Table 2.

A summary of metabolism and potential interactions between ARPIs and relugolix

ARPI	CYP3A4 substrate	CYP3A4 inducer	CYP3A4 inhibitor	Possible interaction with relugolix
Apalutamide	Yes	Strong	No	Reduces relugolix exposure by inducing CYP3A4, although clinical studies do not show reduced effect of relugolix on testosterone suppression
Enzalutamide	Yes	Moderate	No	May reduce relugolix exposure, but clinical studies suggest a neutral net effect due to compensatory mechanisms
Darolutamide	Yes	Weak	No	Minimal impact on relugolix; no dose adjustment needed
Abiraterone	Yes	No	Yes	May increase relugolix exposure, but no clinical significance noted in studies