Erleada (apalutamide) is a prescription oral tablet used to treat certain types of prostate cancer in adults. Erleada can interact with other medications and certain foods. For example, it can interact with atorvastatin (Lipitor) and grapefruit.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Erleada’s possible interactions. And for more information about Erleada, including details about its uses, see this article.
There is no known interaction between Erleada and alcohol. However, Erleada and alcohol can cause some of the same side effects. Examples include diarrhea, fatigue, and nausea. Combining Erleada and alcohol may raise your risk of these side effects or make them more severe.
If you drink alcohol, talk with your doctor about how much (if any) may be safe to consume with Erleada. They may recommend that you limit or avoid alcohol while you take Erleada.
Before you start taking Erleada, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Erleada interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Erleada?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Erleada. Keep in mind that this table does not include all drugs that may interact with Erleada. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
| drugs that decrease the action of certain enzymes | • ketoconazole • clarithromycin • gemfibrozil (Lopid) • ritonavir (Norvir) | can increase the risk of side effects of Erleada |
| drugs that get broken down by certain enzymes | • warfarin (Jantoven) • diazepam (Valium) • simvastatin (Zocor) • omeprazole (Prilosec) | can make the drug broken down by certain enzymes less effective |
| drugs that are transported by certain proteins | • rosuvastatin (Crestor) • digoxin (Lanoxin) • dabigatran (Pradaxa) • fexofenadine (Allegra Allergy) | can make the drug transported by certain proteins less effective |
Learn more about certain drug interactions that can occur with Erleada.
Interaction with drugs that affect certain enzymes in your body
Erleada interacts with drugs that affect certain enzymes (proteins) in your body.
Specifically, Erleada interacts with medications that decrease the activity of the CYP2C8 and CYP3A4 enzymes. Examples include:
- ketoconazole
- verapamil (Verelan)
- gemfibrozil (Lopid)
- clarithromycin
- itraconazole (Sporanox, Tolsura)
What could happen
After you take a dose of Erleada, CYP2C8 and CYP3A4 help break down and remove Erleada from your body. If you take Erleada with a drug that slows the activity of these enzymes, your body may not break down Erleada as quickly. This can increase the level of Erleada in your body, which raises your risk of side effects from the drug.
What you can do
If you take Erleada with a drug that slows the activity of these enzymes, your doctor will closely monitor you for side effects during your treatment. They may decrease your dosage of Erleada if you experience side effects. Or they may adjust your dosage of the other drug or have you stop taking it and switch to another treatment.
Interaction with drugs affected by certain proteins in your body
Erleada interacts with drugs affected by certain proteins in your body. Examples of these drugs include:
- warfarin (Jantoven)
- midazolam
- omeprazole (Prilosec OTC)
- cyclosporine (Gengraf, Neoral)
- quinidine
What could happen
With many medications, after you take a dose, your body uses special proteins to break down the drug.
Erleada speeds up the activity of these proteins. This can lower the level of the other drug in your body, which can make it less effective.
What you can do
Before you begin treatment with Erleada, tell your doctor and pharmacist about all medications you take. They can check to see whether any have this interaction with Erleada.
Depending on the possible interaction, your doctor may increase your dosage of other medication, or they may suggest an alternative to Erleada or the other drug.
Erleada may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Erleada.
Does Erleada interact with supplements?
Before you start taking Erleada, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Erleada and herbs
There are currently no reports of Erleada interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Erleada.
Erleada and vitamins
There are currently no reports of Erleada interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Erleada.
Does Erleada interact with food?
Erleada interacts with grapefruit and grapefruit juice.
Grapefruit blocks the activity of an enzyme (protein) in your body called CYP3A4. This enzyme helps break down Erleada and remove it from your body after you take a dose.
Consuming grapefruit or grapefruit juice while taking Erleada can prevent your body from breaking down Erleada properly. This could raise your risk of side effects from the drug.
Due to this interaction, your doctor may suggest that you do not consume grapefruit or grapefruit juice during your Erleada treatment.
If you have any questions about this interaction, talk with your doctor or pharmacist.
Does Erleada interact with vaccines?
Erleada isn’t known to interact with any vaccines.
If you have questions about receiving specific vaccines while taking Erleada, talk with your doctor.
Does Erleada interact with lab tests?
Erleada isn’t known to interact with any lab tests.
If you have questions about having any lab tests done while taking Erleada, talk with your doctor.
Does Erleada interact with cannabis or CBD?There are currently no reports of Erleada interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Erleada.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Erleada. Before taking Erleada, talk with your doctor about your health history. They’ll determine whether Erleada is right for you.
Health conditions or other factors that might interact with Erleada include:
High blood pressure or heart disease. Having high blood pressure or heart disease raises your risk of serious side effects from Erleada, including heart attack and stroke. Talk with your doctor to learn more about whether Erleada is safe for you to take.
High level of cholesterol or other fats in your blood. Having a high level of cholesterol or high levels of other fats (such as triglycerides) in your blood raises your risk of serious side effects from Erleada, including heart attack and stroke. Talk with your doctor about whether Erleada is right for you.
Seizure, stroke, or a brain injury or tumor. In rare cases, people taking Erleada in studies had a seizure. People with a history of seizures, stroke, brain injury, or tumors were not included in these studies. It’s not known whether people with these health factors have a higher risk of experiencing a seizure with Erleada. Your doctor can determine whether Erleada is safe for you to take.
Diabetes. Having type 1 or type 2 diabetes raises your risk of serious side effects from Erleada, including heart attack and stroke. Your doctor can determine whether Erleada is safe for you to take.
History of falls, bone fractures, or weak bones. If you have a history of falls, bone fractures (broken bones), or weak bones, talk with your doctor. Taking Erleada can increase your risk of falls and fractures. Your doctor can determine whether Erleada is safe for you.
Pregnancy. Erleada is not prescribed for females and is not safe to take during pregnancy. The drug could cause fetal harm or pregnancy loss.
If you’re taking Erleada and you have a sexual partner who may become pregnant, you should use birth control (such as condoms) during your Erleada treatment and for at least 3 months after your last dose.
Note: In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Breastfeeding. Erleada is not prescribed for females, and its use while breastfeeding hasn’t been studied. Because of this, Erleada should not be taken while breastfeeding.
Allergic reaction. If you’ve had an allergic reaction to Erleada or any of its ingredients, your doctor will likely not prescribe Erleada. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Taking certain steps can help you avoid interactions with Erleada. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Whether you drink alcohol or use cannabis.
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list . - What to do if you start taking a new drug during your Erleada treatment.
It’s also important to understand Erleada’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Erleada exactly as prescribed can also help prevent interactions.
If you still have questions about Erleada and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- If I’m prescribed a new drug while taking Erleada, can you check whether they interact?
- Should I let you know if I change my diet or other habits while taking Erleada?
- Do other drugs that treat prostate cancer have similar interactions to Erleada?
- If I take Erleada and have certain health conditions, will I be monitored more closely during treatment?
To learn more about Erleada, see these articles:
To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.