Drug interactions
Apalutamide + Ergotamine
Severity: Moderate
Apalutamide and Ergotamine: 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 strongly induces CYP3A4 and can reduce ergotamine concentrations, with loss of anti-migraine effect. Reduced exposure is unlikely to cause toxicity, but ergotamine effect may become unpredictable.
What this interaction means in plain words
Apalutamide and Ergotamine 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; Ergotamine belongs to Central Nervous System.
Why it happens
Apalutamide induction of CYP3A4 increases ergotamine metabolism.
What to do
Monitor for loss of efficacy and consider an alternative migraine therapy that does not rely on CYP3A4. Avoid dose escalation of ergotamine beyond labeled limits.
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 Ergotamine
- Almotriptan + Ergotamine Contraindicated
- Atazanavir + Ergotamine Contraindicated
- Clarithromycin + Ergotamine Contraindicated
- Cobicistat + Ergotamine Contraindicated
- Darunavir + Ergotamine Contraindicated
- Dihydroergotamine intranasal + Ergotamine 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 Ergotamine?
MediHelp rates the interaction as moderate. Apalutamide and Ergotamine 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 strongly induces CYP3A4 and can reduce ergotamine concentrations, with loss of anti-migraine effect. Reduced exposure is unlikely to cause toxicity, but ergotamine effect may become unpredictable.
How serious is the interaction between Apalutamide and Ergotamine?
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 loss of efficacy and consider an alternative migraine therapy that does not rely on CYP3A4. Avoid dose escalation of ergotamine beyond labeled limits.
What other medicines interact with Ergotamine?
MediHelp also lists interactions of Ergotamine with, for example, Almotriptan, Atazanavir, Clarithromycin. The full list is on the Ergotamine page.
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