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Hello from a difficult patient in London
Prostate Cancer | Last Active: May 21 3:11pm | Replies (45)Comment receiving replies
Yes, Paul, thank you very much for your reply.
I've been drinking green tea for a while now, and is it incompatible with Erleada? Or did I misunderstand you?
Replies to "@paulsweeney Yes, Paul, thank you very much for your reply. I've been drinking green tea for..."
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@denis76 Denis, good question and no you didn't misunderstand — I should have been clearer.
The short answer: drinking green tea in normal amounts (2-3 cups a day) is very unlikely to cause a problem with Erleada.
What I was flagging is the interaction risk with high-dose green tea extract supplements (EGCG capsules), which deliver much higher concentrations than a cup of tea.
Here's the detail. Erleada (apalutamide) is metabolised by CYP2C8 and CYP3A4 enzymes. Green tea catechins, particularly EGCG, can inhibit CYP3A4 — and strong CYP3A4 inhibitors can increase Erleada's active metabolite levels, which could potentially increase side effects.
However, one clinical study found that EGCG at 800mg/day did not inhibit CYP3A4 to a clinically significant degree.
A cup of green tea contains roughly 50-100mg of EGCG, so at 2-3 cups a day you're well below levels that would meaningfully affect drug metabolism.
The concern is really about concentrated EGCG supplement capsules (typically 400-800mg per dose) rather than brewed tea.
That's why evidence.zone has separate cards for Green Tea (Dietary) and Green Tea Extract (EGCG Capsules) — they're different interventions with different risks.
Paul