Drug interactions
Enzalutamide + Saquinavir
Severity: Major
Enzalutamide and Saquinavir: 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
Saquinavir may raise enzalutamide levels through CYP3A4 inhibition, while enzalutamide can markedly lower saquinavir exposure through induction. Reduced saquinavir levels risk HIV virologic failure and resistance, and saquinavir also prolongs QT.
What this interaction means in plain words
Enzalutamide and Saquinavir 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 lowering saquinavir; saquinavir inhibits CYP3A4 modestly increasing enzalutamide.
What to do
Avoid the combination and use an antiretroviral regimen without reliance on boosted saquinavir. If unavoidable, monitor HIV viral load and ECG.
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 Saquinavir?
MediHelp rates the interaction as major. Enzalutamide and Saquinavir 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. Saquinavir may raise enzalutamide levels through CYP3A4 inhibition, while enzalutamide can markedly lower saquinavir exposure through induction. Reduced saquinavir levels risk HIV virologic failure and resistance, and saquinavir also prolongs QT.
How serious is the interaction between Enzalutamide and Saquinavir?
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 use an antiretroviral regimen without reliance on boosted saquinavir. If unavoidable, monitor HIV viral load and ECG.
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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