Drug interactions
Apalutamide + Felodipine
Severity: Major
Apalutamide and Felodipine: 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 felodipine is highly dependent on CYP3A4 for its clearance. Exposure to felodipine can fall markedly, causing loss of antihypertensive effect.
What this interaction means in plain words
Apalutamide and Felodipine 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; Felodipine belongs to Cardiovascular.
Why it happens
Apalutamide induces CYP3A4, greatly increasing first-pass and systemic metabolism of felodipine.
What to do
Prefer an alternative antihypertensive that is not a CYP3A4 substrate. If combined, monitor blood pressure closely and adjust felodipine, reassessing after apalutamide is stopped.
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 Felodipine
- Felodipine + Itraconazole Contraindicated
- Aldesleukin + Felodipine Major
- Amifostine + Felodipine Major
- Atazanavir + Felodipine Major
- Carbamazepine + Felodipine Major
- Clarithromycin + Felodipine 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 Felodipine?
MediHelp rates the interaction as major. Apalutamide and Felodipine 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 felodipine is highly dependent on CYP3A4 for its clearance. Exposure to felodipine can fall markedly, causing loss of antihypertensive effect.
How serious is the interaction between Apalutamide and Felodipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative antihypertensive that is not a CYP3A4 substrate. If combined, monitor blood pressure closely and adjust felodipine, reassessing after apalutamide is stopped.
What other medicines interact with Felodipine?
MediHelp also lists interactions of Felodipine with, for example, Itraconazole, Aldesleukin, Amifostine. The full list is on the Felodipine page.
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