Drug interactions
Apalutamide + Zafirlukast
Severity: Moderate
Apalutamide and Zafirlukast: 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 weak inducer of CYP2C9 and can lower the plasma concentration of zafirlukast, which is cleared mainly by CYP2C9. Reduced exposure may weaken control of asthma symptoms.
What this interaction means in plain words
Apalutamide and Zafirlukast 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; Zafirlukast belongs to Respiratory.
Why it happens
Apalutamide induces CYP2C9 (and CYP3A4), increasing the hepatic metabolism of zafirlukast.
What to do
Monitor asthma control and watch for loss of zafirlukast effect when apalutamide is started. Consider an alternative controller or dose reassessment if control worsens.
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 Zafirlukast
- Pimozide + Zafirlukast Contraindicated
- Lomitapide + Zafirlukast Major
- Nilotinib + Zafirlukast Major
- Warfarin + Zafirlukast Major
- Carbamazepine + Zafirlukast Moderate
- Conivaptan + Zafirlukast Moderate
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 Zafirlukast?
MediHelp rates the interaction as moderate. Apalutamide and Zafirlukast 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 weak inducer of CYP2C9 and can lower the plasma concentration of zafirlukast, which is cleared mainly by CYP2C9. Reduced exposure may weaken control of asthma symptoms.
How serious is the interaction between Apalutamide and Zafirlukast?
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 asthma control and watch for loss of zafirlukast effect when apalutamide is started. Consider an alternative controller or dose reassessment if control worsens.
What other medicines interact with Zafirlukast?
MediHelp also lists interactions of Zafirlukast with, for example, Pimozide, Lomitapide, Nilotinib. The full list is on the Zafirlukast page.
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