Drug interactions
Apalutamide + Rifampin
Severity: Moderate
Apalutamide and Rifampin: 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
Rifampin is a strong CYP3A4 inducer that will itself lower apalutamide exposure. Any effect of apalutamide on rifampin is minor and of doubtful clinical relevance. The more relevant concern is the reduced apalutamide exposure with rifampin.
What this interaction means in plain words
Apalutamide and Rifampin 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.
Why it happens
Rifampin induces CYP3A4 and CYP2C8, which may increase apalutamide clearance and lower its concentrations.
What to do
Avoid rifampin where an alternative antimycobacterial is available. If it is needed, monitor PSA and clinical response to apalutamide.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Apalutamide and Rifampin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Rifampin?
MediHelp rates the interaction as moderate. Apalutamide and Rifampin 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. Rifampin is a strong CYP3A4 inducer that will itself lower apalutamide exposure. Any effect of apalutamide on rifampin is minor and of doubtful clinical relevance. The more relevant concern is the reduced apalutamide exposure with rifampin.
How serious is the interaction between Apalutamide and Rifampin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid rifampin where an alternative antimycobacterial is available. If it is needed, monitor PSA and clinical response to apalutamide.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
