Drug interactions
Dasatinib + Ketoconazole
Severity: Major
Dasatinib and Ketoconazole: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ketoconazole increases dasatinib exposure, raising the risk of myelosuppression, fluid retention including pleural effusion, bleeding and QT prolongation.
What this interaction means in plain words
Dasatinib and Ketoconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Dasatinib belongs to Oncology; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4, the main metabolic pathway of dasatinib.
What to do
Use an alternative antifungal with no or weak CYP3A4 inhibition if possible. If needed, reduce the dasatinib dose per labeling and monitor blood counts and QTc.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Other interactions of Dasatinib
- Dasatinib + Saquinavir Contraindicated
- Dasatinib + Thioridazine Contraindicated
- Adagrasib + Dasatinib Major
- Amiodarone + Dasatinib Major
- Amisulpride + Dasatinib Major
- Amitriptyline + Dasatinib Major
Frequently asked questions
Can I take Dasatinib with Ketoconazole?
MediHelp rates the interaction as major. Dasatinib and Ketoconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ketoconazole increases dasatinib exposure, raising the risk of myelosuppression, fluid retention including pleural effusion, bleeding and QT prolongation.
How serious is the interaction between Dasatinib and Ketoconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use an alternative antifungal with no or weak CYP3A4 inhibition if possible. If needed, reduce the dasatinib dose per labeling and monitor blood counts and QTc.
What other medicines interact with Ketoconazole?
MediHelp also lists interactions of Ketoconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Ketoconazole page.
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