Drug interactions
Enzalutamide + Methadone
Severity: Major
Enzalutamide and Methadone: 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 can reduce methadone exposure, which may lead to withdrawal or reduced analgesia. The induction persists for weeks after enzalutamide is stopped.
What this interaction means in plain words
Enzalutamide and Methadone 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; Methadone belongs to Musculoskeletal.
Why it happens
Induction of CYP3A4 (and possibly CYP2B6) by enzalutamide increases methadone metabolism.
What to do
Monitor for withdrawal and loss of effect and titrate methadone as needed. When enzalutamide is discontinued, reassess methadone dose and monitor for sedation.
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 Methadone
- Alvimopan + Methadone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Methadone Contraindicated
- Droperidol + Methadone Contraindicated
- Ibutilide + Methadone Contraindicated
- Isocarboxazid + Methadone Contraindicated
- Lefamulin + Methadone 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 Methadone?
MediHelp rates the interaction as major. Enzalutamide and Methadone 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 can reduce methadone exposure, which may lead to withdrawal or reduced analgesia. The induction persists for weeks after enzalutamide is stopped.
How serious is the interaction between Enzalutamide and Methadone?
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 for withdrawal and loss of effect and titrate methadone as needed. When enzalutamide is discontinued, reassess methadone dose and monitor for sedation.
What other medicines interact with Methadone?
MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone page.
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