Enzalutamide with Nevirapine Interaction Details


Brand Names Associated with Enzalutamide

  • Enzalutamide
  • Xtandi®

Brand Names Associated with Nevirapine

  • Nevirapine
  • Viramune®
  • Viramune® XR

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Last updated Dec 20, 2023


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Interaction Effect

Decreased enzalutamide plasma concentrations; decreased nevirapine plasma concentrations


Interaction Summary

Although no formal studies have been conducted between nevirapine and enzalutamide, nevirapine is a moderate CYP3A inducer, enzalutamide is strong CYP3A4 inducer , and both are CYP3A substrates. Coadministration of nevirapine and drugs that strongly induce CYP3A4 metabolism, such as enzalutamide, may decrease nevirapine plasma concentrations and reduce its therapeutic effect . Furthermore, nevirapine may induce the CYP3A metabolism of enzalutamide resulting in decreased concentrations of enzalutamide, and should be avoided if possible .


Severity

Major


Onset

Unspecified


Evidence

Theoretical


How To Manage Interaction

Coadministration of nevirapine with enzalutamide may decrease the plasma exposure of either drug. Avoid coadministration of enzalutamide with moderate CYP3A4 inducers, if possible, by selecting an alternate concomitant medication with no or minimal CYP3A4 induction .


Mechanism Of Interaction

Induction of CYP3A-mediated enzalutamide metabolism by nevirapine; induction of CYP3A4-mediated nevirapine metabolism by enzalutamide

Enzalutamide Overview

  • Enzalutamide is used to treat prostate cancer that has spread to other parts of the body in men and who have been helped by certain medical and surgical treatments that decrease testosterone levels. It is also used to treat prostate cancer in men who have not been helped by certain medical and surgical treatments that decrease testosterone levels. Enzalutamide is in a class of medications called androgen receptor inhibitors. It works by blocking the effects of androgen (a male reproductive hormone) to stop the growth and spread of cancer cells.

See More information Regarding Enzalutamide

Nevirapine Overview

  • Nevirapine is used along with other medications to treat human immunodeficiency virus (HIV) infection in adults and children 15 days of age and older. Nevirapine should not be used to treat healthcare workers or other individuals exposed to HIV infection after contact with HIV-contaminated blood, tissues, or other body fluids. Nevirapine is in a class of medications called non-nucleoside reverse transcriptase inhibitors (NNRTIs). It works by decreasing the amount of HIV in the blood. Although nevirapine does not cure HIV, it may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer. Taking these medications along with practicing safer sex and making other life-style changes may decrease the risk of transmitting (spreading) the HIV virus to other people.

See More information Regarding Nevirapine

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.


Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.


Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.


Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.


Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.


Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.


How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.


Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.


Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.