Drug interactions
Apalutamide + Hydrocodone
Severity: Moderate
Apalutamide and Hydrocodone: 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 CYP3A4 inducer that can lower hydrocodone concentrations and reduce analgesia, and may precipitate withdrawal. If apalutamide is stopped, hydrocodone levels can rise again and cause serious respiratory depression.
What this interaction means in plain words
Apalutamide and Hydrocodone 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; Hydrocodone belongs to Musculoskeletal.
Why it happens
Induction of CYP3A4 increases hydrocodone metabolism to norhydrocodone.
What to do
Monitor pain control and withdrawal when starting apalutamide and increase the hydrocodone dose if needed. When apalutamide is discontinued, reduce the hydrocodone dose and monitor for respiratory depression.
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 Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone 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 Hydrocodone?
MediHelp rates the interaction as moderate. Apalutamide and Hydrocodone 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 CYP3A4 inducer that can lower hydrocodone concentrations and reduce analgesia, and may precipitate withdrawal. If apalutamide is stopped, hydrocodone levels can rise again and cause serious respiratory depression.
How serious is the interaction between Apalutamide and Hydrocodone?
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 pain control and withdrawal when starting apalutamide and increase the hydrocodone dose if needed. When apalutamide is discontinued, reduce the hydrocodone dose and monitor for respiratory depression.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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