Drug interactions
Apalutamide + Buprenorphine
Severity: Major
Apalutamide and Buprenorphine: 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
Apalutamide is a strong CYP3A4 inducer and can lower buprenorphine concentrations. This may lead to reduced analgesia or opioid withdrawal symptoms in dependent patients.
What this interaction means in plain words
Apalutamide and Buprenorphine 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; Buprenorphine belongs to Musculoskeletal.
Why it happens
Induction of CYP3A4-mediated buprenorphine metabolism, lowering systemic exposure.
What to do
Monitor for loss of analgesic effect or withdrawal and increase the buprenorphine dose if needed. Re-evaluate the dose when apalutamide is stopped because induction wanes and exposure rises.
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 Buprenorphine
- Alvimopan + Buprenorphine Contraindicated
- Buprenorphine + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Buprenorphine + Olanzapine / samidorphan Contraindicated
- Buprenorphine + Phenelzine Contraindicated
- Buprenorphine + Pimozide Contraindicated
- Buprenorphine + Thioridazine Contraindicated
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 Buprenorphine?
MediHelp rates the interaction as major. Apalutamide and Buprenorphine 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 is a strong CYP3A4 inducer and can lower buprenorphine concentrations. This may lead to reduced analgesia or opioid withdrawal symptoms in dependent patients.
How serious is the interaction between Apalutamide and Buprenorphine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of analgesic effect or withdrawal and increase the buprenorphine dose if needed. Re-evaluate the dose when apalutamide is stopped because induction wanes and exposure rises.
What other medicines interact with Buprenorphine?
MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan. The full list is on the Buprenorphine page.
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