Drug interactions
Enzalutamide + Olanzapine / samidorphan
Severity: Major
Enzalutamide and Olanzapine / samidorphan: 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
Strong CYP3A4 induction substantially lowers exposure to both olanzapine and samidorphan. This can lead to loss of antipsychotic control and reduced opioid antagonism.
What this interaction means in plain words
Enzalutamide and Olanzapine / samidorphan 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, increasing clearance of samidorphan and olanzapine.
What to do
Avoid concurrent use; consider an alternative antipsychotic. If used together, monitor for psychiatric relapse and weight effects.
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 Olanzapine / samidorphan?
MediHelp rates the interaction as major. Enzalutamide and Olanzapine / samidorphan 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 induction substantially lowers exposure to both olanzapine and samidorphan. This can lead to loss of antipsychotic control and reduced opioid antagonism.
How serious is the interaction between Enzalutamide and Olanzapine / samidorphan?
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 concurrent use; consider an alternative antipsychotic. If used together, monitor for psychiatric relapse and weight effects.
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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