Drug interactions
Apalutamide + Zuranolone
Severity: Major
Apalutamide and Zuranolone: 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, a strong CYP3A4 inducer, is expected to reduce zuranolone concentrations markedly. This may result in loss of antidepressant efficacy in postpartum depression.
What this interaction means in plain words
Apalutamide and Zuranolone 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; Zuranolone belongs to Central Nervous System.
Why it happens
Apalutamide induces CYP3A4, accelerating zuranolone metabolism.
What to do
Avoid concurrent use; zuranolone labeling advises against strong CYP3A4 inducers. Consider an alternative treatment if apalutamide cannot be stopped.
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 Zuranolone
Frequently asked questions
Can I take Apalutamide with Zuranolone?
MediHelp rates the interaction as major. Apalutamide and Zuranolone 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, a strong CYP3A4 inducer, is expected to reduce zuranolone concentrations markedly. This may result in loss of antidepressant efficacy in postpartum depression.
How serious is the interaction between Apalutamide and Zuranolone?
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 concurrent use; zuranolone labeling advises against strong CYP3A4 inducers. Consider an alternative treatment if apalutamide cannot be stopped.
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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