Drug interactions
Apalutamide + Sofosbuvir-velpatasvir-voxilaprevir
Severity: Major
Apalutamide and Sofosbuvir-velpatasvir-voxilaprevir: 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 also induces P-gp, which can substantially reduce exposure to velpatasvir, voxilaprevir and sofosbuvir. This risks virologic failure.
What this interaction means in plain words
Apalutamide and Sofosbuvir-velpatasvir-voxilaprevir 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; Sofosbuvir-velpatasvir-voxilaprevir belongs to Anti Virals.
Why it happens
Apalutamide induces CYP3A4 and P-gp, increasing metabolism and efflux of the antiviral components.
What to do
Avoid the combination; defer HCV therapy or pick an alternative anticancer therapy if possible. If unavoidable, monitor HCV RNA and seek specialist advice.
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 Sofosbuvir-velpatasvir-voxilaprevir
- Fosphenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenobarbital + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifampin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir 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 Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp rates the interaction as major. Apalutamide and Sofosbuvir-velpatasvir-voxilaprevir 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 also induces P-gp, which can substantially reduce exposure to velpatasvir, voxilaprevir and sofosbuvir. This risks virologic failure.
How serious is the interaction between Apalutamide and Sofosbuvir-velpatasvir-voxilaprevir?
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; defer HCV therapy or pick an alternative anticancer therapy if possible. If unavoidable, monitor HCV RNA and seek specialist advice.
What other medicines interact with Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp also lists interactions of Sofosbuvir-velpatasvir-voxilaprevir with, for example, Fosphenytoin, Phenobarbital, Phenytoin. The full list is on the Sofosbuvir-velpatasvir-voxilaprevir page.
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