{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:19:39Z","timestamp":1787653179330,"version":"build-2736575974"},"reference-count":33,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Second-generation antiandrogens have significantly improved outcomes in patients with prostate cancer; however, their complex pharmacokinetic profiles can result in significant drug-drug interactions (DDIs) in patients with comorbid conditions which require chronic anticoagulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This review aims to describe the DDIs between antiandrogens and commonly used anticoagulants, with a focus on understanding the clinical implications of pharmacokinetics and drug metabolism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature review of pharmacokinetic data, clinical trials, and prescribing information was performed. Drug metabolism of antiandrogens and anticoagulants was examined, including the effects of CYP450 enzyme and\/or P-glycoprotein (P-gp) inhibition and induction on anticoagulant efficacy and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Enzalutamide and apalutamide are strong inducers of CYP3A4, which may reduce exposure to warfarin, apixaban, and rivaroxaban. Apalutamide induces P-gp, and therefore has DDIs with all direct oral anticoagulants (DOACs). Darolutamide and abiraterone exhibit minimal CYP450 induction and inhibition, and do not interact with warfarin or DOACs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Drug-drug interactions between antiandrogens and anticoagulants are common and can affect therapeutic efficacy and safety. Clinical decision-making surrounding drug selection requires an interprofessional approach grounded in pharmacokinetic knowledge to ensure safe and effective care in patients with prostate cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552251406879","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T15:29:32Z","timestamp":1766503772000},"page":"1126-1131","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Antiandrogen therapies: Management of drug interactions with anticoagulation"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1837-716X","authenticated-orcid":false,"given":"Arianne","family":"Duong","sequence":"first","affiliation":[{"name":"Department of Pharmacy, UW Medicine"},{"name":"Department of Pharmacy, Fred Hutchinson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanh","family":"Bui","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Masonic Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dane","family":"Fritzsche","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Fred Hutchinson Cancer Center"},{"name":"Department of Pharmacy, Seattle Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Ruplin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, UW Medicine"},{"name":"Department of Pharmacy, Fred Hutchinson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.00801"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-020-00310-3"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.18.00483"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2017.022004"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.01.017"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70038-3"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2021.04.003"},{"key":"e_1_3_3_9_2","first-page":"1","article-title":"Drug\u2013drug interactions with direct oral anticoagulants","volume":"59","author":"Foerster KI","year":"2020","unstructured":"Foerster KI, Hermann S, Mikus G, et al. Drug\u2013drug interactions with direct oral anticoagulants. Clin Pharmacokinet 2020; 59: 1\u201314.","journal-title":"Clin Pharmacokinet"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-015-1314-3"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1207506"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1405095"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-015-0283-1"},{"key":"e_1_3_3_14_2","unstructured":"Enzalutamide. Package insert. Astellas Pharma Inc 2023."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa025313"},{"key":"e_1_3_3_16_2","unstructured":"Edoxaban. Package insert. Daiichi Sankyo Inc 2023."},{"key":"e_1_3_3_17_2","unstructured":"Rivaroxaban. Package insert. Janssen Pharmaceuticals Inc 2023."},{"key":"e_1_3_3_18_2","unstructured":"Apixaban. Package insert. Bristol-Myers Squibb Company 2021."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1060028013504741"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003442"},{"key":"e_1_3_3_21_2","unstructured":"Dabigatran. Package insert. Boehringer Ingelheim Pharmaceuticals Inc 2023."},{"key":"e_1_3_3_22_2","unstructured":"Apalutamide. Package insert. Janssen Pharmaceutical Companies 2018."},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1715546"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-020-00881-3"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-020-00882-2"},{"key":"e_1_3_3_26_2","unstructured":"Warfarin. Package insert. Bristol-Myers Squibb Company 1954."},{"key":"e_1_3_3_27_2","volume-title":"Package insert","author":"Darolutamide","year":"2019","unstructured":"Darolutamide. Package insert. 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