Drug interactions
Enzalutamide + Sunitinib
Severity: Major
Enzalutamide and Sunitinib: major interaction.
Last updated Sources: Health Canada product monograph
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
Sunitinib and its active metabolite are cleared by CYP3A4, and strong inducers reduce their exposure. This may reduce efficacy.
What this interaction means in plain words
Enzalutamide and Sunitinib 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; Sunitinib belongs to Oncology.
Why it happens
Enzalutamide induces CYP3A4, increasing sunitinib metabolism.
What to do
Avoid if possible. If it is unavoidable, labeling allows a stepwise sunitinib dose increase with monitoring, and the dose should be reduced after enzalutamide is stopped.
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 Sunitinib
- Adagrasib + Sunitinib Major
- Amiodarone + Sunitinib Major
- Amisulpride + Sunitinib Major
- Anagrelide + Sunitinib Major
- Apalutamide + Sunitinib Major
- Arsenic trioxide + Sunitinib Major
Frequently asked questions
Can I take Enzalutamide with Sunitinib?
MediHelp rates the interaction as major. Enzalutamide and Sunitinib 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. Sunitinib and its active metabolite are cleared by CYP3A4, and strong inducers reduce their exposure. This may reduce efficacy.
How serious is the interaction between Enzalutamide and Sunitinib?
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 if possible. If it is unavoidable, labeling allows a stepwise sunitinib dose increase with monitoring, and the dose should be reduced after enzalutamide is stopped.
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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