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Drug Interactions between nilutamide and Xtandi

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

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Interactions between your drugs

Moderate

nilutamide enzalutamide

Applies to: nilutamide and Xtandi (enzalutamide)

MONITOR: Coadministration with enzalutamide may decrease the plasma concentrations of drugs that are substrates of CYP450 3A4, 2C9, 2C19, and/or P-glycoprotein (P-gp) efflux transporter. The proposed mechanism involves accelerated clearance via these routes due to enzalutamide-mediated induction. The resulting plasma concentrations will depend on the sensitivity of the affected drugs to these isoenzymes.

MANAGEMENT: Caution is advised when enzalutamide is used concomitantly with drugs that are substrates of CYP450 3A4, 2C9, 2C19, and/or P-gp, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever enzalutamide is added to or withdrawn from therapy.

References (4)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. (2012) "Product Information. Xtandi (enzalutamide)." Astellas Pharma US, Inc
  4. Benoist G, van Oort I, et al. (2017) "Drug-drug interaction potential in men treated with enzalutamide: Mind the gap." Br J Clin Pharmacol, epub

Drug and food interactions

Moderate

nilutamide food

Applies to: nilutamide

GENERALLY AVOID: Alcohol intolerance has been reported in 5% to 20% of patients following administration of nilutamide in clinical studies. Symptoms include facial flushes, malaise, and hypotension.

MANAGEMENT: Consumption of alcoholic beverages should be avoided in patients who experience alcohol intolerance with nilutamide.

References (2)
  1. (2001) "Product Information. Nilandron (nilutamide)." Hoechst Marion Roussel
  2. Decensi A, Guarneri D, Paoletti MC, Lalanne JM, Merlo F, Boccardo F (1991) "Phase II study of the pure non-steroidal antiandrogen nilutamide in prostatic cancer. Italian Prostatic Cancer Project (PONCAP)." Eur J Cancer, 27, p. 1100-4

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:

  • nilutamide
  • Xtandi (enzalutamide)

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