Drug interactions
Apalutamide + Maraviroc
Severity: Major
Apalutamide and Maraviroc: 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 may markedly reduce maraviroc concentrations because it is a CYP3A4 and P-gp substrate. Subtherapeutic exposure can result in virologic failure.
What this interaction means in plain words
Apalutamide and Maraviroc 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; Maraviroc belongs to Anti Virals.
Why it happens
Apalutamide induces CYP3A4 and P-glycoprotein, increasing maraviroc clearance.
What to do
Avoid the combination; if used without a CYP3A4 inhibitor the maraviroc dose generally needs to be increased per labeling. Monitor HIV viral load.
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
Other interactions of Maraviroc
Frequently asked questions
Can I take Apalutamide with Maraviroc?
MediHelp rates the interaction as major. Apalutamide and Maraviroc 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 may markedly reduce maraviroc concentrations because it is a CYP3A4 and P-gp substrate. Subtherapeutic exposure can result in virologic failure.
How serious is the interaction between Apalutamide and Maraviroc?
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; if used without a CYP3A4 inhibitor the maraviroc dose generally needs to be increased per labeling. Monitor HIV viral load.
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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