Drug interactions
Apalutamide + Ethinyl estradiol-drospirenone
Severity: Major
Apalutamide and Ethinyl estradiol-drospirenone: 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 is a strong CYP3A4 inducer and can markedly lower contraceptive hormone concentrations, risking contraceptive failure. Apalutamide is used in men, but female partners may use hormonal contraception.
What this interaction means in plain words
Apalutamide and Ethinyl estradiol-drospirenone 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; Ethinyl estradiol-drospirenone belongs to Endocrine.
Why it happens
Induction of CYP3A4 (and other enzymes) by apalutamide increases metabolism of ethinyl estradiol and progestin.
What to do
Use a non-hormonal contraceptive method or another reliable alternative for the duration of therapy. Do not rely solely on hormonal contraception.
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 Ethinyl estradiol-drospirenone
- Ethinyl estradiol-drospirenone + Fezolinetant Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-drospirenone + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-drospirenone Major
- Amobarbital + Ethinyl estradiol-drospirenone Major
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 Ethinyl estradiol-drospirenone?
MediHelp rates the interaction as major. Apalutamide and Ethinyl estradiol-drospirenone 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 markedly lower contraceptive hormone concentrations, risking contraceptive failure. Apalutamide is used in men, but female partners may use hormonal contraception.
How serious is the interaction between Apalutamide and Ethinyl estradiol-drospirenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a non-hormonal contraceptive method or another reliable alternative for the duration of therapy. Do not rely solely on hormonal contraception.
What other medicines interact with Ethinyl estradiol-drospirenone?
MediHelp also lists interactions of Ethinyl estradiol-drospirenone with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir, Ombitasvir / paritaprevir / ritonavir and dasabuvir. The full list is on the Ethinyl estradiol-drospirenone page.
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