Enzalutamide and Abiraterone: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Enzalutamide
Abiraterone
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased enzalutamide exposure and reduced abiraterone exposure
Interaction Deep Dive
Concurrent use of enzalutamide, a CYP2C8 substrate, with a strong CYP2C8 inhibitor (eg, abiraterone) should be avoided, as it may increase enzalutamide exposure4. Additionally, concurrent use of abiraterone, a CYP3A4 substrate, with a strong CYP3A4 inducer (eg, enzalutamide) should be avoided if possible, as it may reduce abiraterone exposure 3. If concurrent use cannot be avoided, increase the abiraterone dosing frequency to twice daily 21 and reduce the enzalutamide dose to 80 mg once daily during the period of coadministration. If concurrent abiraterone is discontinued, resume the enzalutamide dose used prior to coadministration 4; if concurrent enzalutamide is discontinued, reduce the abiraterone to the previous dose and frequency 21.
Why it happens (mechanism)
Inhibition of CYP2C8-mediated enzalutamide metabolism by abiraterone; induction of CYP3A4-mediated abiraterone metabolism by enzalutamide
Literature reports
2 reports — tap to read
a) Coadministration of multiple oral doses of another strong CYP2C8 inhibitor, gemfibrozil (600 mg twice a day), with a single 160 mg-dose of enzalutamide to healthy volunteers increased the composite AUC of enzalutamide and the major active metabolite, N-desmethyl enzalutamide, by 2.2-fold with minimal effect on Cmax 4.
b) While the concomitant use of abiraterone and enzalutamide has not been studied, administration of another strong CYP3A4 inducer, rifAMPin (600 mg/day for 6 days), followed by a single 1000-mg dose of abiraterone decreased the mean AUC of abiraterone by 55% 21.
Common questions
Can I take Enzalutamide and Abiraterone together?
Increased enzalutamide exposure and reduced abiraterone exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Enzalutamide and Abiraterone interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Enzalutamide or Abiraterone need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (4)
- Product Information: ZYTIGA(R) oral tablets, abiraterone acetate oral tablets. Janssen Biotech Inc (per FDA), Horsham, PA, 2018. DailyMed
- Product Information: YONSA(R) oral tablets, abiraterone acetate oral tablets. Sun Pharmaceutical Industries Inc (per FDA), Cranbury, NJ, 2018. DailyMed
- Product Information: AKEEGA(TM) oral tablets, niraparib, abiraterone acetate oral tablets. Janssen Biotech, Inc. (per FDA), Horsham, PA, 2023. DailyMed
- Product Information: XTANDI(R) oral capsules, enzalutamide oral capsules. Astellas Pharma US, Inc. (per FDA), Northbrook, IL, 2012. DailyMed
Keep reading about Enzalutamide
Keep reading about Abiraterone
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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