Drug interactions
Enzalutamide + Zonisamide
Severity: Moderate
Enzalutamide and Zonisamide: moderate 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
Enzalutamide is a strong CYP3A4 inducer and may lower zonisamide concentrations, with a risk of breakthrough seizures. Seizure risk is also a recognized concern with enzalutamide itself.
What this interaction means in plain words
Enzalutamide and Zonisamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Enzalutamide belongs to Endocrine; Zonisamide belongs to Central Nervous System.
Why it happens
Induction of CYP3A4 by enzalutamide increases zonisamide metabolism.
What to do
Monitor seizure control and zonisamide levels, and increase the zonisamide dose if needed. Readjust when enzalutamide is stopped.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Zonisamide
- Zonisamide + Zuranolone Major
- Acetazolamide + Zonisamide Moderate
- Amisulpride + Zonisamide Moderate
- Amobarbital + Zonisamide Moderate
- Apalutamide + Zonisamide Moderate
- Asenapine transdermal + Zonisamide Moderate
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 Zonisamide?
MediHelp rates the interaction as moderate. Enzalutamide and Zonisamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Enzalutamide is a strong CYP3A4 inducer and may lower zonisamide concentrations, with a risk of breakthrough seizures. Seizure risk is also a recognized concern with enzalutamide itself.
How serious is the interaction between Enzalutamide and Zonisamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor seizure control and zonisamide levels, and increase the zonisamide dose if needed. Readjust when enzalutamide is stopped.
What other medicines interact with Zonisamide?
MediHelp also lists interactions of Zonisamide with, for example, Zuranolone, Acetazolamide, Amisulpride. The full list is on the Zonisamide page.
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