Drug interactions
Apalutamide + Nimodipine
Severity: Major
Apalutamide and Nimodipine: major 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 a strong CYP3A4 inducer and can markedly reduce nimodipine exposure. This may result in loss of neuroprotective benefit in subarachnoid hemorrhage.
What this interaction means in plain words
Apalutamide and Nimodipine 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; Nimodipine belongs to Cardiovascular.
Why it happens
Induction of CYP3A4 increases the extensive first-pass metabolism of nimodipine.
What to do
Avoid the combination where possible, particularly when nimodipine is used for subarachnoid hemorrhage. If unavoidable, monitor clinical response and blood pressure.
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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Other interactions of Nimodipine
- Carbamazepine + Nimodipine Major
- Ceritinib + Nimodipine Major
- Clarithromycin + Nimodipine Major
- Cobicistat + Nimodipine Major
- Darunavir + Nimodipine Major
- Duvelisib + Nimodipine Major
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 Nimodipine?
MediHelp rates the interaction as major. Apalutamide and Nimodipine 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 markedly reduce nimodipine exposure. This may result in loss of neuroprotective benefit in subarachnoid hemorrhage.
How serious is the interaction between Apalutamide and Nimodipine?
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, particularly when nimodipine is used for subarachnoid hemorrhage. If unavoidable, monitor clinical response and blood pressure.
What other medicines interact with Nimodipine?
MediHelp also lists interactions of Nimodipine with, for example, Carbamazepine, Ceritinib, Clarithromycin. The full list is on the Nimodipine page.
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