Drug interactions
Apalutamide + Tolbutamide
Severity: Moderate
Apalutamide and Tolbutamide: 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 induces CYP2C9 and may lower tolbutamide exposure, weakening glycemic control. The induction effect on CYP2C9 is described as modest.
What this interaction means in plain words
Apalutamide and Tolbutamide 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; Tolbutamide belongs to Endocrine.
Why it happens
Apalutamide induction of CYP2C9 increases tolbutamide metabolism.
What to do
Monitor blood glucose after starting or stopping apalutamide and increase the tolbutamide dose if control worsens, or choose an alternative agent.
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 Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide 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 Tolbutamide?
MediHelp rates the interaction as moderate. Apalutamide and Tolbutamide 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 induces CYP2C9 and may lower tolbutamide exposure, weakening glycemic control. The induction effect on CYP2C9 is described as modest.
How serious is the interaction between Apalutamide and Tolbutamide?
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 blood glucose after starting or stopping apalutamide and increase the tolbutamide dose if control worsens, or choose an alternative agent.
What other medicines interact with Tolbutamide?
MediHelp also lists interactions of Tolbutamide with, for example, Glyburide-metformin, Insulin degludec-liraglutide, Aceclofenac. The full list is on the Tolbutamide page.
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