Which fruits should not be eaten with Dasatinib/Startaxed?

Dasatinib (Dasatinib) is a tyrosine kinase inhibitor, and its metabolism is mainly completed through the CYP3A4 enzyme system of the liver. CYP3A4 is one of the most important metabolic enzymes in the liver and is involved in the metabolism of many drugs. Because of this, the metabolism of dasatinib is affected by certain foods and drugs, especially when taken with certain fruits, which may interfere with its pharmacokinetics and affect the efficacy and safety of the drug.

Of these, grapefruit (Grapefruit) is the fruit most important to avoid when taking dasatinib. Certain chemical components in grapefruit (such as furanocoumarins) can inhibit the activity of CYP3A4 enzyme, leading to a decrease in the liver's ability to metabolize dasatinib. Specifically, grapefruit significantly reduces the activity of CYP3A4, thereby increasing the concentration of dasatinib in the blood. This may lead to excessively high serum levels of dasatinib, thereby increasing the risk of side effects of the drug, such as abnormal liver function, adverse cardiac reactions, etc. Therefore, grapefruit and its products should be avoided when used together with dasatinib, including fresh grapefruit, grapefruit juice, etc.

In addition to grapefruit, some high-fat foods may also affect the absorption of dasatinib. For example, a high-fat diet may increase the AUC (area under the plasma concentration-time curve) of dasatinib by approximately 14%. This means that if a patient eats a large amount of high-fat food after taking dasatinib, the rate of absorption and bioavailability of the drug may change, potentially affecting the drug's effectiveness. In this case, although the effect is small, in order to maintain the best effect of the drug, patients should try to avoid excessive intake of high-fat foods.

Although certain foods may affect the absorption or metabolism of dasatinib, the drug's label does not specifically require patients to avoid food. In fact, dasatinib can be taken with or without food. There is no significant difference in the absorption of the drug whether taken before or after meals.

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