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Enzalutamide
Generic name: enzalutamide
Brand names: Xtandi
What is enzalutamide?
Enzalutamide is a prescription medicine used to treat prostate cancer in men who have received surgery or hormone therapy to lower testosterone.
Enzalutamide is sometimes used when the cancer no longer responds to treatment, but has not spread to other parts of the body.
Enzalutamide is also used when the cancer has responded to treatment and has spread to other parts of the body (metastatic).
It is not known if enzalutamide is safe and effective in children or females.
How should I take enzalutamide?
Take enzalutamide exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.
Take the medicine at the same time each day, with or without food.
You may need to take 2 to 4 tablets at a time to get a full dose.
Swallow the enzalutamide pill whole with enough water to make sure that you can swallow all of the medicine successfully. Do not cut, break, chew, or crush a tablet. Do not chew, open, or dissolve a capsule.
Use all medications as directed and read all medication guides you receive. Do not change your dose or dosing schedule without your doctor's advice.
Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.
Warnings
Although not for use by women, enzalutamide can cause birth defects if the mother or the father is taking this medicine. Use a condom and one other form of birth control to prevent pregnancy while using this medicine, and for at least 3 months after your last dose.
Before taking this medicine
You should not use enzalutamide if you are allergic to it.
To make sure enzalutamide is safe for you, tell your doctor if you have ever had:
- a seizure;
- a head injury, stroke, or brain tumor;
- heart disease, circulation problems;
- high blood pressure;
- diabetes; or
- high cholesterol or triglycerides (a type of fat in the blood).
Enzalutamide can harm an unborn baby or cause birth defects, even if the father is taking this medicine.
- If your sex partner is pregnant, always use a condom during sex.
- If your sex partner could become pregnant, use effective birth control to prevent pregnancy. Keep using birth control for at least 3 months after you stop taking enzalutamide.
- Tell your doctor at once if a pregnancy occurs while you are taking this morning.
Although this medicine is not for use by women, enzalutamide should not be taken by a woman who is breastfeeding a baby.
Enzalutamide side effects
Stop taking this medicine and get emergency medical help if you have signs of an allergic reaction to enzalutamide: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using enzalutamide and call your doctor at once if you have:
- dizziness, spinning sensation;
- a seizure (black-out or convulsions);
- confusion, thinking problems, severe headache, vision problems;
- weakness, loss of consciousness;
- red or pink urine;
- heart problems - chest pain, shortness of breath (even with mild exertion);
- increased blood pressure - severe headache, blurred vision, pounding in your neck or ears, anxiety, nosebleed;
- signs of a lung infection - fever, cough with yellow or green mucus, stabbing chest pain, wheezing, feeling short of breath; or
- severe swallowing problems or choking.
Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.
Common enzalutamide side effects may include:
- feeling weak or tired;
- constipation, diarrhea;
- loss of appetite;
- flushing (redness, hot feeling);
- back pain, muscle or joint pain; or
- high blood pressure, headache, or bleeding problems.
This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Dosing information
Usual Adult Dose for Prostate Cancer:
160 mg orally once a dayComments:-This drug can be taken with or without food.-Swallow capsules and tablets whole with a sufficient amount of water. Do not chew, dissolve, or open the capsules. Do not cut, crush, or chew the tablets.-Patients receiving this drug for castration-resistant prostate cancer or metastatic castration-sensitive prostate cancer should also receive a gonadotropin-releasing hormone (GnRH) analog concurrently or should have had bilateral orchiectomy.-Patients with non-metastatic castration-sensitive prostate cancer with biochemical recurrence at high risk for metastasis may be treated with or without a GnRH analog.Uses: Castration-resistant prostate cancer; metastatic castration-sensitive prostate cancer; non-metastatic castration-sensitive prostate cancer with biochemical recurrence at high risk for metastasis
What happens if I miss a dose?
Take the missed dose as soon as you remember. If you forget your dose for the entire day, skip the missed dose and go back to your regular schedule the next day. Do not take two doses in one day.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose could cause you to have a seizure.
Enzalutamide can increase your risk of seizure. Avoid any activity that could be dangerous if you have a seizure or lose consciousness.
Avoid driving or hazardous activity until you know how enzalutamide will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.
Even without dizziness, taking enzalutamide could increase your risk of falls or bone fractures. Avoid activities or situations that may lead to injury or falls.
What other drugs will affect enzalutamide?
Enzalutamide can increase your risk of having a seizure, especially if you also use certain other medicines for infections, swelling or inflammation, asthma, hormone replacement, diabetes, depression, or mental illness.
Many drugs can interact with enzalutamide. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.
Common questions about enzalutamide
Is Xtandi a chemotherapy drug and how does it work?
Does Xtandi lower prostate-specific antigen (PSA)?
What is Xtandi (enzalutamide) used for?
Related medicines
Content is provided for education and is not medical advice. See our medical disclaimer. Source page medically reviewed by Philip Thornton, DipPharm on October 16, 2026.