Drug interactions
Enzalutamide + Irinotecan liposomal
Severity: Major
Enzalutamide and Irinotecan liposomal: major interaction.
Last updated Sources: Health Canada product monograph
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
Strong CYP3A4 inducers speed the oxidative metabolism of irinotecan to inactive metabolites and reduce exposure to the active metabolite SN-38, which may reduce efficacy. The effect applies to liposomal irinotecan as well.
What this interaction means in plain words
Enzalutamide and Irinotecan liposomal 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, diverting irinotecan toward inactive oxidative metabolites and lowering SN-38 exposure.
What to do
Avoid strong inducers and substitute a non-inducing therapy at least 2 weeks before starting irinotecan if feasible. If used together, monitor tumor response.
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 Irinotecan liposomal?
MediHelp rates the interaction as major. Enzalutamide and Irinotecan liposomal 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. Strong CYP3A4 inducers speed the oxidative metabolism of irinotecan to inactive metabolites and reduce exposure to the active metabolite SN-38, which may reduce efficacy. The effect applies to liposomal irinotecan as well.
How serious is the interaction between Enzalutamide and Irinotecan liposomal?
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 strong inducers and substitute a non-inducing therapy at least 2 weeks before starting irinotecan if feasible. If used together, monitor tumor response.
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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