Drug interactions
Apalutamide + Pitolisant
Severity: Moderate
Apalutamide and Pitolisant: 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
Apalutamide, a strong CYP3A4 inducer, is expected to substantially reduce pitolisant exposure and may lead to loss of efficacy for narcolepsy symptoms.
What this interaction means in plain words
Apalutamide and Pitolisant 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.
Apalutamide belongs to Endocrine; Pitolisant belongs to Central Nervous System.
Why it happens
Apalutamide induces CYP3A4, increasing pitolisant metabolism.
What to do
Double the pitolisant dose over 7 days as per labeling for strong CYP3A4 inducers. Halve the dose again if apalutamide is discontinued.
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
Other interactions of Pitolisant
- Alfuzosin + Pitolisant Major
- Amiodarone + Pitolisant Major
- Amisulpride + Pitolisant Major
- Anagrelide + Pitolisant Major
- Asenapine + Pitolisant Major
- Bupropion + Pitolisant Major
Frequently asked questions
Can I take Apalutamide with Pitolisant?
MediHelp rates the interaction as moderate. Apalutamide and Pitolisant 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. Apalutamide, a strong CYP3A4 inducer, is expected to substantially reduce pitolisant exposure and may lead to loss of efficacy for narcolepsy symptoms.
How serious is the interaction between Apalutamide and Pitolisant?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Double the pitolisant dose over 7 days as per labeling for strong CYP3A4 inducers. Halve the dose again if apalutamide is discontinued.
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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