Drug interactions
Enzalutamide + Fentanyl transmucosal
Severity: Major
Enzalutamide and Fentanyl transmucosal: major interaction.
Last updated Sources: EMA SmPC
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 strongly induces CYP3A4, the main route of fentanyl clearance, so fentanyl levels may drop, causing reduced breakthrough pain relief or withdrawal in dependent patients. After enzalutamide is stopped, fentanyl exposure may rise and cause respiratory depression.
What this interaction means in plain words
Enzalutamide and Fentanyl transmucosal 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.
Why it happens
Enzalutamide induces CYP3A4, accelerating fentanyl metabolism.
What to do
Monitor analgesic response and withdrawal signs and retitrate the transmucosal dose as needed. When enzalutamide is stopped, reduce the fentanyl dose and monitor for respiratory depression.
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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References
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 Fentanyl transmucosal?
MediHelp rates the interaction as major. Enzalutamide and Fentanyl transmucosal 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 strongly induces CYP3A4, the main route of fentanyl clearance, so fentanyl levels may drop, causing reduced breakthrough pain relief or withdrawal in dependent patients. After enzalutamide is stopped, fentanyl exposure may rise and cause respiratory depression.
How serious is the interaction between Enzalutamide and Fentanyl transmucosal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor analgesic response and withdrawal signs and retitrate the transmucosal dose as needed. When enzalutamide is stopped, reduce the fentanyl dose and monitor for respiratory depression.
What other medicines interact with Enzalutamide?
MediHelp also lists interactions of Enzalutamide with, for example, Doravirine, Elbasvir / grazoprevir, Ensitrelvir. The full list is on the Enzalutamide page.
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