Drug interactions
Dasatinib + St john's wort
Severity: Major
Dasatinib and St john's wort: major interaction.
Last updated Sources: US FDA label
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
St John's wort induces CYP3A4 and can lower dasatinib concentrations, risking reduced efficacy and loss of disease control.
What this interaction means in plain words
Dasatinib and St john's wort 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.
Why it happens
Induction of CYP3A4 (and possibly P-glycoprotein) by hyperforin, increasing dasatinib clearance.
What to do
Avoid St John's wort in patients on dasatinib and use an alternative for mood symptoms. If it was taken, monitor response closely and expect enzyme induction to persist for about two weeks after stopping.
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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References
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 St john's wort?
MediHelp rates the interaction as major. Dasatinib and St john's wort 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. St John's wort induces CYP3A4 and can lower dasatinib concentrations, risking reduced efficacy and loss of disease control.
How serious is the interaction between Dasatinib and St john's wort?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid St John's wort in patients on dasatinib and use an alternative for mood symptoms. If it was taken, monitor response closely and expect enzyme induction to persist for about two weeks after stopping.
What other medicines interact with Dasatinib?
MediHelp also lists interactions of Dasatinib with, for example, Saquinavir, Thioridazine, Adagrasib. The full list is on the Dasatinib page.
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