Drug interactions
Apalutamide + Tadalafil
Severity: Moderate
Apalutamide and Tadalafil: 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 lower tadalafil exposure, leading to loss of efficacy. This matters most when tadalafil is used for pulmonary arterial hypertension.
What this interaction means in plain words
Apalutamide and Tadalafil 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; Tadalafil belongs to Genitourinary.
Why it happens
Induction of CYP3A4 increasing tadalafil metabolism.
What to do
Monitor for loss of effect and consider an alternative, particularly in pulmonary hypertension. Adjust tadalafil dose per labeling if the combination is necessary.
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 Tadalafil
- Amyl nitrite + Tadalafil Contraindicated
- Isosorbide dinitrate + Tadalafil Contraindicated
- Isosorbide mononitrate + Tadalafil Contraindicated
- Nitroglycerin po + Tadalafil Contraindicated
- Nitroglycerin rectal + Tadalafil Contraindicated
- Nitroglycerin sublingual + Tadalafil 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 Tadalafil?
MediHelp rates the interaction as moderate. Apalutamide and Tadalafil 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 lower tadalafil exposure, leading to loss of efficacy. This matters most when tadalafil is used for pulmonary arterial hypertension.
How serious is the interaction between Apalutamide and Tadalafil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of effect and consider an alternative, particularly in pulmonary hypertension. Adjust tadalafil dose per labeling if the combination is necessary.
What other medicines interact with Tadalafil?
MediHelp also lists interactions of Tadalafil with, for example, Amyl nitrite, Isosorbide dinitrate, Isosorbide mononitrate. The full list is on the Tadalafil page.
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