Drug interactions
Apalutamide + Artemether / lumefantrine
Severity: Major
Apalutamide and Artemether / lumefantrine: 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
Both artemether and lumefantrine are metabolized by CYP3A4, and apalutamide strongly induces this enzyme. Lower antimalarial exposure risks treatment failure and recrudescence.
What this interaction means in plain words
Apalutamide and Artemether / lumefantrine 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
Apalutamide induces CYP3A4, accelerating metabolism of artemether and lumefantrine.
What to do
Avoid the combination and choose another antimalarial if possible. If it cannot be avoided, monitor closely for treatment failure.
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 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 Artemether / lumefantrine?
MediHelp rates the interaction as major. Apalutamide and Artemether / lumefantrine 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. Both artemether and lumefantrine are metabolized by CYP3A4, and apalutamide strongly induces this enzyme. Lower antimalarial exposure risks treatment failure and recrudescence.
How serious is the interaction between Apalutamide and Artemether / lumefantrine?
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 the combination and choose another antimalarial if possible. If it cannot be avoided, monitor closely for treatment failure.
What other medicines interact with Apalutamide?
MediHelp also lists interactions of Apalutamide with, for example, Cabotegravir, Cobicistat, Doravirine. The full list is on the Apalutamide page.
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