Drug interactions
Apalutamide + Carbamazepine
Severity: Major
Apalutamide and Carbamazepine: 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 is a strong CYP3A4 inducer and may reduce carbamazepine concentrations, risking loss of seizure control. Carbamazepine, also an inducer, may reduce apalutamide exposure as well.
What this interaction means in plain words
Apalutamide and Carbamazepine 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; Carbamazepine belongs to Central Nervous System.
Why it happens
Apalutamide induces CYP3A4 (and other enzymes), and carbamazepine induces CYP3A4, which lowers exposure to both drugs.
What to do
Avoid the combination where possible. If used together, monitor carbamazepine concentrations and seizure control, and watch for reduced prostate cancer response.
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 Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir 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 Carbamazepine?
MediHelp rates the interaction as major. Apalutamide and Carbamazepine 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 may reduce carbamazepine concentrations, risking loss of seizure control. Carbamazepine, also an inducer, may reduce apalutamide exposure as well.
How serious is the interaction between Apalutamide and Carbamazepine?
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 used together, monitor carbamazepine concentrations and seizure control, and watch for reduced prostate cancer response.
What other medicines interact with Carbamazepine?
MediHelp also lists interactions of Carbamazepine with, for example, Artemether / lumefantrine, Cabotegravir, Delamanid. The full list is on the Carbamazepine page.
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