Drug interactions
Apalutamide + Darunavir
Severity: Major
Apalutamide and Darunavir: major interaction.
Last updated Sources: US FDA label
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 reduce darunavir concentrations, risking virologic failure and resistance. The effect is magnified because darunavir is dependent on CYP3A4 and boosting.
What this interaction means in plain words
Apalutamide and Darunavir 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; Darunavir belongs to Anti Virals.
Why it happens
Induction of CYP3A4 increases darunavir clearance.
What to do
Avoid the combination and choose an alternative antiandrogen. If unavoidable, involve an HIV specialist and monitor viral load.
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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References
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 Darunavir
- Alfuzosin + Darunavir Contraindicated
- Avanafil + Darunavir Contraindicated
- Darunavir + Dronedarone Contraindicated
- Darunavir + Eletriptan Contraindicated
- Darunavir + Ergotamine Contraindicated
- Darunavir + Flibanserin Contraindicated
Frequently asked questions
Can I take Apalutamide with Darunavir?
MediHelp rates the interaction as major. Apalutamide and Darunavir 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 may markedly reduce darunavir concentrations, risking virologic failure and resistance. The effect is magnified because darunavir is dependent on CYP3A4 and boosting.
How serious is the interaction between Apalutamide and Darunavir?
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 and choose an alternative antiandrogen. If unavoidable, involve an HIV specialist and monitor viral load.
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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