Drug interactions
Apalutamide + Nisoldipine
Severity: Major
Apalutamide and Nisoldipine: 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
Nisoldipine has low bioavailability due to extensive CYP3A4 first-pass metabolism, and apalutamide further reduces its exposure. Blood pressure control may be lost.
What this interaction means in plain words
Apalutamide and Nisoldipine 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; Nisoldipine belongs to Cardiovascular.
Why it happens
Apalutamide induces intestinal and hepatic CYP3A4, increasing nisoldipine first-pass and systemic clearance.
What to do
Avoid the combination; nisoldipine labeling advises against strong CYP3A4 inducers. Use a different antihypertensive such as one not dependent on CYP3A4 and monitor 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 Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
Other interactions of Nisoldipine
- Itraconazole + Nisoldipine Contraindicated
- Ketoconazole + Nisoldipine Contraindicated
- Carbamazepine + Nisoldipine Major
- Chloramphenicol + Nisoldipine Major
- Clarithromycin + Nisoldipine Major
- Cyclosporin + Nisoldipine Major
Frequently asked questions
Can I take Apalutamide with Nisoldipine?
MediHelp rates the interaction as major. Apalutamide and Nisoldipine 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. Nisoldipine has low bioavailability due to extensive CYP3A4 first-pass metabolism, and apalutamide further reduces its exposure. Blood pressure control may be lost.
How serious is the interaction between Apalutamide and Nisoldipine?
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; nisoldipine labeling advises against strong CYP3A4 inducers. Use a different antihypertensive such as one not dependent on CYP3A4 and monitor blood pressure.
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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