Drug interactions
Apalutamide + Enzalutamide
Severity: Major
Apalutamide and Enzalutamide: 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
Both are strong CYP3A4 inducers and can lower each other's exposure, and they have the same antiandrogen action. The combination adds toxicity such as seizure risk without added benefit.
What this interaction means in plain words
Apalutamide and Enzalutamide 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; Enzalutamide belongs to Endocrine.
Why it happens
Mutual CYP3A4 induction increases clearance of each drug, with duplicate androgen receptor blockade.
What to do
Avoid using the two together and select a single androgen receptor inhibitor.
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 Enzalutamide
- Doravirine + Enzalutamide Contraindicated
- Elbasvir / grazoprevir + Enzalutamide Contraindicated
- Ensitrelvir + Enzalutamide Contraindicated
- Enzalutamide + Fostemsavir Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
- Enzalutamide + Lenacapavir 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 Enzalutamide?
MediHelp rates the interaction as major. Apalutamide and Enzalutamide 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. Both are strong CYP3A4 inducers and can lower each other's exposure, and they have the same antiandrogen action. The combination adds toxicity such as seizure risk without added benefit.
How serious is the interaction between Apalutamide and Enzalutamide?
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 using the two together and select a single androgen receptor inhibitor.
What other medicines interact with Enzalutamide?
MediHelp also lists interactions of Enzalutamide with, for example, Doravirine, Elbasvir / grazoprevir, Ensitrelvir. The full list is on the Enzalutamide page.
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