Other Brands/Names

Xtandi

How It Works

Enzalutamide is an antiandrogen that blocks the actions of androgen hormones such as testosterone. In prostate cancer, malignant cells rely on testosterone and related androgens to grow and survive. By inhibiting androgen effects, enzalutamide can slow the growth of prostate cancer and help prevent its spread.

Indications

This medicine is used to treat prostate cancer in men and may be given in the following situations:

• When the cancer has spread to other parts of the body (metastatic disease).

• When symptoms worsen despite treatment that lowers testosterone production or after surgical removal of the testicles.

• When hormone therapy is ineffective and the patient has no symptoms or only mild symptoms, and chemotherapy is not considered clinically necessary.

• When treatment with the anticancer medicine docetaxel has failed to provide benefit or is no longer effective.

Contraindication

• Hypersensitivity to this medicine.

• Female sex, pregnancy, and breastfeeding.

• Concurrent therapy with the blood thinner warfarin.

Side Effects

Although they are uncommon, some people may experience adverse effects that can occasionally be life-threatening. Contact a doctor or healthcare professional right away if any of the following occur, as they may be related to drug side effects:

• Allergic reactions, including a red rash; swelling of the face, mouth, lips, tongue, or throat; or shortness of breath.

• Posterior Reversible Encephalopathy Syndrome (PRES), a neurologic condition that can cause confusion, decreased awareness, fainting, seizures, and severe headaches.

• High blood pressure.

• Severe headache.

• Severe chest pain.

• Abnormal burning or tingling sensations.

• Dry or itchy skin.

• Memory difficulties.

• Trouble concentrating.

• Enzalutamide can also reduce the white blood cell count, which may weaken the immune system.

Other possible effects include:

• Dizziness

• Weakness

• Back pain

• Hot flushes (a sudden hot or stuffy feeling in the face and neck)

• Muscle weakness

• Diarrhea

• Difficulty sleeping

• Anxiety

Types

This medicine is supplied as 40 mg softgel capsules.

Dosage

The dose is determined by the physician based on the patient’s condition. Treatment generally begins with 160 mg once daily.

Safety

This medicine is intended for use in men only; women should not take it. Use during pregnancy can cause fetal harm, so pregnant women must not use this medicine (Category X).

Drug Interactions

• May decrease the concentration of the following medicines in the serum when they are used with enzalutamide:
  

  • The anticoagulant warfarin

  • Opioid pain medicines (fentanyl, tramadol)

  • Antihypertensives (bisoprolol, nifedipine)

  • Corticosteroids (dexamethasone, prednisone)

  • HIV antivirals (ritonavir)

  • Antiarrhythmics (amiodarone)

  • Immunosuppressants (tacrolimus, cyclosporine)

  • Stomach acid suppressants (omeprazole and related drugs)

• Concentration of this medicine increases if it is used together with drugs such as:

  • Lipid-lowering medicines (gemfibrozil)

  • The antifungal itraconazole

• Concentrations of these medicines decrease when used with strong CYP3A4 inducers such as:
  • The antituberculosis agent rifampicin

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