Drug interactions
Apalutamide + Ripretinib
Severity: Major
Apalutamide and Ripretinib: 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
Strong CYP3A inducers lower ripretinib and active metabolite exposure, and may reduce efficacy in GIST. Ripretinib labeling recommends increasing the dose to 150 mg twice daily with such inducers, so the interaction is relevant despite the legacy comment.
What this interaction means in plain words
Apalutamide and Ripretinib 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; Ripretinib belongs to Oncology.
Why it happens
Apalutamide induces CYP3A4, increasing the clearance of ripretinib and its active metabolite DP-5439.
What to do
Avoid the combination if possible. If unavoidable, follow the ripretinib label guidance on dose escalation and monitor tumor response.
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 Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
Other interactions of Ripretinib
- Amobarbital + Ripretinib Major
- Carbamazepine + Ripretinib Major
- Efavirenz + Ripretinib Major
- Enzalutamide + Ripretinib Major
- Phenytoin + Ripretinib Major
- Ripretinib + Secobarbital Major
Frequently asked questions
Can I take Apalutamide with Ripretinib?
MediHelp rates the interaction as major. Apalutamide and Ripretinib 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. Strong CYP3A inducers lower ripretinib and active metabolite exposure, and may reduce efficacy in GIST. Ripretinib labeling recommends increasing the dose to 150 mg twice daily with such inducers, so the interaction is relevant despite the legacy comment.
How serious is the interaction between Apalutamide and Ripretinib?
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 the combination if possible. If unavoidable, follow the ripretinib label guidance on dose escalation and monitor tumor response.
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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