Drug interactions
Apalutamide + Everolimus
Severity: Major
Apalutamide and Everolimus: 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 can substantially lower everolimus levels, risking loss of efficacy or, in transplant patients, rejection.
What this interaction means in plain words
Apalutamide and Everolimus 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; Everolimus belongs to Oncology.
Why it happens
Strong CYP3A4 and P-gp induction increases everolimus clearance.
What to do
Avoid strong CYP3A4 inducers with everolimus; if unavoidable, increase the everolimus dose per labeling and monitor trough levels where applicable.
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 Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
Other interactions of Everolimus
- Bcg vaccine live + Everolimus Contraindicated
- Everolimus + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Everolimus + Levoketoconazole Contraindicated
- Everolimus + Measles mumps and rubella vaccine live Contraindicated
- Everolimus + Measles mumps rubella and varicella vaccine live Contraindicated
- Everolimus + Measles vaccine Contraindicated
Frequently asked questions
Can I take Apalutamide with Everolimus?
MediHelp rates the interaction as major. Apalutamide and Everolimus 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 can substantially lower everolimus levels, risking loss of efficacy or, in transplant patients, rejection.
How serious is the interaction between Apalutamide and Everolimus?
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 strong CYP3A4 inducers with everolimus; if unavoidable, increase the everolimus dose per labeling and monitor trough levels where applicable.
What other medicines interact with Apalutamide?
MediHelp also lists interactions of Apalutamide with, for example, Cabotegravir, Cobicistat, Doravirine. The full list is on the Apalutamide page.
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