Drug interactions
Apalutamide + Hydrochlorothiazide-losartan
Severity: Moderate
Apalutamide and Hydrochlorothiazide-losartan: 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 and CYP2C19 inducer and may lower exposure to losartan and its active metabolite. Loss of antihypertensive effect is possible, though the clinical impact is variable.
What this interaction means in plain words
Apalutamide and Hydrochlorothiazide-losartan 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; Hydrochlorothiazide-losartan belongs to Cardiovascular.
Why it happens
Enzyme induction of CYP2C9 and CYP3A4 by apalutamide increases losartan clearance.
What to do
Monitor blood pressure after starting or stopping apalutamide and increase the losartan dose if needed.
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 Hydrochlorothiazide-losartan
- Aliskiren + Hydrochlorothiazide-losartan Contraindicated
- Dofetilide + Hydrochlorothiazide-losartan Contraindicated
- Hydrochlorothiazide-losartan + Sparsentan Contraindicated
- Aceclofenac + Hydrochlorothiazide-losartan Major
- Aldesleukin + Hydrochlorothiazide-losartan Major
- Amifostine + Hydrochlorothiazide-losartan 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 Hydrochlorothiazide-losartan?
MediHelp rates the interaction as moderate. Apalutamide and Hydrochlorothiazide-losartan 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 and CYP2C19 inducer and may lower exposure to losartan and its active metabolite. Loss of antihypertensive effect is possible, though the clinical impact is variable.
How serious is the interaction between Apalutamide and Hydrochlorothiazide-losartan?
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 blood pressure after starting or stopping apalutamide and increase the losartan dose if needed.
What other medicines interact with Hydrochlorothiazide-losartan?
MediHelp also lists interactions of Hydrochlorothiazide-losartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-losartan page.
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