Drug interactions
Enzalutamide + Ifosfamide
Severity: Moderate
Enzalutamide and Ifosfamide: 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
Enzalutamide is a strong CYP3A4 inducer and can speed up the hepatic conversion of ifosfamide. This may raise formation of both the active alkylating metabolites and the neurotoxic and nephrotoxic metabolite chloroacetaldehyde, increasing the risk of encephalopathy and kidney injury.
What this interaction means in plain words
Enzalutamide and Ifosfamide 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.
Enzalutamide belongs to Endocrine; Ifosfamide belongs to Oncology.
Why it happens
Induction of CYP3A4 (and CYP2B6) by enzalutamide increases ifosfamide bioactivation and N-dechloroethylation to chloroacetaldehyde.
What to do
Monitor for neurotoxicity, renal function and myelosuppression during ifosfamide cycles. Consider an alternative to enzalutamide or reassess ifosfamide dosing if toxicity appears.
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 Enzalutamide
- Doravirine + Enzalutamide Contraindicated
- Elbasvir / grazoprevir + Enzalutamide Contraindicated
- Ensitrelvir + Enzalutamide Contraindicated
- Enzalutamide + Fostemsavir Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
- Enzalutamide + Lenacapavir Contraindicated
Other interactions of Ifosfamide
- Adenovirus types 4 and 7 live + Ifosfamide Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine live Contraindicated
- Ifosfamide + Measles mumps rubella and varicella vaccine live Contraindicated
- Ifosfamide + Measles vaccine Contraindicated
- Ifosfamide + Rotavirus oral vaccine live Contraindicated
Frequently asked questions
Can I take Enzalutamide with Ifosfamide?
MediHelp rates the interaction as moderate. Enzalutamide and Ifosfamide 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. Enzalutamide is a strong CYP3A4 inducer and can speed up the hepatic conversion of ifosfamide. This may raise formation of both the active alkylating metabolites and the neurotoxic and nephrotoxic metabolite chloroacetaldehyde, increasing the risk of encephalopathy and kidney injury.
How serious is the interaction between Enzalutamide and Ifosfamide?
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 for neurotoxicity, renal function and myelosuppression during ifosfamide cycles. Consider an alternative to enzalutamide or reassess ifosfamide dosing if toxicity appears.
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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