Morgans Alicia K, Looney Brooke, Mack Jesse, Bianco Judeth
Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Dana 09-930, Boston, MA, 02215, USA.
Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA.
Drug Saf. 2025 Sep 16. doi: 10.1007/s40264-025-01600-2.
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).
恩杂鲁胺是一种口服雄激素受体信号抑制剂，用于治疗前列腺癌。老年前列腺癌患者通常伴有与年龄相关的合并症，需要同时进行积极治疗。作为细胞色素P450（CYP）酶CYP2C9和CYP2C19的中度诱导剂以及CYP3A4的强诱导剂，当恩杂鲁胺与其他作为CYP3A4底物的药物合用时，存在药物相互作用（DDIs）的可能性，这可能导致疗效丧失或意外药物相关不良事件风险增加。在本播客中，我们使用几个具有现实临床意义的假设患者病例来描述恩杂鲁胺，包括其给药剂量、药代动力学以及与合用药物相互作用的可能性。对每个患者病例的讨论将突出管理策略，并说明几乎所有恩杂鲁胺药物相互作用都可以通过适当了解哪些药物存在相互作用风险、何时需要调整剂量以及何时可以替代其他药物而得到有效管理。补充文件1（MP4 192541 KB）。
