Drug interactions
Apalutamide + Atazanavir
Severity: Major
Apalutamide and Atazanavir: 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
Atazanavir is a CYP3A4 substrate, and apalutamide is a strong inducer. Atazanavir concentrations may fall below effective levels, risking virologic failure and resistance.
What this interaction means in plain words
Apalutamide and Atazanavir 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.
Apalutamide belongs to Endocrine; Atazanavir belongs to Anti Virals.
Why it happens
Apalutamide induces CYP3A4 (and possibly UGT), lowering atazanavir exposure.
What to do
Avoid the combination and select an alternative antiretroviral or antiandrogen. If unavoidable, monitor HIV viral load closely with specialist input.
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
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Apalutamide with Atazanavir?
MediHelp rates the interaction as major. Apalutamide and Atazanavir 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. Atazanavir is a CYP3A4 substrate, and apalutamide is a strong inducer. Atazanavir concentrations may fall below effective levels, risking virologic failure and resistance.
How serious is the interaction between Apalutamide and Atazanavir?
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 select an alternative antiretroviral or antiandrogen. If unavoidable, monitor HIV viral load closely with specialist input.
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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