Drug interactions
Apalutamide + Macitentan
Severity: Major
Apalutamide and Macitentan: 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
Apalutamide can substantially reduce macitentan and its active metabolite exposure. This may lessen control of pulmonary arterial hypertension.
What this interaction means in plain words
Apalutamide and Macitentan 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; Macitentan belongs to Cardiovascular.
Why it happens
CYP3A4 induction by apalutamide increases clearance of macitentan.
What to do
Avoid the combination, as macitentan labeling advises against strong CYP3A4 inducers. If unavoidable, monitor for worsening PAH symptoms.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Apalutamide and Macitentan, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Macitentan
- Amiodarone + Macitentan Major
- Bosentan + Macitentan Major
- Carbamazepine + Macitentan Major
- Clarithromycin + Macitentan Major
- Efavirenz + Macitentan Major
- Enzalutamide + Macitentan Major
Frequently asked questions
Can I take Apalutamide with Macitentan?
MediHelp rates the interaction as major. Apalutamide and Macitentan 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 substantially reduce macitentan and its active metabolite exposure. This may lessen control of pulmonary arterial hypertension.
How serious is the interaction between Apalutamide and Macitentan?
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, as macitentan labeling advises against strong CYP3A4 inducers. If unavoidable, monitor for worsening PAH symptoms.
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
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
