Drug interactions
Apalutamide + Lefamulin
Severity: Major
Apalutamide and Lefamulin: 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 can reduce lefamulin exposure because lefamulin is a CYP3A and P-glycoprotein substrate. Subtherapeutic antibiotic levels may lead to treatment failure of the infection.
What this interaction means in plain words
Apalutamide and Lefamulin 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; Lefamulin belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 (and P-gp) by apalutamide increases lefamulin clearance and reduces its absorption and exposure.
What to do
Avoid the combination unless benefit clearly outweighs risk, and consider a different antibiotic. If used together, monitor closely for clinical failure of the infection.
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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References
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 Lefamulin
- Lefamulin + Methadone Contraindicated
- Lefamulin + Pimavanserin Contraindicated
- Lefamulin + Pimozide Contraindicated
- Lefamulin + Quinidine Contraindicated
- Alfuzosin + Lefamulin Major
- Amiodarone + Lefamulin Major
Frequently asked questions
Can I take Apalutamide with Lefamulin?
MediHelp rates the interaction as major. Apalutamide and Lefamulin 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 can reduce lefamulin exposure because lefamulin is a CYP3A and P-glycoprotein substrate. Subtherapeutic antibiotic levels may lead to treatment failure of the infection.
How serious is the interaction between Apalutamide and Lefamulin?
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 unless benefit clearly outweighs risk, and consider a different antibiotic. If used together, monitor closely for clinical failure of the infection.
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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