Drug interactions
Apalutamide + Primaquine
Severity: Moderate
Apalutamide and Primaquine: 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 is a strong CYP3A4 inducer and may lower primaquine exposure, risking reduced antimalarial efficacy. Primaquine is metabolized mainly by MAO-A with some CYP involvement, so the size of the effect is uncertain.
What this interaction means in plain words
Apalutamide and Primaquine 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; Primaquine belongs to Anti Parasitic.
Why it happens
Apalutamide induces CYP3A4 and other enzymes, potentially increasing primaquine clearance.
What to do
Monitor for treatment failure or relapse of malaria. Consider an alternative regimen if efficacy is critical.
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 Primaquine
- Pimozide + Primaquine Contraindicated
- Amiodarone + Primaquine Major
- Amisulpride + Primaquine Major
- Anagrelide + Primaquine Major
- Arsenic trioxide + Primaquine Major
- Asenapine + Primaquine 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 Primaquine?
MediHelp rates the interaction as moderate. Apalutamide and Primaquine 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 is a strong CYP3A4 inducer and may lower primaquine exposure, risking reduced antimalarial efficacy. Primaquine is metabolized mainly by MAO-A with some CYP involvement, so the size of the effect is uncertain.
How serious is the interaction between Apalutamide and Primaquine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for treatment failure or relapse of malaria. Consider an alternative regimen if efficacy is critical.
What other medicines interact with Primaquine?
MediHelp also lists interactions of Primaquine with, for example, Pimozide, Amiodarone, Amisulpride. The full list is on the Primaquine page.
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