Drug interactions
Apalutamide + Naldemedine
Severity: Moderate
Apalutamide and Naldemedine: moderate 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 lower naldemedine concentrations since it is a CYP3A4 substrate. This could reduce relief of opioid-induced constipation.
What this interaction means in plain words
Apalutamide and Naldemedine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Apalutamide belongs to Endocrine; Naldemedine belongs to Gastrointestinal Tract.
Why it happens
CYP3A4 induction by apalutamide increases naldemedine clearance.
What to do
Avoid if possible per labeling for strong CYP3A inducers; otherwise monitor bowel response and consider an alternative laxative.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Naldemedine
- Bupropion-naltrexone + Naldemedine Major
- Naldemedine + Naltrexone Major
- Naldemedine + Phenytoin Major
- Naldemedine + Rifampicin Major
- Amobarbital + Naldemedine Moderate
- Aprepitant + Naldemedine Moderate
Frequently asked questions
Can I take Apalutamide with Naldemedine?
MediHelp rates the interaction as moderate. Apalutamide and Naldemedine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Apalutamide may lower naldemedine concentrations since it is a CYP3A4 substrate. This could reduce relief of opioid-induced constipation.
How serious is the interaction between Apalutamide and Naldemedine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible per labeling for strong CYP3A inducers; otherwise monitor bowel response and consider an alternative laxative.
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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