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Drug interactions

Apalutamide + Indinavir

Severity: Major

Apalutamide and Indinavir: major interaction.

Last updated Sources: US FDA label

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 may markedly reduce indinavir concentrations, risking virologic failure and resistance.

What this interaction means in plain words

Apalutamide and Indinavir 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.

Evidence level: Moderate

Why it happens

Apalutamide induces CYP3A4, the main enzyme metabolizing indinavir.

What to do

Avoid the combination and use an antiretroviral regimen less affected by inducers; if unavoidable, monitor viral load.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Apalutamide with Indinavir?

MediHelp rates the interaction as major. Apalutamide and Indinavir 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 may markedly reduce indinavir concentrations, risking virologic failure and resistance.

How serious is the interaction between Apalutamide and Indinavir?

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 and use an antiretroviral regimen less affected by inducers; if unavoidable, monitor viral load.

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.

Full monographs, dosing and an interaction checker in the MediHelp app

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