Drug interactions
Enzalutamide + Netupitant / palonosetron
Severity: Major
Enzalutamide and Netupitant / palonosetron: 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
Netupitant is cleared mainly by CYP3A4, and enzalutamide's strong induction of this enzyme can lower its concentrations. This may reduce protection against chemotherapy-induced nausea and vomiting.
What this interaction means in plain words
Enzalutamide and Netupitant / palonosetron 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, accelerating netupitant metabolism.
What to do
Avoid the fixed-dose combination in patients on chronic enzalutamide, and consider an antiemetic regimen not dependent on netupitant. Monitor for breakthrough nausea and vomiting if it is used.
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 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 Netupitant / palonosetron?
MediHelp rates the interaction as major. Enzalutamide and Netupitant / palonosetron 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. Netupitant is cleared mainly by CYP3A4, and enzalutamide's strong induction of this enzyme can lower its concentrations. This may reduce protection against chemotherapy-induced nausea and vomiting.
How serious is the interaction between Enzalutamide and Netupitant / palonosetron?
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 fixed-dose combination in patients on chronic enzalutamide, and consider an antiemetic regimen not dependent on netupitant. Monitor for breakthrough nausea and vomiting if it is used.
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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