Drug Interaction Report

Dasatinib and Clarithromycin: Interaction Details

A pharmacist-reviewed analysis of the Dasatinib and Clarithromycin interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Clarithromycin

Biaxin
+

Dasatinib

Phyrago Sprycel Sprycel®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 342 documented Dasatinib interactions, 297 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Increased dasatinib exposure and an increased risk of QT interval prolongation

Interaction Deep Dive

Avoid concomitant use of dasatinib, a CYP3A4 substrate, with strong CYP3A4 inhibitors due to the potential for increased dasatinib exposure. When administered with ketoconazole (a strong CYP3A4 inhibitor), dasatinib Cmax and AUC increased 4-fold and 5-fold, respectively. However, if a strong CYP3A4 inhibitor must be administered with dasatinib, then consider reducing the dasatinib dose from 70 mg/day or 100 mg/day to 20 mg daily or from 140 mg/day to 40 mg daily. For patients on dasatinib 40 mg or 60 mg daily, stop dasatinib until the CYP3A4 inhibitor is discontinued. If dasatinib is not tolerated following a dose reduction, then either discontinue the CYP3A4 inhibitor or discontinue dasatinib until treatment with the CYP3A4 inhibitor is stopped. Once therapy with the CYP3A4 inhibitor is discontinued, allow a washout period of approximately 1 week before reinitiating dasatinib or increasing the dasatinib dose to the indicated dose. Concomitant use may also increase the risk of QT prolongation. Correct hypomagnesemia or hypokalemia before and during dasatinib therapy21.

Why it happens (mechanism)

Inhibition of CYP3A4-mediated dasatinib metabolism; additive QT interval prolongation

Literature reports

1 report — tap to read

a) Following coadministration with a single dose of dasatinib 20 mg and ketoconazole (a strong CYP3A4 inhibitor) twice daily, the mean Cmax of dasatinib increased 4-fold and the mean AUC increased 5-fold 21.

Common questions

Can I take Dasatinib and Clarithromycin together?

Increased dasatinib exposure and an increased risk of QT interval prolongation Always confirm with your pharmacist or prescriber before making any change.

How serious is the Dasatinib and Clarithromycin interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Dasatinib or Clarithromycin need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (2)

  1. Product Information: PHYRAGO oral tablets, dasatinib oral tablets. Nanocopoeia, LLC (per FDA), New Brighton, MN, 2023. DailyMed
  2. Product Information: SPRYCEL(R) oral tablets, dasatinib oral tablets. Bristol-Myers Squibb Company (per FDA), Princeton, NJ, 2023. DailyMed
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Clarithromycin

Keep reading about Clarithromycin

All Clarithromycin interactions (197)
Also serious with: Ivabradine Lovastatin Lurasidone Colchicine
Dasatinib

Keep reading about Dasatinib

All Dasatinib interactions (342) Dasatinib drug information
Also serious with: Bacillus Of Calmette And Guerin Vaccine, Live Sparfloxacin Thioridazine Terfenadine
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Clarithromycin + Activated Charcoal American Hellebore Arsenic Cesium Ephedra Grapefruit Oleander Sida Cordifolia + 188 more
Dasatinib + Activated Charcoal American Hellebore Arsenic Cesium Ephedra Grapefruit Sida Cordifolia St. John's Wort + 138 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.