Drug interactions
Apalutamide + Methylprednisolone
Severity: Major
Apalutamide and Methylprednisolone: 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 is a strong CYP3A4 inducer and can substantially lower methylprednisolone exposure. This may lead to loss of anti-inflammatory or replacement effect.
What this interaction means in plain words
Apalutamide and Methylprednisolone 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; Methylprednisolone belongs to Endocrine.
Why it happens
Induction of CYP3A4 by apalutamide increases methylprednisolone metabolism.
What to do
Avoid the combination where possible or monitor for reduced steroid effect and increase the methylprednisolone dose as clinically needed. Consider an alternative less dependent on CYP3A4 such as prednisolone dose adjustment with monitoring.
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 Methylprednisolone
- Bcg vaccine live + Methylprednisolone Contraindicated
- Measles mumps and rubella vaccine live + Methylprednisolone Contraindicated
- Measles mumps rubella and varicella vaccine live + Methylprednisolone Contraindicated
- Measles vaccine + Methylprednisolone Contraindicated
- Methylprednisolone + Mifepristone Contraindicated
- Methylprednisolone + Rubella vaccine 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 Methylprednisolone?
MediHelp rates the interaction as major. Apalutamide and Methylprednisolone 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 is a strong CYP3A4 inducer and can substantially lower methylprednisolone exposure. This may lead to loss of anti-inflammatory or replacement effect.
How serious is the interaction between Apalutamide and Methylprednisolone?
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 where possible or monitor for reduced steroid effect and increase the methylprednisolone dose as clinically needed. Consider an alternative less dependent on CYP3A4 such as prednisolone dose adjustment with monitoring.
What other medicines interact with Methylprednisolone?
MediHelp also lists interactions of Methylprednisolone with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Methylprednisolone page.
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