Managing Drug Interactions with Enzalutamide in Patients with Prostate Cancer: A Podcast

Enzalutamide is an oral androgen receptor signaling inhibitor used in the treatment of prostate cancer. Elderly patients with prostate cancer commonly have age-related comorbidities that require concomitant, active treatment. As a moderate inducer of the cytochrome P450 (CYP) enzymes CYP2C9 and CYP2C19, and a strong inducer of CYP3A4, there is potential for drug-drug interactions (DDIs) when enzalutamide is coadministered with other drugs that are CYP3A4 substrates-resulting in loss of efficacy or increased risk of unintended drug-related adverse events. In this podcast, we describe enzalutamide including its dosing, pharmacokinetics, and potential for interaction with coadministered drugs using several hypothetical patient cases with real-world clinical implications. Discussion of each patient case will highlight management strategies and illustrate that nearly all enzalutamide drug-drug interactions can be effectively managed with appropriate knowledge of which drugs pose interaction risks, when dose adjustments are indicated, and when alternative drugs can be substituted. Supplementary file1 (MP4 192541 KB).