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Drug interactions

Apalutamide + Lumacaftor / ivacaftor

Severity: Moderate

Apalutamide and Lumacaftor / ivacaftor: moderate 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

Lumacaftor is itself a strong CYP3A inducer, and ivacaftor exposure is already reduced; adding apalutamide would add further induction. The effect on this combination is poorly characterized and could reduce efficacy.

What this interaction means in plain words

Apalutamide and Lumacaftor / ivacaftor can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.

Evidence level: Low

Why it happens

Apalutamide induces CYP3A4, which metabolizes ivacaftor, adding to induction already produced by lumacaftor.

What to do

Monitor for reduced CFTR modulator response and consider specialist review of alternatives.

What to ask your pharmacist

  • Should I take them at different times of day?
  • Does the dose of either medicine need to change?
  • Is there anything I should avoid, such as alcohol or certain foods, while on both?

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

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Frequently asked questions

Can I take Apalutamide with Lumacaftor / ivacaftor?

MediHelp rates the interaction as moderate. Apalutamide and Lumacaftor / ivacaftor can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Lumacaftor is itself a strong CYP3A inducer, and ivacaftor exposure is already reduced; adding apalutamide would add further induction. The effect on this combination is poorly characterized and could reduce efficacy.

How serious is the interaction between Apalutamide and Lumacaftor / ivacaftor?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced CFTR modulator response and consider specialist review of alternatives.

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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