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Drug Interactions between apalutamide and exemestane

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

exemestane apalutamide

Applies to: exemestane and apalutamide

ADJUST DOSE: Coadministration with potent inducers of CYP450 3A4 may significantly decrease the plasma concentrations of exemestane, which is primarily metabolized by the isoenzyme. In 10 healthy postmenopausal volunteers, administration of exemestane (25 mg single dose) following pretreatment with the potent inducer rifampin (600 mg daily for 14 days) resulted in a 41% decrease in exemestane peak plasma concentration (Cmax) and a 54% decrease in exemestane systemic exposure (AUC).

MANAGEMENT: The manufacturer recommends increasing the dosage of exemestane to 50 mg once daily when used with potent CYP450 3A4 inducers such as carbamazepine, enzalutamide, lumacaftor, mitotane, phenobarbital, phenytoin, primidone (partially metabolized to phenobarbital), rifamycins, and St. John's wort. However, it has also been suggested that suppression of estrogen levels is not affected by the interaction, thus dosage adjustment of exemestane is not required. The extent to which other, less potent CYP450 3A4 inducers may interact with exemestane is unknown. Caution is advised if they are used with exemestane.

References (1)
  1. (2001) "Product Information. Aromasin (exemestane)." Pharmacia and Upjohn

Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Antineoplastic hormones

Therapeutic duplication

The recommended maximum number of medicines in the 'antineoplastic hormones' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antineoplastic hormones' category:

  • apalutamide
  • exemestane

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer