Drug Interaction Report

MONITOR: Imaging results with flotufolastat or piflufolastat may be affected by coadministration of androgen deprivation therapy (ADT) or other therapies targeting the androgen pathway. Flotufolastat and piflufolastat are prostate specific membrane antigen (PSMA)-targeted positron emission tomography (PET) imaging agents that visualize the presence of PSMA in tissues. PSMA is usually overexpressed in malignant prostate cancer cells. Cellular PSMA expression is regulated by the androgen receptor, and therefore drugs that affect the androgen pathway may also affect PSMA expression. However, the impact on imaging results from concomitant use of these therapies with flotufolastat or piflufolastat has not been established.

MANAGEMENT: Caution is recommended when interpreting flotufolastat or piflufolastat PSMA-targeted PET results in men receiving ADT or other therapies targeting the androgen pathway. Clinical correlation, such as histopathological evaluation of the suspected prostate cancer site may be needed if an imaging error is suspected.

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.