Drug interactions
Apalutamide + Vincristine
Severity: Major
Apalutamide and Vincristine: 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 may lower vincristine concentrations by inducing its metabolism. This could reduce antineoplastic efficacy, and the effect of a strong inducer on vinca alkaloids is well recognized with other agents.
What this interaction means in plain words
Apalutamide and Vincristine 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; Vincristine belongs to Oncology.
Why it happens
Apalutamide induces CYP3A4, increasing the clearance of vincristine, a CYP3A4 substrate.
What to do
Avoid the combination or substitute an alternative agent where possible. If unavoidable, monitor for loss of therapeutic response.
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 Vincristine
- Adenovirus types 4 and 7 live + Vincristine Contraindicated
- Atazanavir + Vincristine Major
- Ceritinib + Vincristine Major
- Chloramphenicol + Vincristine Major
- Clarithromycin + Vincristine Major
- Cobicistat + Vincristine Major
Frequently asked questions
Can I take Apalutamide with Vincristine?
MediHelp rates the interaction as major. Apalutamide and Vincristine 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 may lower vincristine concentrations by inducing its metabolism. This could reduce antineoplastic efficacy, and the effect of a strong inducer on vinca alkaloids is well recognized with other agents.
How serious is the interaction between Apalutamide and Vincristine?
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 or substitute an alternative agent where possible. If unavoidable, monitor for loss of therapeutic response.
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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