Compatibility «Romiclar» and «Xtandi»

• Interactions Romiclar with Xtandi

  • Dangerous interactions
    • ⓘ If possible, the combined use of CYP3A4 inducers (e.g. carbamazepine, phenobarbital, phenytoin, rifabutin, rifampicin, rifapentin) with enzalutamide should be avoided.
    • ⓘ The combined use of enzalutamide with drugs with a narrow therapeutic index that are metabolized by CYP3A4 (e.g. alfentanil, cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus and tacrolimus), CYP2C9 (e.g. phenytoin, warfarin) and CYP2C19 (e.g. S-mephenytoin), etc. should be avoided; Enzalutamide may reduce their exposure.
  • Negative interactions
    • ⓘ After taking a strong inhibitor of the CYP3A4 enzyme itraconazole (200 mg 1 time per day) in healthy volunteers, the AUC of enzalutamide increased by 41%, while the C_max did not change.
    • ⓘ The combined use of enzalutamide (160 mg 1 time per day) in patients with prostate cancer led to an 86% decrease in the AUC of midazolam (CYP3A4 substrate), a 56% decrease in the AUC of S-warfarin (CYP2C9 substrate) and a 70% decrease in the AUC of omeprazole (CYP2C19 substrate).
    • ⓘ In patients taking drugs that are substrates of the enzymes CYP2B6, CYP3A4, CYP2C9, CYP2C19 or UGT1A1, a possible decrease in pharmacological effects (or an increase in exposure in case of formation of active metabolites) during the first month of treatment with enzalutamide should be evaluated and the dose adjusted accordingly.
    • ⓘ The combined use of rifampicin (a strong CYP3A4 inducer and a moderate CYP2C8 inducer) reduces the compound AUC of enzalutamide and N-desmethylenzalutamide by 37%.
    • ⓘ If the combined use of a strong CYP3A4 inducer and enzalutamide cannot be avoided, the dose of enzalutamide should be increased.
  • No interactions
    • ⓘ When enzalutamide is co-administered with CYP3A4 inhibitors or inducers, dose adjustment is not required.
  • Unclear interactions
    • ⓘ Inhibitors and inducers of CYP3A4.
    • ⓘ The enzyme CYP3A4 plays a minor role in the metabolism of enzalutamide.
    • ⓘ In vivo studies have shown that enzalutamide is a strong inducer of CYP3A4 and a moderate inducer of CYP2C9 and CYP2C19.
    • ⓘ Drugs that can interact with enzalutamide include: analgesics (e.g. fentanyl, tramadol), antibiotics (e.g. clarithromycin, doxycycline), antitumor drugs (e.g. cabazitaxel), anticoagulants (e.g. acenocumarol, warfarin), antiepileptic drugs (e.g. carbamazepine, clonazepam, phenytoin, primidone, valproic acid), neuroleptics (for example haloperidol), beta-blockers (e.g. bisoprolol, propranolol), BCC (e.g. diltiazem, felodipine, nicardipine, nifedipine, verapamil), cardiac glycosides (e.g. digoxin), GCS (e.g. dexamethasone, prednisolone), antiviral drugs for the treatment of HIV infection (e.g. indinavir, ritonavir), hypnotic drugs (e.g. diazepam, midazolam, zolpidem), statins metabolized with the participation of the enzyme CYP3A4 (e.g. atorvastatin, simvastatin), thyroid drugs (e.g. levothyroxine).
    • ⓘ Drugs are CYP3A4 inducers.
    • ⓘ Enzalutamide is a strong inducer of CYP3A4 and a moderate inducer of CYP2C9 and CYP2C19 in humans.
    • ⓘ At steady state, enzalutamide decreased plasma concentrations of midazolam (CYP3A4 substrate), warfarin (CYP2C9 substrate) and omeprazole (CYP2C19 substrate).

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 169,990,749 possible combinations of drugs and their components were found 412,526 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2024-11-07

Category - medicine