Drug interactions
Apalutamide + Dexamethasone
Severity: Major
Apalutamide and Dexamethasone: 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 can substantially reduce dexamethasone exposure. This may cause loss of the intended anti-inflammatory, antiemetic or replacement effect.
What this interaction means in plain words
Apalutamide and Dexamethasone 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; Dexamethasone belongs to Endocrine.
Why it happens
Apalutamide induces CYP3A4, increasing dexamethasone metabolism and lowering plasma concentrations.
What to do
Where possible choose an alternative to dexamethasone; if needed, assess for loss of effect and increase the dexamethasone dose based on clinical 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 Dexamethasone
- Bcg vaccine live + Dexamethasone Contraindicated
- Dexamethasone + Mifepristone Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexamethasone + Smallpox vaccine live Contraindicated
- Dexamethasone + Varicella virus vaccine live Contraindicated
- Dexamethasone + Yellow fever vaccine 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 Dexamethasone?
MediHelp rates the interaction as major. Apalutamide and Dexamethasone 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 can substantially reduce dexamethasone exposure. This may cause loss of the intended anti-inflammatory, antiemetic or replacement effect.
How serious is the interaction between Apalutamide and Dexamethasone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Where possible choose an alternative to dexamethasone; if needed, assess for loss of effect and increase the dexamethasone dose based on clinical response.
What other medicines interact with Dexamethasone?
MediHelp also lists interactions of Dexamethasone with, for example, Bcg vaccine live, Mifepristone, Rilpivirine. The full list is on the Dexamethasone page.
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