Drug interactions
Apalutamide + Grapefruit
Severity: Minor
Apalutamide and Grapefruit: minor 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
Grapefruit inhibits intestinal CYP3A4 and may modestly raise apalutamide levels. Apalutamide has a wide therapeutic margin and strong CYP3A4 inhibitors do not require a starting dose change, so the effect is expected to be small.
What this interaction means in plain words
Apalutamide and Grapefruit have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Why it happens
Grapefruit constituents inhibit intestinal CYP3A4, reducing the metabolism of apalutamide.
What to do
No restriction is required, but monitor for adverse effects such as fatigue and rash. Reduce the apalutamide dose only if tolerability issues arise.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Grapefruit?
MediHelp rates the interaction as minor. Apalutamide and Grapefruit have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Grapefruit inhibits intestinal CYP3A4 and may modestly raise apalutamide levels. Apalutamide has a wide therapeutic margin and strong CYP3A4 inhibitors do not require a starting dose change, so the effect is expected to be small.
How serious is the interaction between Apalutamide and Grapefruit?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No restriction is required, but monitor for adverse effects such as fatigue and rash. Reduce the apalutamide dose only if tolerability issues arise.
What other medicines interact with Apalutamide?
MediHelp also lists interactions of Apalutamide with, for example, Cabotegravir, Cobicistat, Doravirine. The full list is on the Apalutamide page.
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