Drug interactions
Enzalutamide + Indinavir
Severity: Major
Enzalutamide and Indinavir: 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 induces CYP3A4 and can substantially lower indinavir concentrations, risking virologic failure and resistance. Indinavir, a CYP3A4 inhibitor, may increase enzalutamide exposure and its dose-related adverse effects.
What this interaction means in plain words
Enzalutamide and Indinavir 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-mediated indinavir metabolism, while indinavir inhibits CYP3A4 metabolism of enzalutamide.
What to do
Avoid coadministration and choose an antiretroviral regimen without CYP3A4 dependence. If it cannot be avoided, monitor HIV viral load and enzalutamide toxicity, and reduce the enzalutamide dose as labeling advises for strong inhibitors.
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 Indinavir?
MediHelp rates the interaction as major. Enzalutamide and Indinavir 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 induces CYP3A4 and can substantially lower indinavir concentrations, risking virologic failure and resistance. Indinavir, a CYP3A4 inhibitor, may increase enzalutamide exposure and its dose-related adverse effects.
How serious is the interaction between Enzalutamide and Indinavir?
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 coadministration and choose an antiretroviral regimen without CYP3A4 dependence. If it cannot be avoided, monitor HIV viral load and enzalutamide toxicity, and reduce the enzalutamide dose as labeling advises for strong inhibitors.
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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