Drug interactions
Apalutamide + Sildenafil
Severity: Moderate
Apalutamide and Sildenafil: 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 can substantially reduce sildenafil exposure. This may lead to loss of efficacy for erectile dysfunction or pulmonary arterial hypertension.
What this interaction means in plain words
Apalutamide and Sildenafil 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; Sildenafil belongs to Genitourinary.
Why it happens
Induction of CYP3A4 increases the hepatic and intestinal metabolism of sildenafil.
What to do
Assess response to sildenafil and adjust the dose within labeled limits if the effect is inadequate. For pulmonary arterial hypertension, consider an alternative therapy if efficacy is lost.
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 Sildenafil
- Amyl nitrite + Sildenafil Contraindicated
- Atazanavir + Sildenafil Contraindicated
- Cobicistat + Sildenafil Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Sildenafil Contraindicated
- Glyceryl trinitrate pr + Sildenafil Contraindicated
- Isosorbide dinitrate + Sildenafil 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 Sildenafil?
MediHelp rates the interaction as moderate. Apalutamide and Sildenafil 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 can substantially reduce sildenafil exposure. This may lead to loss of efficacy for erectile dysfunction or pulmonary arterial hypertension.
How serious is the interaction between Apalutamide and Sildenafil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Assess response to sildenafil and adjust the dose within labeled limits if the effect is inadequate. For pulmonary arterial hypertension, consider an alternative therapy if efficacy is lost.
What other medicines interact with Sildenafil?
MediHelp also lists interactions of Sildenafil with, for example, Amyl nitrite, Atazanavir, Cobicistat. The full list is on the Sildenafil page.
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