Colchicine–enzalutamide interaction: clinical implications and multi-disciplinary management

Among the androgen receptor targeted agents (ARTAs) used to treat prostate cancer, enzalutamide1 is a valid option at several stages of the disease. In terms of its drug–drug interaction2 (DDI) profile, it is a strong inducer of CYP3A4 and a moderate inducer of CYP2C9 and CYP2C19, and in vitro data indicate that it can be an inhibitor of the efflux transporter P-glycoprotein (P-gp). DDIs with apixaban and rivaroxaban (dual substrates of CYP3A4 and P-gp) and digoxin (P-gp substrate) seem to be well characterised.