Drug interactions
Apalutamide + Methotrexate
Severity: Minor
Apalutamide and Methotrexate: minor 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 is an enzyme and transporter inducer that may lower exposure to substrates of BCRP and OATP1B1. Methotrexate is handled by these transporters, so its levels and efficacy could fall, though the clinical impact is not well characterized.
What this interaction means in plain words
Apalutamide and Methotrexate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Apalutamide belongs to Endocrine; Methotrexate belongs to Oncology.
Why it happens
Apalutamide weakly induces BCRP and OATP1B1 transporters, possibly increasing methotrexate elimination.
What to do
Monitor for reduced methotrexate response in patients on long-term therapy, particularly for non-oncology indications. Adjust the dose according to clinical response.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Methotrexate
- Acitretin + Methotrexate Contraindicated
- Adenovirus types 4 and 7 live + Methotrexate Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Methotrexate Contraindicated
- Ketorolac + Methotrexate Contraindicated
- Measles mumps and rubella vaccine live + Methotrexate Contraindicated
- Measles mumps and rubella vaccine + Methotrexate Contraindicated
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 Methotrexate?
MediHelp rates the interaction as minor. Apalutamide and Methotrexate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Apalutamide is an enzyme and transporter inducer that may lower exposure to substrates of BCRP and OATP1B1. Methotrexate is handled by these transporters, so its levels and efficacy could fall, though the clinical impact is not well characterized.
How serious is the interaction between Apalutamide and Methotrexate?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced methotrexate response in patients on long-term therapy, particularly for non-oncology indications. Adjust the dose according to clinical response.
What other medicines interact with Methotrexate?
MediHelp also lists interactions of Methotrexate with, for example, Acitretin, Adenovirus types 4 and 7 live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Methotrexate page.
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