Drug interactions
Apalutamide + Aprepitant
Severity: Moderate
Apalutamide and Aprepitant: moderate 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
Apalutamide is a strong CYP3A4 inducer and can substantially lower aprepitant concentrations. This may reduce antiemetic efficacy and lead to breakthrough nausea and vomiting.
What this interaction means in plain words
Apalutamide and Aprepitant can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Apalutamide belongs to Endocrine; Aprepitant belongs to Gastrointestinal Tract.
Why it happens
Induction of CYP3A4 by apalutamide increases aprepitant metabolism.
What to do
Monitor for loss of antiemetic control and add or optimize other antiemetics such as a 5-HT3 antagonist and dexamethasone. Note that aprepitant itself may alter the exposure of other CYP3A4 substrates.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Other interactions of Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
Frequently asked questions
Can I take Apalutamide with Aprepitant?
MediHelp rates the interaction as moderate. Apalutamide and Aprepitant can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Apalutamide is a strong CYP3A4 inducer and can substantially lower aprepitant concentrations. This may reduce antiemetic efficacy and lead to breakthrough nausea and vomiting.
How serious is the interaction between Apalutamide and Aprepitant?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of antiemetic control and add or optimize other antiemetics such as a 5-HT3 antagonist and dexamethasone. Note that aprepitant itself may alter the exposure of other CYP3A4 substrates.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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