Drug interactions
Apalutamide + Warfarin
Severity: Moderate
Apalutamide and Warfarin: 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 drug-metabolising enzymes and can lower warfarin exposure, reducing anticoagulant effect and INR. This raises the risk of thromboembolism if the dose is not adjusted.
What this interaction means in plain words
Apalutamide and Warfarin 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; Warfarin belongs to Cardiovascular.
Why it happens
Induction of CYP2C9 and other metabolising enzymes by apalutamide increases warfarin clearance.
What to do
Check INR more frequently when starting or stopping apalutamide and adjust the warfarin dose to the target INR. Consider an alternative anticoagulant if control is unstable.
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 Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
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 Warfarin?
MediHelp rates the interaction as moderate. Apalutamide and Warfarin 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 drug-metabolising enzymes and can lower warfarin exposure, reducing anticoagulant effect and INR. This raises the risk of thromboembolism if the dose is not adjusted.
How serious is the interaction between Apalutamide and Warfarin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check INR more frequently when starting or stopping apalutamide and adjust the warfarin dose to the target INR. Consider an alternative anticoagulant if control is unstable.
What other medicines interact with Warfarin?
MediHelp also lists interactions of Warfarin with, for example, Defibrotide, Ketorolac, Abciximab. The full list is on the Warfarin page.
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