Drug interactions
Apalutamide + Mifepristone
Severity: Major
Apalutamide and Mifepristone: major interaction.
Last updated Sources: Base de donnees publique des medicaments (France)
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, a strong CYP3A4 inducer, may markedly reduce mifepristone exposure and its efficacy. Mifepristone, a CYP3A4 inhibitor, may in turn raise apalutamide levels, though the net effect is likely dominated by induction.
What this interaction means in plain words
Apalutamide and Mifepristone 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; Mifepristone belongs to Endocrine.
Why it happens
Apalutamide induces CYP3A4 increasing mifepristone clearance, while mifepristone inhibits CYP3A4 which contributes to apalutamide metabolism.
What to do
Avoid the combination where possible. If needed, monitor for loss of mifepristone effect and for apalutamide adverse effects, adjusting doses as required.
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 Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone 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 Mifepristone?
MediHelp rates the interaction as major. Apalutamide and Mifepristone 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, a strong CYP3A4 inducer, may markedly reduce mifepristone exposure and its efficacy. Mifepristone, a CYP3A4 inhibitor, may in turn raise apalutamide levels, though the net effect is likely dominated by induction.
How serious is the interaction between Apalutamide and Mifepristone?
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. If needed, monitor for loss of mifepristone effect and for apalutamide adverse effects, adjusting doses as required.
What other medicines interact with Mifepristone?
MediHelp also lists interactions of Mifepristone with, for example, Apixaban, Argatroban, Cisapride. The full list is on the Mifepristone page.
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