Drug interactions
Apalutamide + Terbinafine
Severity: Minor
Apalutamide and Terbinafine: minor 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 moderate-to-strong inducer of CYP3A4 and other enzymes and may lower terbinafine exposure. Terbinafine is cleared by multiple CYP enzymes, so the effect is probably modest, but antifungal efficacy could be reduced.
What this interaction means in plain words
Apalutamide and Terbinafine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Apalutamide belongs to Endocrine; Terbinafine belongs to Anti Fungals.
Why it happens
Apalutamide induces CYP3A4 and other CYP enzymes involved in part of terbinafine clearance, increasing its metabolism.
What to do
No empiric dose change is needed; monitor clinical response to terbinafine, particularly in onychomycosis, and consider a longer course or alternative if response is poor.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Terbinafine
- Terbinafine + Thioridazine Contraindicated
- Desipramine + Terbinafine Major
- Eliglustat + Terbinafine Major
- Flecainide + Terbinafine Major
- Imipramine + Terbinafine Major
- Maprotiline + Terbinafine Major
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 Terbinafine?
MediHelp rates the interaction as minor. Apalutamide and Terbinafine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Apalutamide is a moderate-to-strong inducer of CYP3A4 and other enzymes and may lower terbinafine exposure. Terbinafine is cleared by multiple CYP enzymes, so the effect is probably modest, but antifungal efficacy could be reduced.
How serious is the interaction between Apalutamide and Terbinafine?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No empiric dose change is needed; monitor clinical response to terbinafine, particularly in onychomycosis, and consider a longer course or alternative if response is poor.
What other medicines interact with Terbinafine?
MediHelp also lists interactions of Terbinafine with, for example, Thioridazine, Desipramine, Eliglustat. The full list is on the Terbinafine page.
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