Drug interactions
Apalutamide + Ifosfamide
Severity: Moderate
Apalutamide and Ifosfamide: 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 inducer and may accelerate ifosfamide activation. This could alter the balance of active alkylating metabolites and neurotoxic and nephrotoxic chloroacetaldehyde.
What this interaction means in plain words
Apalutamide and Ifosfamide 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; Ifosfamide belongs to Oncology.
Why it happens
Apalutamide induces CYP3A4 and CYP2B6, increasing ifosfamide metabolism.
What to do
Monitor for CNS toxicity, renal function and myelosuppression, and consider an alternative to apalutamide if feasible.
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 Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
Other interactions of Ifosfamide
- Adenovirus types 4 and 7 live + Ifosfamide Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine live Contraindicated
- Ifosfamide + Measles mumps rubella and varicella vaccine live Contraindicated
- Ifosfamide + Measles vaccine Contraindicated
- Ifosfamide + Rotavirus oral vaccine live Contraindicated
Frequently asked questions
Can I take Apalutamide with Ifosfamide?
MediHelp rates the interaction as moderate. Apalutamide and Ifosfamide 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 inducer and may accelerate ifosfamide activation. This could alter the balance of active alkylating metabolites and neurotoxic and nephrotoxic chloroacetaldehyde.
How serious is the interaction between Apalutamide and Ifosfamide?
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 for CNS toxicity, renal function and myelosuppression, and consider an alternative to apalutamide if feasible.
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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