Xtandi interactions: Alcohol, medications, and other factors

Before you start treatment with Xtandi, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Xtandi interacts with supplements, herbs, or vitamins, see the “Xtandi and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Xtandi. Keep in mind that this table doesn’t include all drugs that may interact with Xtandi. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* For details about this interaction, see the “Drug interactions“in depth” section below.

There aren’t any known interactions between Xtandi and alcohol. However, drinking alcohol while taking the drug may worsen some of Xtandi’s side effects. For example, you may experience worsened headache, dizziness, or fatigue.

If you have questions about drinking alcohol during Xtandi treatment, talk with your doctor or pharmacist.

Here’s a closer look at certain drug interactions of Xtandi.

Buspirone

Buspirone is prescribed to treat anxiety.

Interaction result: Taking Xtandi with buspirone could make buspirone less effective.

Interaction explained: A specific enzyme (type of protein) breaks down buspirone in the body. Xtandi speeds up the activity of this enzyme, which could lead to a lower level of buspirone in your system. Having a low level of the drug could make buspirone less effective.

Steps you or your doctor may take: Before starting treatment with Xtandi, tell your doctor if you’re taking buspirone. They can tell you whether it’s safe to take these medications together.

If your doctor prescribes Xtandi with buspirone, they may prescribe a higher dosage of buspirone than usual. Doing so can help keep the level of buspirone high enough in your body for it to be effective.

To learn more about Xtandi and buspirone, talk with your doctor or pharmacist.

Certain benzodiazepines

Benzodiazepines are prescribed to treat anxiety, seizures, and other conditions.

Interaction result: Taking Xtandi with certain benzodiazepines could increase the risk of benzodiazepine withdrawal in certain situations. Taking these drugs together could also make the benzodiazepine less effective.

Interaction explained: Taking Xtandi with certain benzodiazepines could make the benzodiazepine less effective. This is because Xtandi speeds up the activity of an enzyme that breaks down certain benzodiazepines in your system. As a result, the level of the benzodiazepine may be low, which could make the drug less effective.

In some cases, having a low level of benzodiazepine in your body could lead to withdrawal symptoms. These are side effects that happen when you stop taking a drug your body has become dependent on. With dependence, your body relies on a drug to function as usual.

Examples of benzodiazepine drugs: Here are some benzodiazepines that may interact with Xtandi:

• clonazepam (Klonopin)
• diazepam (Valium, Valtoco, others)
• midazolam (Nayzilam, Seizalam)

Steps you or your doctor may take: Before starting treatment with Xtandi, tell your doctor if you’re taking a benzodiazepine. They can tell you whether it’s safe to take these medications together.

If you start Xtandi treatment after you’re already taking a benzodiazepine, tell your doctor right away if you have symptoms of withdrawal. These may include anxiety, muscle spasms, and insomnia. They’ll recommend what to do if you have these symptoms.

To learn more about Xtandi and benzodiazepines, talk with your doctor or pharmacist.

Sedative-hypnotics

Sedative-hypnotics are prescribed to treat insomnia.

Interaction result: Taking Xtandi with sedative-hypnotics can make the sedative-hypnotic less effective.

Interaction explained: Xtandi speeds up the activity of an enzyme that breaks down sedative-hypnotics in your system. Taking Xtandi with these drugs could result in a low level of the sedative-hypnotic in your body, making the drug less effective.

Examples of sedative-hypnotic drugs: Here are some sedative-hypnotics that may interact with Xtandi:

• eszopiclone (Lunesta)
• suvorexant (Belsomra)
• zolpidem (Ambien, Edluar)

Steps you or your doctor may take: Before taking Xtandi, tell your doctor if you’re taking a sedative-hypnotic. They can tell you whether it’s safe to take these medications together. If necessary, your doctor can recommend an alternative to Xtandi or the sedative-hypnotic.

To learn more about Xtandi and sedative-hypnotics, talk with your doctor or pharmacist.

Xtandi may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all possible interactions with Xtandi.

Xtandi interactions with supplements

Before you start treatment with Xtandi, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Xtandi interactions with herbs

Xtandi may interact with St. John’s wort. This herbal supplement may help with depression and other conditions.

St. John’s wort may speed up the activity of an enzyme (protein) in your body that helps break down Xtandi. This may lead to a low level of Xtandi in your system, which could make Xtandi less effective.

Before taking an herbal product with Xtandi, talk with your doctor or pharmacist. They can tell you whether it’s safe to take them together.

If your doctor prescribes Xtandi with St. John’s wort, they may give you a higher Xtandi dosage than usual. Doing so can help keep the drug level high enough in your body for it to be effective.

Xtandi and vitamins

There are no reports of vitamins interacting with Xtandi. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Xtandi.

Xtandi and food

There were no reports of food interactions with Xtandi. If you’d like to learn about foods to avoid when taking Xtandi, talk with your doctor.

Xtandi and vaccines

There aren’t any known interactions between Xtandi and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Xtandi and lab tests

Xtandi isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

XTANDI INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been reported to interact with Xtandi. Taking Xtandi with a cannabis product could make the cannabis product less effective.

Before you start treatment with Xtandi, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal in the United States at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Xtandi. Before you take this drug, be sure to talk with your doctor about your health history. Xtandi may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Xtandi include:

• Seizures or related factors: Treatment with Xtandi may cause seizures. This risk may be greater in people who have had seizures before or have other factors, including brain tumors or stroke. Your doctor can review your health history and recommend whether Xtandi is a safe treatment option.
• Bone fractures, falls, or related factors: Treatment with Xtandi may lead to falls that result in bone fractures. This risk may be greater in people with certain factors, including having balance difficulties or osteoporosis. Your doctor can recommend whether Xtandi is a safe treatment option.
• Heart problems or related factors: Treatment with Xtandi may increase the risk of heart disease. This risk may be greater in people with certain factors, including high blood pressure or current heart disease. Your doctor can tell you whether Xtandi is a safe treatment option.
• Allergic reaction: If you’ve had an allergic reaction to Xtandi or any of its ingredients, your doctor will likely not prescribe Xtandi. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether it’s safe to take Xtandi while breastfeeding. However, the drug is not prescribed for females. If you have questions about this, talk with your doctor.
• Pregnancy: Xtandi is not prescribed for females and is not safe to take while pregnant. Animal studies show that the drug may cause harm to a fetus or pregnancy loss. While you’re taking Xtandi, it’s important to use birth control (such as condoms) if you have a sexual partner who may become pregnant. You’ll need to keep using birth control for at least 3 months after your last dose of the drug. If you have questions about this, talk with your doctor.

Note: Sex and gender exist on spectrums. The terms “female” and “male“ in this article refer to sex assigned at birth.

You can take certain steps to help prevent interactions with Xtandi. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Xtandi label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Xtandi doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Xtandi by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Xtandi. These resources might help:

• Overview of Xtandi: For a general overview of Xtandi, you can see this article.
• Side effects: If you’re interested in finding out about the side effects of Xtandi, see this article. Another option is to refer to the Xtandi prescribing information.
• Dosage specifics: To learn about the dosage of Xtandi, see this article.
• Cost: If you’d like to learn about Xtandi and cost, see this article.
• Facts about prostate cancer: To learn more about prostate cancer, see our prostate cancer hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.