Enzalutamide for prostate cancer (Xtandi)

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Take four capsules together, once a day.

Swallow the capsules whole with a drink of water.

Type of medicineAn anti-androgen medicine
Used forAdvanced prostate cancer
Also calledXtandi®
Available asCapsules

In some men with prostate cancer, the cancer cells spread to parts of the body other than the prostate. When this happens, it is referred to as late, advanced or metastatic prostate cancer. Treatment options for this type of cancer typically include hormone treatment, surgery, radiotherapy and chemotherapy.

Enzalutamide is a hormone treatment - it belongs to a group of medicines known as anti-androgens. It works by blocking the action of male hormones called androgens. Testosterone is an androgen. Prostate cancer cells need the male hormone testosterone to grow and multiply well. By blocking the action of androgens such as testosterone, enzalutamide slows the growth of the cancer cells.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking enzalutamide it is important that your doctor knows:

  • If you have ever had a fit (seizure) or if you have been told you may be at risk of having a seizure.
  • If you have heart or blood vessel problems.
  • If you have any problems with the way your kidneys work or any problems with the way your liver works.
  • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.
  • Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about enzalutamide and will provide you with a full list of the side-effects which you may experience from taking it.
  • Take enzalutamide exactly as your doctor tells you to. The usual dose is four 40 mg capsules taken together, once a day. Your dose will be printed on the label of the pack to remind you about what the doctor said to you.
  • Take the capsules with a drink of water. Swallow the capsules whole - do not chew or open the capsules in order to swallow them.
  • You can take your doses either before or after food, but try to take enzalutamide at the same time of day each day. This will help you to remember to take your doses regularly.
  • If you do forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the forgotten dose. Do not take two doses together to make up for a missed dose.
  • Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
  • If you buy any medicines 'over the counter', always check with a pharmacist that they are suitable for you to take with your other medicines.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking enzalutamide.
  • Enzalutamide may harm an unborn child. This means that if you are having sex with a woman who could become pregnant, you must use a condom along with another effective birth control method. If you are having sex with a woman who is already pregnant, you must use a condom to protect the unborn child.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with enzalutamide. You will find a full list in the manufacturer's information leaflet supplied with your medicine. Speak with your doctor or pharmacist if you experience any symptoms which you think may be due to enzalutamide.

Very common enzalutamide side-effects (these affect more than 1 in 10 men)
What can I do if I experience this?
Feeling tired or weakTake a rest when needed. Do not use tools or machines while affected
HeadacheAsk your doctor or pharmacist to recommend a suitable painkiller
Feeling hot and flushedTry to keep as cool as possible by wearing light and airy clothes
High blood pressureYour doctor will be monitoring your progress and will check for this
Common enzalutamide side-effects (these affect less than 1 in 10 men)What can I do if I experience this?
Feeling anxious, memory problems, itching, dry skin, falls, breast enlargement, an urge to move your legsSpeak with your doctor for advice

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • Manufacturer's PIL, Xtandi® 40 mg soft capsules; Astellas Pharma Ltd, The electronic Medicines Compendium. Dated January 2015.
  • British National Formulary; 69th Edition (Mar 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr John Cox
Document ID:
29048 (v1)
Last Checked:
Next Review:
The Information Standard - certified member

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