Drug interactions
Apalutamide + Gemfibrozil
Severity: Moderate
Apalutamide and Gemfibrozil: 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
Gemfibrozil is a strong CYP2C8 inhibitor and can raise apalutamide and its active metabolite exposure, which may increase adverse effects. Apalutamide is an inducer of several enzymes including UGTs, and could lower gemfibrozil exposure, which is glucuronidated.
What this interaction means in plain words
Apalutamide and Gemfibrozil 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; Gemfibrozil belongs to Cardiovascular.
Why it happens
Gemfibrozil inhibits CYP2C8-mediated apalutamide metabolism, while apalutamide induces UGT-mediated gemfibrozil clearance.
What to do
No starting dose change is needed for apalutamide, but monitor for adverse effects such as rash, fatigue and falls and reduce the dose if poorly tolerated. Check lipid response to gemfibrozil and adjust therapy if efficacy declines.
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 Gemfibrozil
- Daprodustat + Gemfibrozil Contraindicated
- Elagolix + Gemfibrozil Contraindicated
- Gemfibrozil + Mavacamten Contraindicated
- Gemfibrozil + Metformin-repaglinide Contraindicated
- Gemfibrozil + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Gemfibrozil + Repaglinide 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 Gemfibrozil?
MediHelp rates the interaction as moderate. Apalutamide and Gemfibrozil 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. Gemfibrozil is a strong CYP2C8 inhibitor and can raise apalutamide and its active metabolite exposure, which may increase adverse effects. Apalutamide is an inducer of several enzymes including UGTs, and could lower gemfibrozil exposure, which is glucuronidated.
How serious is the interaction between Apalutamide and Gemfibrozil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No starting dose change is needed for apalutamide, but monitor for adverse effects such as rash, fatigue and falls and reduce the dose if poorly tolerated. Check lipid response to gemfibrozil and adjust therapy if efficacy declines.
What other medicines interact with Gemfibrozil?
MediHelp also lists interactions of Gemfibrozil with, for example, Daprodustat, Elagolix, Mavacamten. The full list is on the Gemfibrozil page.
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