What drugs may Dasatinib interact with?

Dasatinib (Dasatinib) is a second-generation BCR-ABL tyrosine kinase inhibitor. Its metabolism mainly depends on the cytochrome P450 enzyme system of the liver, especially the CYP3A4 enzyme. This means that any drug that affects CYP3A4 activity may alter the plasma concentration of dasatinib, thereby affecting efficacy or safety. The most common clinical drug interactions include CYP3A4 inhibitors and inducers. CYP3A4 inhibitors, such as ketoconazole, itraconazole, clarithromycin, and certain antiviral drugs, may significantly increase the plasma concentration of dasatinib and increase the risk of adverse reactions, such as myelosuppression or cardiotoxicity.

In addition, the absorption of dasatinib is significantly affected by the acid environment of the stomach. The use of drugs that reduce gastric acid, such as proton pump inhibitors (PPI, such as omeprazole), H2 receptor antagonists (such as ranitidine), or antacids, may inhibit the solubility of dasatinib in the stomach, thereby reducing its oral bioavailability. Therefore, when these drugs are used together, it is usually recommended to adjust the administration time or change the gastric drug regimen to minimize interference. The concomitant use of some calcium channel blockers with dasatinib may also increase the risk of QT prolongation, especially in patients at risk for arrhythmias, and their use should be carefully weighed.

It is worth noting that certain drugs, such as the anticoagulant warfarin or new oral anticoagulants, require close monitoring of bleeding risks when combined with dasatinib, because dasatinib itself may inhibit platelet function, and combined anticoagulation may increase the possibility of severe bleeding. In addition, when combined with immunosuppressants such as cyclosporine or tacrolimus, complex interactions may occur through the CYP3A4 pathway, which requires careful evaluation and dose adjustment. In clinical practice, patients' drug use history should be fully assessed, possible interaction risks should be identified, and drug efficacy and adverse reactions should be monitored regularly to ensure the safety and effectiveness of dasatinib treatment.

Reference materials:https://go.drugbank.com/drugs/DB01254