Drug interactions
Apalutamide + Tolterodine
Severity: Moderate
Apalutamide and Tolterodine: 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 lower exposure to CYP3A4 substrates. Tolterodine is mainly cleared by CYP2D6 with CYP3A4 as the alternative route, so the net change in active moiety is likely modest.
What this interaction means in plain words
Apalutamide and Tolterodine 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; Tolterodine belongs to Genitourinary.
Why it happens
Induction of CYP3A4 (and possibly other enzymes) by apalutamide increases tolterodine clearance.
What to do
Monitor for reduced antimuscarinic effect and increase the tolterodine dose or switch agents if symptoms are not controlled.
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 Tolterodine
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 Tolterodine?
MediHelp rates the interaction as moderate. Apalutamide and Tolterodine 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 lower exposure to CYP3A4 substrates. Tolterodine is mainly cleared by CYP2D6 with CYP3A4 as the alternative route, so the net change in active moiety is likely modest.
How serious is the interaction between Apalutamide and Tolterodine?
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 reduced antimuscarinic effect and increase the tolterodine dose or switch agents if symptoms are not controlled.
What other medicines interact with Tolterodine?
MediHelp also lists interactions of Tolterodine with, for example, Clarithromycin, Clozapine, Cobicistat. The full list is on the Tolterodine page.
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