be more sensitive to the side effects of this drug, especially diarrhea, swelling hands/ankles/feet, sudden/unexplained weight gain, unusual tiredness, shortness of breath, and QT prolongation (see above).Since this drug can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the tablets.Tell your doctor if you are pregnant or plan to become pregnant. Your doctor may order a pregnancy test before starting this medication. You should not become pregnant while using dasatinib. Dasatinib may harm an unborn baby. Women of childbearing age should ask about reliable forms of birth control while using this medication and for 30 days after the last dose. Men with female partners of childbearing age should use reliable forms of birth control while using this medication and for 30 days after the last dose. If you or your partner becomes pregnant, talk to your doctor right away about the risks and benefits of this medication.It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug and for 2 weeks after stopping treatment is not recommended. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: See also How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, "blood thinners" such as warfarin/dabigatran), drugs that reduce stomach acid (for example, antacids, H2 blockers such as famotidine/ranitidine, proton pump inhibitors such as omeprazole).Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.Other medications can affect the removal of dasatinib from your body, which may affect how dasatinib works. Examples include azole antifungals (such as itraconazole, ketoconazole), dexamethasone, macrolide antibiotics (such as clarithromycin), rifamycins (such as rifampin, rifabutin), saquinavir, St. John's wort, telithromycin, among others.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as bone growth and development in children, complete blood count) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
