dasatinib + rabeprazole

Dasatinib + rabeprazole is not a fixed-dose combination drug but refers to the coadministration of dasatinib, an oral small molecule tyrosine kinase inhibitor used primarily for Philadelphia chromosome-positive leukemias (chronic myeloid leukemia and acute lymphoblastic leukemia), and rabeprazole, a proton pump inhibitor (PPI) used to reduce gastric acid. Dasatinib’s absorption is highly pH-dependent; concomitant use with PPIs like rabeprazole significantly reduces its bioavailability by increasing gastric pH. Studies show that coadministration of rabeprazole can decrease dasatinib Cmax and AUC by over 90%, potentially compromising therapeutic efficacy[1][3][5]. This interaction is clinically significant and generally contraindicated unless no alternatives exist.