Drug interactions
Enzalutamide + Nelfinavir
Severity: Major
Enzalutamide and Nelfinavir: 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, as a strong CYP3A4 inducer, can reduce nelfinavir exposure, risking virologic failure and resistance. Nelfinavir may also modestly raise enzalutamide levels.
What this interaction means in plain words
Enzalutamide and Nelfinavir 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; Nelfinavir belongs to Anti Virals.
Why it happens
CYP3A4 induction by enzalutamide increases nelfinavir metabolism.
What to do
Avoid the combination and choose an alternative antiretroviral. Monitor HIV RNA if unavoidable.
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
Other interactions of Nelfinavir
- Alfuzosin + Nelfinavir Contraindicated
- Avanafil + Nelfinavir Contraindicated
- Dronedarone + Nelfinavir Contraindicated
- Eletriptan + Nelfinavir Contraindicated
- Ergotamine + Nelfinavir Contraindicated
- Flibanserin + Nelfinavir Contraindicated
Frequently asked questions
Can I take Enzalutamide with Nelfinavir?
MediHelp rates the interaction as major. Enzalutamide and Nelfinavir 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, as a strong CYP3A4 inducer, can reduce nelfinavir exposure, risking virologic failure and resistance. Nelfinavir may also modestly raise enzalutamide levels.
How serious is the interaction between Enzalutamide and Nelfinavir?
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 the combination and choose an alternative antiretroviral. Monitor HIV RNA if unavoidable.
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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