Drug interactions
Apalutamide + Upadacitinib
Severity: Major
Apalutamide and Upadacitinib: 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
Strong CYP3A4 inducers reduce upadacitinib exposure, and apalutamide is expected to do the same. Lower exposure may result in reduced efficacy for the inflammatory disease being treated.
What this interaction means in plain words
Apalutamide and Upadacitinib 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; Upadacitinib belongs to Musculoskeletal.
Why it happens
Apalutamide induces CYP3A4, accelerating the hepatic and intestinal metabolism of upadacitinib.
What to do
Avoid concomitant use per upadacitinib labeling advice on strong CYP3A4 inducers. Consider an alternative therapy and monitor disease control if the combination is unavoidable.
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 Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
Other interactions of Upadacitinib
- Abrocitinib + Upadacitinib Contraindicated
- Adenovirus types 4 and 7 live + Upadacitinib Contraindicated
- Baricitinib + Upadacitinib Contraindicated
- Bcg vaccine live + Upadacitinib Contraindicated
- Dengue vaccine + Upadacitinib Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Upadacitinib Contraindicated
Frequently asked questions
Can I take Apalutamide with Upadacitinib?
MediHelp rates the interaction as major. Apalutamide and Upadacitinib 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. Strong CYP3A4 inducers reduce upadacitinib exposure, and apalutamide is expected to do the same. Lower exposure may result in reduced efficacy for the inflammatory disease being treated.
How serious is the interaction between Apalutamide and Upadacitinib?
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 concomitant use per upadacitinib labeling advice on strong CYP3A4 inducers. Consider an alternative therapy and monitor disease control if the combination is unavoidable.
What other medicines interact with Apalutamide?
MediHelp also lists interactions of Apalutamide with, for example, Cabotegravir, Cobicistat, Doravirine. The full list is on the Apalutamide page.
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