Drug interactions
Apalutamide + Nirmatrelvir
Severity: Contraindicated
Apalutamide and Nirmatrelvir: contraindicated 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 markedly decreases nirmatrelvir concentrations, which may result in treatment failure for COVID-19 and potential resistance. The inducing effect persists after apalutamide is stopped.
What this interaction means in plain words
Apalutamide and Nirmatrelvir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Apalutamide belongs to Endocrine; Nirmatrelvir belongs to Anti Virals.
Why it happens
Apalutamide induces CYP3A4, increasing the metabolism of nirmatrelvir.
What to do
Do not use together; consider another COVID-19 antiviral not affected by induction. Avoid starting nirmatrelvir soon after stopping apalutamide.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Apalutamide and Nirmatrelvir, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Nirmatrelvir
- Alfuzosin + Nirmatrelvir Contraindicated
- Amiodarone + Nirmatrelvir Contraindicated
- Carbamazepine + Nirmatrelvir Contraindicated
- Colchicine + Nirmatrelvir Contraindicated
- Dronedarone + Nirmatrelvir Contraindicated
- Enzalutamide + Nirmatrelvir Contraindicated
Frequently asked questions
Can I take Apalutamide with Nirmatrelvir?
MediHelp rates the interaction as contraindicated. Apalutamide and Nirmatrelvir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Apalutamide markedly decreases nirmatrelvir concentrations, which may result in treatment failure for COVID-19 and potential resistance. The inducing effect persists after apalutamide is stopped.
How serious is the interaction between Apalutamide and Nirmatrelvir?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together; consider another COVID-19 antiviral not affected by induction. Avoid starting nirmatrelvir soon after stopping apalutamide.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
