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Open Access 12-04-2024 | Enzalutamide | Review Article

Enzalutamide: Understanding and Managing Drug Interactions to Improve Patient Safety and Drug Efficacy

Authors: Brandon W. Lennep, Jesse Mack, Srinivasu Poondru, Elizabeth Hood, Brooke D. Looney, Monique Williams, Judeth J. Bianco, Alicia K. Morgans

Published in: Drug Safety

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Abstract

Enzalutamide is an oral androgen receptor signaling inhibitor utilized in the treatment of men with prostate cancer. It is a moderate inducer of the cytochrome P450 (CYP) enzymes CYP2C9 and CYP2C19, and a strong inducer of CYP3A4. It was also shown to be a mild inhibitor of the efflux transporter P-glycoprotein in patients with prostate cancer. Enzalutamide is primarily metabolized by CYP3A4 and CYP2C8. The risk of enzalutamide drug interactions arises primarily when it is coadministered with other drugs that interact with these CYPs, including CYP3A4. In this review, we begin by providing an overview of enzalutamide including its dosing, use in special populations, pharmacokinetics, changes to its prescribing information, and potential for interaction with coadministered drugs. Enzalutamide interactions with drugs from a wide range of medication classes commonly prescribed to patients with prostate cancer are described, including oral androgen deprivation therapy, agents used to treat a range of cardiovascular diseases, antidiabetic drugs, antidepressants, anti-seizure medications, common urology medications, analgesics, proton pump inhibitors, immunosuppressants, and antigout drugs. Enzalutamide interactions with common vitamins and supplements are also briefly discussed. This review provides a resource for healthcare practitioners and patients that will help provide a basis for the understanding and management of enzalutamide drug–drug interactions to inform decision making, improve patient safety, and optimize drug efficacy.
Literature
3.
go back to reference Chin HW, Kim J, Rasp G, Hristov B. Prostate cancer in seniors: part 1: epidemiology, pathology, and screening. Fed Pract. 2015;32(Suppl. 4):41S-44S.PubMedPubMedCentral Chin HW, Kim J, Rasp G, Hristov B. Prostate cancer in seniors: part 1: epidemiology, pathology, and screening. Fed Pract. 2015;32(Suppl. 4):41S-44S.PubMedPubMedCentral
36.
go back to reference Albermann N, Schmitz-Winnenthal FH, Z’Graggen K, Volk C, Hoffmann MM, Haefeli WE, Weiss J. Expression of the drug transporters MDR1/ABCB1, MRP1/ABCC1, MRP2/ABCC2, BCRP/ABCG2, and PXR in peripheral blood mononuclear cells and their relationship with the expression in intestine and liver. Biochem Pharmacol. 2005;70(6):949–58. https://doi.org/10.1016/j.bcp.2005.06.018.CrossRefPubMed Albermann N, Schmitz-Winnenthal FH, Z’Graggen K, Volk C, Hoffmann MM, Haefeli WE, Weiss J. Expression of the drug transporters MDR1/ABCB1, MRP1/ABCC1, MRP2/ABCC2, BCRP/ABCG2, and PXR in peripheral blood mononuclear cells and their relationship with the expression in intestine and liver. Biochem Pharmacol. 2005;70(6):949–58. https://​doi.​org/​10.​1016/​j.​bcp.​2005.​06.​018.CrossRefPubMed
37.
go back to reference Sternberg CN, de Bono JS, Chi KN, Fizazi K, Mulders P, Cerbone L, et al. Improved outcomes in elderly patients with metastatic castration-resistant prostate cancer treated with the androgen receptor inhibitor enzalutamide: results from the phase III AFFIRM trial. Ann Oncol. 2014;25(2):429–34. https://doi.org/10.1093/annonc/mdt571.CrossRefPubMed Sternberg CN, de Bono JS, Chi KN, Fizazi K, Mulders P, Cerbone L, et al. Improved outcomes in elderly patients with metastatic castration-resistant prostate cancer treated with the androgen receptor inhibitor enzalutamide: results from the phase III AFFIRM trial. Ann Oncol. 2014;25(2):429–34. https://​doi.​org/​10.​1093/​annonc/​mdt571.CrossRefPubMed
38.
48.
go back to reference Edwards BK, Noone AM, Mariotto AB, Simard EP, Boscoe FP, Henley SJ, et al. Annual Report to the Nation on the status of cancer, 1975–2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer. Cancer. 2014;120(9):1290–314. https://doi.org/10.1002/cncr.28509.CrossRefPubMed Edwards BK, Noone AM, Mariotto AB, Simard EP, Boscoe FP, Henley SJ, et al. Annual Report to the Nation on the status of cancer, 1975–2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer. Cancer. 2014;120(9):1290–314. https://​doi.​org/​10.​1002/​cncr.​28509.CrossRefPubMed
66.
go back to reference Smith SC Jr, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation. 2011;124(22):2458–73. https://doi.org/10.1161/CIR.0b013e318235eb4d.CrossRefPubMed Smith SC Jr, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation. 2011;124(22):2458–73. https://​doi.​org/​10.​1161/​CIR.​0b013e318235eb4d​.CrossRefPubMed
75.
go back to reference Go AS, Bauman MA, Coleman King SM, Fonarow GC, Lawrence W, Williams KA, Sanchez E. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. J Am Coll Cardiol. 2014;63(12):1230–8. https://doi.org/10.1016/j.jacc.2013.11.007.CrossRefPubMed Go AS, Bauman MA, Coleman King SM, Fonarow GC, Lawrence W, Williams KA, Sanchez E. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. J Am Coll Cardiol. 2014;63(12):1230–8. https://​doi.​org/​10.​1016/​j.​jacc.​2013.​11.​007.CrossRefPubMed
93.
100.
go back to reference Detert Oude Weme SEH, Vervenne WL, Imhoz ALT, Cremers RGHM, van Berlo-van de Laar IFR, Jansman FGA, et al. Assessment of the pharmacokinetic interaction of enzalutamide with oxycodone in men with prostate cancer: the ENZYME study. Ann Oncol. 2022;33(Suppl._7):S713-42. Detert Oude Weme SEH, Vervenne WL, Imhoz ALT, Cremers RGHM, van Berlo-van de Laar IFR, Jansman FGA, et al. Assessment of the pharmacokinetic interaction of enzalutamide with oxycodone in men with prostate cancer: the ENZYME study. Ann Oncol. 2022;33(Suppl._7):S713-42.
Metadata
Title
Enzalutamide: Understanding and Managing Drug Interactions to Improve Patient Safety and Drug Efficacy
Authors
Brandon W. Lennep
Jesse Mack
Srinivasu Poondru
Elizabeth Hood
Brooke D. Looney
Monique Williams
Judeth J. Bianco
Alicia K. Morgans
Publication date
12-04-2024
Publisher
Springer International Publishing
Published in
Drug Safety
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI
https://doi.org/10.1007/s40264-024-01415-7