Drug interactions
Apalutamide + Fentanyl
Severity: Moderate
Apalutamide and Fentanyl: 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 is a strong CYP3A4 inducer and can reduce fentanyl exposure, leading to inadequate analgesia. When apalutamide is stopped, fentanyl levels may rise and cause toxicity.
What this interaction means in plain words
Apalutamide and Fentanyl 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; Fentanyl belongs to Musculoskeletal.
Why it happens
Induction of CYP3A4 by apalutamide increases fentanyl metabolism.
What to do
Monitor analgesic response and titrate fentanyl upward if needed. Reduce the dose and monitor for respiratory depression after apalutamide is discontinued.
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 Fentanyl
- Alvimopan + Fentanyl Contraindicated
- Fentanyl + Isocarboxazid Contraindicated
- Fentanyl + Olanzapine / samidorphan Contraindicated
- Fentanyl + Phenelzine Contraindicated
- Fentanyl + Tranylcypromine Contraindicated
- Alfentanil + Fentanyl 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 Fentanyl?
MediHelp rates the interaction as moderate. Apalutamide and Fentanyl 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 is a strong CYP3A4 inducer and can reduce fentanyl exposure, leading to inadequate analgesia. When apalutamide is stopped, fentanyl levels may rise and cause toxicity.
How serious is the interaction between Apalutamide and Fentanyl?
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 analgesic response and titrate fentanyl upward if needed. Reduce the dose and monitor for respiratory depression after apalutamide is discontinued.
What other medicines interact with Fentanyl?
MediHelp also lists interactions of Fentanyl with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Fentanyl page.
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