Drug interactions
Apalutamide + Ethinyl estradiol-norgestimate
Severity: Major
Apalutamide and Ethinyl estradiol-norgestimate: 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 markedly lower exposure to ethinyl estradiol and norgestimate-derived progestins. This increases the risk of contraceptive failure.
What this interaction means in plain words
Apalutamide and Ethinyl estradiol-norgestimate 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-norgestimate belongs to Endocrine.
Why it happens
Strong induction of CYP3A4 (and other enzymes) accelerates hormone metabolism.
What to do
Use non-hormonal contraception rather than relying on the combined pill. Maintain it during therapy and for a period after stopping per labeling.
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 Ethinyl estradiol-norgestimate
- Ethinyl estradiol-norgestimate + Fezolinetant Contraindicated
- Ethinyl estradiol-norgestimate + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-norgestimate + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-norgestimate Major
- Amobarbital + Ethinyl estradiol-norgestimate Major
- Anastrozole + Ethinyl estradiol-norgestimate 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-norgestimate?
MediHelp rates the interaction as major. Apalutamide and Ethinyl estradiol-norgestimate 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 exposure to ethinyl estradiol and norgestimate-derived progestins. This increases the risk of contraceptive failure.
How serious is the interaction between Apalutamide and Ethinyl estradiol-norgestimate?
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 non-hormonal contraception rather than relying on the combined pill. Maintain it during therapy and for a period after stopping per labeling.
What other medicines interact with Ethinyl estradiol-norgestimate?
MediHelp also lists interactions of Ethinyl estradiol-norgestimate with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Tranexamic acid. The full list is on the Ethinyl estradiol-norgestimate page.
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