Drug interactions
Apalutamide + Clomipramine
Severity: Moderate
Apalutamide and Clomipramine: 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 induces several metabolizing enzymes including CYP2C19 and CYP3A4, which can reduce clomipramine exposure. This may lead to loss of antidepressant or anti-obsessional effect, although the active metabolite desmethylclomipramine may be less affected.
What this interaction means in plain words
Apalutamide and Clomipramine 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; Clomipramine belongs to Central Nervous System.
Why it happens
Enzyme induction (CYP2C19 and CYP3A4) by apalutamide increases clomipramine clearance.
What to do
Monitor clinical response and consider tricyclic plasma levels, increasing the clomipramine dose if needed. Reassess the dose when apalutamide is stopped.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Apalutamide and Clomipramine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Methylene blue Contraindicated
- Clomipramine + Pentamidine 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 Clomipramine?
MediHelp rates the interaction as moderate. Apalutamide and Clomipramine 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 induces several metabolizing enzymes including CYP2C19 and CYP3A4, which can reduce clomipramine exposure. This may lead to loss of antidepressant or anti-obsessional effect, although the active metabolite desmethylclomipramine may be less affected.
How serious is the interaction between Apalutamide and Clomipramine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response and consider tricyclic plasma levels, increasing the clomipramine dose if needed. Reassess the dose when apalutamide is stopped.
What other medicines interact with Clomipramine?
MediHelp also lists interactions of Clomipramine with, for example, Arsenic trioxide, Dofetilide, Droperidol. The full list is on the Clomipramine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
