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NOTICE OF POTENTIAL DRUG-DRUG INTERACTIONS


        This form must be completed by the prescribing physician and the patient should present it to all other healthcare providers involved in their care.
        Patient Name:                                                         Prostate Cancer Diagnosis
                                                                                 Metastatic hormone-sensitive prostate cancer
        Urology/Oncology Provider
                                                                                 Non-metastatic castration-resistant prostate cancer
        Name:                                    Phone: (   )                    Metastatic castration-resistant prostate cancer
        Family Physician
                                                                              New Drug Prescribed
        Name:                                    Phone: (   )
                                                                                 abiraterone acetate (with prednisone)
        Other Healthcare Professional                                            apalutamide
                                                                                 darolutamide
        Name:                                    Phone: (   )
                                                                                 enzalutamide
        For Patients and their Healthcare Professionals,
        The patient above has been prescribed an androgen deprivation therapy 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 m
        •  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
                                           Escitalopram   1  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.
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                                                                                                         Continued on reverse
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