Drug interactions
Apalutamide + Quinidine
Severity: Major
Apalutamide and Quinidine: 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 can substantially lower quinidine concentrations. This may cause loss of antiarrhythmic or antimalarial effect.
What this interaction means in plain words
Apalutamide and Quinidine 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; Quinidine belongs to Anti Parasitic.
Why it happens
Induction of CYP3A4 by apalutamide increases quinidine metabolism.
What to do
Avoid if possible and choose an alternative. If used, monitor ECG and quinidine concentrations and adjust the dose.
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 Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine Contraindicated
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 Quinidine?
MediHelp rates the interaction as major. Apalutamide and Quinidine 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 can substantially lower quinidine concentrations. This may cause loss of antiarrhythmic or antimalarial effect.
How serious is the interaction between Apalutamide and Quinidine?
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 if possible and choose an alternative. If used, monitor ECG and quinidine concentrations and adjust the dose.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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