Drug interactions
Apalutamide + Tofacitinib
Severity: Major
Apalutamide and Tofacitinib: 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 inducer of CYP3A4 and CYP2C19, the enzymes that clear tofacitinib. Exposure to tofacitinib may fall and its therapeutic effect may be reduced.
What this interaction means in plain words
Apalutamide and Tofacitinib 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; Tofacitinib belongs to Musculoskeletal.
Why it happens
Induction of CYP3A4 and CYP2C19 increases the metabolism of tofacitinib.
What to do
Avoid the combination where possible and choose an alternative. If it cannot be avoided, monitor for loss of tofacitinib efficacy and adjust therapy accordingly.
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 Tofacitinib
- Baricitinib + Tofacitinib Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Tofacitinib + Upadacitinib Contraindicated
- Abatacept + Tofacitinib Major
- Anti-thymocyte + Tofacitinib Major
- Antithymocyte globulin equine + Tofacitinib 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 Tofacitinib?
MediHelp rates the interaction as major. Apalutamide and Tofacitinib 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 inducer of CYP3A4 and CYP2C19, the enzymes that clear tofacitinib. Exposure to tofacitinib may fall and its therapeutic effect may be reduced.
How serious is the interaction between Apalutamide and Tofacitinib?
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 where possible and choose an alternative. If it cannot be avoided, monitor for loss of tofacitinib efficacy and adjust therapy accordingly.
What other medicines interact with Tofacitinib?
MediHelp also lists interactions of Tofacitinib with, for example, Baricitinib, Cladribine, Upadacitinib. The full list is on the Tofacitinib page.
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