Drug interactions
Apalutamide + Busulfan
Severity: Moderate
Apalutamide and Busulfan: 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 may reduce busulfan exposure through CYP3A4 induction, which could compromise conditioning efficacy. Busulfan exposure is tightly linked to outcome and toxicity.
What this interaction means in plain words
Apalutamide and Busulfan 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; Busulfan belongs to Oncology.
Why it happens
CYP3A4 induction (with possible GST effects) increases busulfan clearance.
What to do
Avoid apalutamide around busulfan conditioning when possible, and use busulfan therapeutic drug monitoring if coadministration occurs.
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 Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
Other interactions of Busulfan
- Busulfan + Carboplatin Major
- Busulfan + Chlorambucil Major
- Busulfan + Cyclophosphamide Major
- Busulfan + Fingolimod Major
- Busulfan + Hydroxycarbamide Major
- Busulfan + Ifosfamide Major
Frequently asked questions
Can I take Apalutamide with Busulfan?
MediHelp rates the interaction as moderate. Apalutamide and Busulfan 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 may reduce busulfan exposure through CYP3A4 induction, which could compromise conditioning efficacy. Busulfan exposure is tightly linked to outcome and toxicity.
How serious is the interaction between Apalutamide and Busulfan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid apalutamide around busulfan conditioning when possible, and use busulfan therapeutic drug monitoring if coadministration occurs.
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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