Drug interactions
Enzalutamide + Eplerenone
Severity: Major
Enzalutamide and Eplerenone: 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
Enzalutamide is a strong CYP3A4 inducer and is expected to lower eplerenone concentrations considerably. This may result in reduced antihypertensive or heart failure efficacy.
What this interaction means in plain words
Enzalutamide and Eplerenone 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.
Enzalutamide belongs to Endocrine; Eplerenone belongs to Cardiovascular.
Why it happens
Enzalutamide induces CYP3A4, increasing the metabolism of eplerenone and lowering its exposure.
What to do
Avoid the combination where possible and use an alternative agent. If coadministered, monitor blood pressure, potassium and clinical response and adjust the eplerenone dose.
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 Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Other interactions of Enzalutamide
- Doravirine + Enzalutamide Contraindicated
- Elbasvir / grazoprevir + Enzalutamide Contraindicated
- Ensitrelvir + Enzalutamide Contraindicated
- Enzalutamide + Fostemsavir Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
- Enzalutamide + Lenacapavir Contraindicated
Frequently asked questions
Can I take Enzalutamide with Eplerenone?
MediHelp rates the interaction as major. Enzalutamide and Eplerenone 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. Enzalutamide is a strong CYP3A4 inducer and is expected to lower eplerenone concentrations considerably. This may result in reduced antihypertensive or heart failure efficacy.
How serious is the interaction between Enzalutamide and Eplerenone?
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 where possible and use an alternative agent. If coadministered, monitor blood pressure, potassium and clinical response and adjust the eplerenone dose.
What other medicines interact with Eplerenone?
MediHelp also lists interactions of Eplerenone with, for example, Amiloride, Atazanavir, Clarithromycin. The full list is on the Eplerenone page.
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