Drug interactions
Apalutamide + Cabozantinib
Severity: Major
Apalutamide and Cabozantinib: major 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, a strong CYP3A4 inducer, can lower cabozantinib exposure and may reduce antitumor efficacy. Cabozantinib labeling advises avoiding chronic use of strong CYP3A4 inducers.
What this interaction means in plain words
Apalutamide and Cabozantinib 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; Cabozantinib belongs to Oncology.
Why it happens
Induction of CYP3A4 increases the metabolic clearance of cabozantinib.
What to do
Avoid the combination where possible. If coadministration is necessary, consider increasing the cabozantinib dose per labeling and monitor for toxicity, reducing the dose again after apalutamide is stopped.
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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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 Cabozantinib
Frequently asked questions
Can I take Apalutamide with Cabozantinib?
MediHelp rates the interaction as major. Apalutamide and Cabozantinib 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, a strong CYP3A4 inducer, can lower cabozantinib exposure and may reduce antitumor efficacy. Cabozantinib labeling advises avoiding chronic use of strong CYP3A4 inducers.
How serious is the interaction between Apalutamide and Cabozantinib?
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 where possible. If coadministration is necessary, consider increasing the cabozantinib dose per labeling and monitor for toxicity, reducing the dose again after apalutamide is stopped.
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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