Drug interactions
Apalutamide + Cyclophosphamide
Severity: Moderate
Apalutamide and Cyclophosphamide: 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 is a strong inducer of CYP3A4 and CYP2B6 and can alter cyclophosphamide activation. Induction may speed formation of the active alkylating metabolites, shifting efficacy and toxicity unpredictably, so the effect is not simply lower exposure.
What this interaction means in plain words
Apalutamide and Cyclophosphamide 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; Cyclophosphamide belongs to Oncology.
Why it happens
Induction of CYP3A4 and CYP2B6 by apalutamide changes the hepatic activation and clearance of cyclophosphamide.
What to do
Monitor for altered response and toxicity, particularly myelosuppression, and consider an alternative to apalutamide if feasible.
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 Cyclophosphamide
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 Cyclophosphamide?
MediHelp rates the interaction as moderate. Apalutamide and Cyclophosphamide 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 is a strong inducer of CYP3A4 and CYP2B6 and can alter cyclophosphamide activation. Induction may speed formation of the active alkylating metabolites, shifting efficacy and toxicity unpredictably, so the effect is not simply lower exposure.
How serious is the interaction between Apalutamide and Cyclophosphamide?
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 for altered response and toxicity, particularly myelosuppression, and consider an alternative to apalutamide if feasible.
What other medicines interact with Cyclophosphamide?
MediHelp also lists interactions of Cyclophosphamide with, for example, Adenovirus types 4 and 7 live, Belatacept, Bendamustine. The full list is on the Cyclophosphamide page.
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