Drug interactions
Apalutamide + Tenofovir alafenamide
Severity: Major
Apalutamide and Tenofovir alafenamide: 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 induces drug transporters and metabolic enzymes and may lower exposure to tenofovir alafenamide, which could reduce antiviral efficacy. Tenofovir alafenamide labeling advises against coadministration with strong inducers.
What this interaction means in plain words
Apalutamide and Tenofovir alafenamide 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; Tenofovir alafenamide belongs to Anti Virals.
Why it happens
Induction of intestinal P-glycoprotein and BCRP lowers absorption of tenofovir alafenamide.
What to do
Avoid coadministration where possible and choose an alternative antiandrogen or antiviral. If combined, monitor HIV RNA or HBV DNA closely.
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 Tenofovir alafenamide
- Berotralstat + Tenofovir alafenamide Moderate
- Danicopan + Tenofovir alafenamide Moderate
- Ifosfamide + Tenofovir alafenamide Moderate
- Orlistat + Tenofovir alafenamide Moderate
- Sotorasib + Tenofovir alafenamide Moderate
- Tenofovir alafenamide + Tepotinib Moderate
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 Tenofovir alafenamide?
MediHelp rates the interaction as major. Apalutamide and Tenofovir alafenamide 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 induces drug transporters and metabolic enzymes and may lower exposure to tenofovir alafenamide, which could reduce antiviral efficacy. Tenofovir alafenamide labeling advises against coadministration with strong inducers.
How serious is the interaction between Apalutamide and Tenofovir alafenamide?
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 coadministration where possible and choose an alternative antiandrogen or antiviral. If combined, monitor HIV RNA or HBV DNA closely.
What other medicines interact with Tenofovir alafenamide?
MediHelp also lists interactions of Tenofovir alafenamide with, for example, Berotralstat, Danicopan, Ifosfamide. The full list is on the Tenofovir alafenamide page.
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