Drug interactions
Apalutamide + Isosorbide dinitrate
Severity: Minor
Apalutamide and Isosorbide dinitrate: minor 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, but isosorbide dinitrate is cleared mainly by hepatic denitration rather than CYP3A4. A clinically meaningful reduction in effect is not established.
What this interaction means in plain words
Apalutamide and Isosorbide dinitrate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Apalutamide belongs to Endocrine; Isosorbide dinitrate belongs to Cardiovascular.
Why it happens
Predicted CYP3A4 induction, though dinitrate is not a major CYP3A4 substrate.
What to do
No dose change is needed; watch for reduced antianginal response.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Isosorbide dinitrate
- Avanafil + Isosorbide dinitrate Contraindicated
- Isosorbide dinitrate + Riociguat Contraindicated
- Isosorbide dinitrate + Sildenafil Contraindicated
- Isosorbide dinitrate + Tadalafil Contraindicated
- Isosorbide dinitrate + Vardenafil Contraindicated
- Ergotamine + Isosorbide dinitrate 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 Isosorbide dinitrate?
MediHelp rates the interaction as minor. Apalutamide and Isosorbide dinitrate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Apalutamide is a strong CYP3A4 inducer, but isosorbide dinitrate is cleared mainly by hepatic denitration rather than CYP3A4. A clinically meaningful reduction in effect is not established.
How serious is the interaction between Apalutamide and Isosorbide dinitrate?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No dose change is needed; watch for reduced antianginal response.
What other medicines interact with Isosorbide dinitrate?
MediHelp also lists interactions of Isosorbide dinitrate with, for example, Avanafil, Riociguat, Sildenafil. The full list is on the Isosorbide dinitrate page.
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