Drug interactions
Apalutamide + Norethisterone
Severity: Major
Apalutamide and Norethisterone: 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 may substantially reduce norethisterone exposure. Hormonal contraception may fail, and bleeding irregularities may occur.
What this interaction means in plain words
Apalutamide and Norethisterone 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; Norethisterone belongs to Endocrine.
Why it happens
Apalutamide induces CYP3A4, increasing norethisterone metabolism.
What to do
Use an alternative non-hormonal contraceptive method during and after apalutamide treatment. Monitor for loss of effect if norethisterone is used therapeutically.
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 Norethisterone
- Acitretin + Norethisterone Contraindicated
- Amobarbital + Norethisterone Major
- Belzutifan + Norethisterone Major
- Bosentan + Norethisterone Major
- Brigatinib + Norethisterone Major
- Carbamazepine + Norethisterone 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 Norethisterone?
MediHelp rates the interaction as major. Apalutamide and Norethisterone 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 may substantially reduce norethisterone exposure. Hormonal contraception may fail, and bleeding irregularities may occur.
How serious is the interaction between Apalutamide and Norethisterone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use an alternative non-hormonal contraceptive method during and after apalutamide treatment. Monitor for loss of effect if norethisterone is used therapeutically.
What other medicines interact with Norethisterone?
MediHelp also lists interactions of Norethisterone with, for example, Acitretin, Amobarbital, Belzutifan. The full list is on the Norethisterone page.
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