Drug interactions
Apalutamide + Quetiapine
Severity: Major
Apalutamide and Quetiapine: 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 is a strong CYP3A4 inducer and substantially lowers quetiapine exposure, since quetiapine is mainly cleared by CYP3A4. This can lead to loss of antipsychotic or mood-stabilizing effect.
What this interaction means in plain words
Apalutamide and Quetiapine 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; Quetiapine belongs to Central Nervous System.
Why it happens
Induction of CYP3A4 by apalutamide increases quetiapine metabolism.
What to do
Monitor for loss of efficacy and titrate the quetiapine dose upward as needed, or choose an alternative not dependent on CYP3A4. Reduce quetiapine back toward the original dose after apalutamide is stopped.
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 Quetiapine
- Adagrasib + Quetiapine Major
- Amiodarone + Quetiapine Major
- Amisulpride + Quetiapine Major
- Amoxapine + Quetiapine Major
- Anagrelide + Quetiapine Major
- Arsenic trioxide + Quetiapine 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 Quetiapine?
MediHelp rates the interaction as major. Apalutamide and Quetiapine 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 is a strong CYP3A4 inducer and substantially lowers quetiapine exposure, since quetiapine is mainly cleared by CYP3A4. This can lead to loss of antipsychotic or mood-stabilizing effect.
How serious is the interaction between Apalutamide and Quetiapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of efficacy and titrate the quetiapine dose upward as needed, or choose an alternative not dependent on CYP3A4. Reduce quetiapine back toward the original dose after apalutamide is stopped.
What other medicines interact with Quetiapine?
MediHelp also lists interactions of Quetiapine with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Quetiapine page.
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