Milsaperidone and Dacomitinib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Dacomitinib
Milsaperidone
No brand names on record
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.
What happens
Increased milsaperidone exposure and an increased risk of milsaperidone-related adverse reactions
Interaction Deep Dive
Concomitant use of milsaperidone with strong CYP2D6 inhibitors may increase milsaperidone exposure, which could increase the risk of milsaperidone-related adverse reactions. Concomitant use (strong CYP2D6 inhibitor, stable dosage) in schizophrenia: Start milsaperidone 1 mg twice daily; titration, increase to 2 mg twice daily on day 2, 4 mg twice daily on day 3, and 6 mg twice daily on day 4 to reach maintenance dosage of 3 to 6 mg twice daily (starting on day 3, may alternatively continue 3 mg twice daily and titrate subsequent doses based on tolerability and response). Concomitant use (strong CYP2D6 inhibitor, stable dosage) in bipolar I disorder, manic or mixed episodes: Start milsaperidone 1 mg twice daily; titration, increase to 3 mg twice daily on day 2, and to maintenance dosage of 6 mg twice daily on day 3. Concomitant use (strong CYP2D6 inhibitor, initiation): Reduce milsaperidone maintenance dosage by one-half; follow titration schedule to return to original dosage once the CYP2D6 inhibitor is discontinued. Patients with schizophrenia may either follow the recommended titration schedule, or starting on day 5, continue 6 mg twice daily milsaperidone dosing. As needed, titrate subsequent doses based on tolerability and response within the recommended maintenance dosing range of 6 to 12 mg twice daily1.
Why it happens (mechanism)
Inhibition of CYP2D6-mediated metabolism of milsaperidone
Literature reports
1 report — tap to read
a) Concomitant administration of FLUoxetine (a strong CYP2D6 inhibitor) (20 mg twice daily for 21 days) with a single 3 mg dose of iloperidone in CYP2D6 normal metabolizers, increased the AUC of iloperidone and milsaperidone by approximately 2- to 3-fold and decreased the AUC of P95 by one-half. Concomitant administration of a single 3 mg iloperidone dose had no effect on the steady-state pharmacokinetics of FLUoxetine. And, concomitant administration of PARoxetine (a strong CYP2D6 inhibitor) (20 mg/day for 5-8 days) with multiple doses of iloperidone (8 or 12 mg twice daily) to patients with schizophrenia resulted in increased mean steady-state peak concentrations of iloperidone and milsaperidone, by about 1.6-fold, and decreased mean steady-state peak concentrations of P95 by one-half 1.
Common questions
Can I take Milsaperidone and Dacomitinib together?
Increased milsaperidone exposure and an increased risk of milsaperidone-related adverse reactions Always confirm with your pharmacist or prescriber before making any change.
How serious is the Milsaperidone and Dacomitinib 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.
Questions for your pharmacist
- Does my dose of Milsaperidone or Dacomitinib 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 (1)
- Product Information: BYSANTI™ oral tablets, milsaperidone oral tablets. Vanda Pharmaceuticals Inc. (Per Manufacturer), Washington, D.C. 2026. DailyMed
Keep reading about Dacomitinib
Keep reading about Milsaperidone
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