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NOTICE OF POTENTIAL DRUG-DRUG INTERACTIONS

Prostate Cancer Diagnosis
Patient Name:
Metastatic hormone-sensitive prostate cancer
Urology/Oncology Provider Non-metastatic castration-resistant prostate cancer
Metastatic castration-resistant prostate cancer
Name: Phone: ( )
Family Physician New Drug Prescribed
Name: Phone: ( ) abiraterone acetate (with prednisone)
apalutamide
Other Healthcare Professional darolutamide
Name: Phone: ( ) enzalutamide
For Patients and their Healthcare Professionals,
The patient above has been prescribed a drug therapy for prostate cancer, and there is a potential for drug-drug interactions with medication(s) the patient is
currently taking, flagged below.
• Note the flagged medications and possible impact on drug effects (see both sides of this page)
• Contact the urology/oncology provider should there be concerns about drug therapy
• Patients should use one pharmacy only, and always carry a list of current medications
• Consider potential drug interactions with future treatment modifications, natural health products, and complementary or alternative medicines
The following tables include medications more commonly encountered in patients undergoing treatment for prostate cancer; these tables are not comprehensive.

Abiraterone acetate
Drug effects Drug effects Abiraterone effects Abiraterone effects
Monitor/Modify: Monitor/Modify: Avoid combination:
Amitriptyline 1 Metoprolol 1 Codeine 1 Carbamazepine 2
Aripiprazole 1 Nortriptyline 1 Tramadol a,1 Phenobarbital 2
Brexpiprazole 1 Paroxetine 1 Phenytoin 2
Carvedilol 1 Pioglitazone 1,2
Clomipramine 1 Propranolol 1 Monitor/Modify:
1
Clozapine 1 Repaglinide 1,2 Primidone 1
Desipramine 1 Risperidone 1 Spironolactone
Haloperidol 1 Tamsulosin 1
Imipramine 1
a. Abiraterone acetate may decrease serum concentrations of tramadol active metabolite(s) and increase tramadol serum concentrations; monitor for decreased opioid effects.
Apalutamide

Drug effects Drug effects Apalutamide effects Apalutamide effects
Monitor/Modify: Avoid combination: Monitor/Modify Monitor/Modify Monitor/Modify:
Clopidogrel 1 Apixaban 1 cont.: cont.: Clarithromycin a,1
Dabigatran 1 Clarithromycin a,1 Oxycodone 1 Gemfibrozil 1,3
Dronedarone 1 Clonazepam 1 Perampanel 1 Ketoconazole b,3
Esomeprazole 1 Clozapine 1 Phenytoin 1
Itraconazole 1 Codeine 1 Prednisone 1
Lansoprazole 1 Cyclosporine 1 Quetiapine 1
Lurasidone 1 Darifenacin 1 Repaglinide 1
Nifedipine 1 Dexamethasone 1 Risperidone 1
Nimodipine 1 Diazepam 1 Rosuvastatin 1,3
Omeprazole 1,3 Digoxin 1 Saxagliptin 1
Rivaroxaban 1 Diltiazem 1 Sertraline 1
Ticagrelor 1 Doxazosin 1 Sildenafil 1
Vorapaxar 1 Erythromycin 1 Silodosin 1
1
Escitalopram Simvastatin 1
Monitor/Modify: Ethosuximide Solifenacin 1
Alfuzosin 1 Felodipine 1 Tadalafil 1
Alprazolam 1 Fentanyl 1 Tamsulosin 1
Amiodarone 1 Fesoterodine 1 Tramadol 1
Amlodipine 1 Flurazepam 1 Trazodone 1
Aripiprazole 1 Haloperidol 1 Triazolam 1
Atorvastatin 1 Ketoconazole b,1 Verapamil 1
Bisoprolol 1 Linagliptin 1 Voriconazole 1
Brexpiprazole 1 Losartan 1 Warfarin 1,3
Carbamazepine 1 Lovastatin 1 Zolpidem 1
Chlordiazepoxide 1 Methadone 1 Zopiclone 1
Citalopram 1 Oxcarbazepine 1
a. Apalutamide may increase serum concentrations of clarithromycin active metabolite(s) and decrease clarithromycin concentration. Clarithromycin may increase apalutamide concentration.
Consider therapy modification. 1
b. Apalutamide may decrease serum concentration of ketoconazole. Ketoconazole may increase concentration of apalutamide. Consider therapy modification.
1,3
1
3
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