Drug interactions
Apalutamide + Flutamide
Severity: Moderate
Apalutamide and Flutamide: 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
Flutamide is converted by CYP1A2 to its active metabolite, with some CYP3A4 involvement. Apalutamide as an inducer may alter exposure, and both drugs are antiandrogens with additive hepatotoxicity potential, and combining them has no therapeutic rationale.
What this interaction means in plain words
Apalutamide and Flutamide 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; Flutamide belongs to Endocrine.
Why it happens
Apalutamide induces CYP3A4 and may change flutamide metabolism, with overlapping antiandrogen pharmacology.
What to do
Avoid using two antiandrogens together. If they must be combined, monitor liver tests and clinical response.
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 Flutamide
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 Flutamide?
MediHelp rates the interaction as moderate. Apalutamide and Flutamide 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. Flutamide is converted by CYP1A2 to its active metabolite, with some CYP3A4 involvement. Apalutamide as an inducer may alter exposure, and both drugs are antiandrogens with additive hepatotoxicity potential, and combining them has no therapeutic rationale.
How serious is the interaction between Apalutamide and Flutamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid using two antiandrogens together. If they must be combined, monitor liver tests and clinical response.
What other medicines interact with Flutamide?
MediHelp also lists interactions of Flutamide with, for example, Idelalisib, Levoketoconazole, Pexidartinib. The full list is on the Flutamide page.
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