Drug interactions
Apalutamide + Cobicistat
Severity: Contraindicated
Apalutamide and Cobicistat: contraindicated 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 markedly lower cobicistat levels, reducing its pharmacokinetic boosting of coadministered antiretrovirals. This risks subtherapeutic antiviral concentrations, virologic failure and resistance.
What this interaction means in plain words
Apalutamide and Cobicistat are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Apalutamide belongs to Endocrine; Cobicistat belongs to Miscellaneous.
Why it happens
Induction of CYP3A4 increases cobicistat clearance.
What to do
Avoid the combination and use a non-boosted antiretroviral regimen or an alternative antiandrogen. Seek HIV specialist advice if coadministration is considered.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
- Apalutamide + Isavuconazonium Contraindicated
Other interactions of Cobicistat
- Alfuzosin + Cobicistat Contraindicated
- Cobicistat + Colchicine Contraindicated
- Cobicistat + Dronedarone Contraindicated
- Cobicistat + Eletriptan Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Cobicistat + Ergotamine Contraindicated
Frequently asked questions
Can I take Apalutamide with Cobicistat?
MediHelp rates the interaction as contraindicated. Apalutamide and Cobicistat are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Apalutamide may markedly lower cobicistat levels, reducing its pharmacokinetic boosting of coadministered antiretrovirals. This risks subtherapeutic antiviral concentrations, virologic failure and resistance.
How serious is the interaction between Apalutamide and Cobicistat?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use a non-boosted antiretroviral regimen or an alternative antiandrogen. Seek HIV specialist advice if coadministration is considered.
What other medicines interact with Apalutamide?
MediHelp also lists interactions of Apalutamide with, for example, Cabotegravir, Doravirine, Elbasvir / grazoprevir. The full list is on the Apalutamide page.
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