Drug Interactions

Caution - decreased level of tramacet due to 3A4 induction. Monitor for efficacy - higher doses than anticipated may be required. Additive risk of QT prolongation. Baseline EKG if risk factors present (ie. older age, female, electrolyte abnormalities, low HR, cardiac comorbidities, etc). Consider choosing alternative agent

Avoid combinaton - decreased level of trazodone due to 3A4 induction. Also additive risk of QT prolongation. Choose an alternative agent.

No clinically significant drug interactions identified.

Caution - additive risk of QT prolongation. Baseline EKG if risk factors present (ie. older age, female, electrolyte abnormalities, low HR, cardiac comorbidities, etc). Consider choosing an alternative agent.

Avoid combinaton - decreased level of verapamil due to 3A4 induction. Potential increased apalutamide toxicity due to 3A4 inhibition. Choose an alternative agent.

Caution - decreased level of warfarin due to 2C9 (major) induction and 2C19/3A4 induction. Monitor INR more closely after initiation of apalutamide therapy or dose changes. Titrate warfarin dose to target INR.

Caution - decreased level of zopiclone due to 3A4 induction. Monitor for efficacy - higher doses than anticipated may be required. Consider choosing an alternative agent.