Drug interactions
Apalutamide + Imatinib
Severity: Major
Apalutamide and Imatinib: major 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 can substantially lower imatinib plasma concentrations. This may lead to loss of response in CML or GIST.
What this interaction means in plain words
Apalutamide and Imatinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Apalutamide belongs to Endocrine; Imatinib belongs to Oncology.
Why it happens
Apalutamide induces CYP3A4, increasing the metabolic clearance of imatinib.
What to do
Avoid the combination if possible. If it cannot be avoided, monitor clinical and molecular response and consider imatinib dose increase per labeling guidance for strong inducers.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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 Imatinib
- Imatinib + Lomitapide Contraindicated
- Imatinib + Lonafarnib Contraindicated
- Amobarbital + Imatinib Major
- Avapritinib + Imatinib Major
- Benzhydrocodone / acetaminophen + Imatinib Major
- Bosutinib + Imatinib Major
Frequently asked questions
Can I take Apalutamide with Imatinib?
MediHelp rates the interaction as major. Apalutamide and Imatinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Apalutamide is a strong CYP3A4 inducer and can substantially lower imatinib plasma concentrations. This may lead to loss of response in CML or GIST.
How serious is the interaction between Apalutamide and Imatinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if possible. If it cannot be avoided, monitor clinical and molecular response and consider imatinib dose increase per labeling guidance for strong inducers.
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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