Drug interactions
Apalutamide + Fluoxetine
Severity: Moderate
Apalutamide and Fluoxetine: 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 induces several metabolizing enzymes including CYP2C19 and CYP3A4, and weakly CYP2C9, and may lower fluoxetine exposure. This could reduce antidepressant effect. The clinical significance is uncertain because fluoxetine and norfluoxetine have long half-lives.
What this interaction means in plain words
Apalutamide and Fluoxetine 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; Fluoxetine belongs to Central Nervous System.
Why it happens
Enzyme induction by apalutamide increases fluoxetine metabolism.
What to do
Monitor for loss of antidepressant response and consider a fluoxetine dose increase if symptoms recur. Reassess dosing if 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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
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 Fluoxetine?
MediHelp rates the interaction as moderate. Apalutamide and Fluoxetine 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 induces several metabolizing enzymes including CYP2C19 and CYP3A4, and weakly CYP2C9, and may lower fluoxetine exposure. This could reduce antidepressant effect. The clinical significance is uncertain because fluoxetine and norfluoxetine have long half-lives.
How serious is the interaction between Apalutamide and Fluoxetine?
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 for loss of antidepressant response and consider a fluoxetine dose increase if symptoms recur. Reassess dosing if apalutamide is discontinued.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
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