Drug interactions
Apalutamide + Ledipasvir / sofosbuvir
Severity: Major
Apalutamide and Ledipasvir / sofosbuvir: 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
Ledipasvir and sofosbuvir are P-gp and BCRP substrates, and apalutamide induces these transporters and CYP3A4. Reduced antiviral exposure could lead to treatment failure or resistance.
What this interaction means in plain words
Apalutamide and Ledipasvir / sofosbuvir 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.
Why it happens
Apalutamide induces P-gp, BCRP and CYP3A4, decreasing absorption and exposure of ledipasvir and sofosbuvir.
What to do
Avoid the combination where possible, as potent inducers are not recommended with this regimen. Consider an alternative antiandrogen or a different HCV regimen.
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
Frequently asked questions
Can I take Apalutamide with Ledipasvir / sofosbuvir?
MediHelp rates the interaction as major. Apalutamide and Ledipasvir / sofosbuvir 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. Ledipasvir and sofosbuvir are P-gp and BCRP substrates, and apalutamide induces these transporters and CYP3A4. Reduced antiviral exposure could lead to treatment failure or resistance.
How serious is the interaction between Apalutamide and Ledipasvir / sofosbuvir?
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 where possible, as potent inducers are not recommended with this regimen. Consider an alternative antiandrogen or a different HCV regimen.
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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