Drug interactions
Apalutamide + Voxelotor
Severity: Major
Apalutamide and Voxelotor: 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 substantially reduce voxelotor concentrations because voxelotor is mainly metabolized by CYP3A4, risking loss of efficacy in sickle cell disease. Voxelotor may weakly inhibit CYP3A4, but this is unlikely to matter for apalutamide.
What this interaction means in plain words
Apalutamide and Voxelotor 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; Voxelotor belongs to Miscellaneous.
Why it happens
Apalutamide induces CYP3A4, increasing voxelotor clearance.
What to do
Avoid concomitant use; if unavoidable, increase voxelotor dose per prescribing information and monitor hemoglobin 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 Voxelotor
- Amobarbital + Voxelotor Major
- Carbamazepine + Voxelotor Major
- Cyclosporin + Voxelotor Major
- Efavirenz + Voxelotor Major
- Enzalutamide + Voxelotor Major
- Ergotamine + Voxelotor Major
Frequently asked questions
Can I take Apalutamide with Voxelotor?
MediHelp rates the interaction as major. Apalutamide and Voxelotor 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 substantially reduce voxelotor concentrations because voxelotor is mainly metabolized by CYP3A4, risking loss of efficacy in sickle cell disease. Voxelotor may weakly inhibit CYP3A4, but this is unlikely to matter for apalutamide.
How serious is the interaction between Apalutamide and Voxelotor?
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; if unavoidable, increase voxelotor dose per prescribing information and monitor hemoglobin 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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