Drug interactions
Apalutamide + Netupitant / palonosetron
Severity: Moderate
Apalutamide and Netupitant / palonosetron: 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
Strong CYP3A4 induction by apalutamide lowers netupitant concentrations. This may reduce antiemetic protection against chemotherapy-induced nausea and vomiting.
What this interaction means in plain words
Apalutamide and Netupitant / palonosetron 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.
Why it happens
Apalutamide induces CYP3A4, the main enzyme metabolizing netupitant, increasing its clearance.
What to do
Monitor for breakthrough nausea and vomiting and add or substitute other antiemetics if control is inadequate. Avoid use with strong inducers where an alternative regimen is feasible.
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
Frequently asked questions
Can I take Apalutamide with Netupitant / palonosetron?
MediHelp rates the interaction as moderate. Apalutamide and Netupitant / palonosetron 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. Strong CYP3A4 induction by apalutamide lowers netupitant concentrations. This may reduce antiemetic protection against chemotherapy-induced nausea and vomiting.
How serious is the interaction between Apalutamide and Netupitant / palonosetron?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for breakthrough nausea and vomiting and add or substitute other antiemetics if control is inadequate. Avoid use with strong inducers where an alternative regimen is feasible.
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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