Enzalutamide for prostate cancer
Xtandi
Peer reviewed by Sid DajaniLast updated by Michael Stewart, MRPharmSLast updated 18 May 2024
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Take four tablets together, once a day.
Swallow the tablets whole with a drink of water.
At a glance
Enzalutamide is an anti-androgen medicine used to treat advanced prostate cancer.
It works by blocking male hormones like testosterone that prostate cancer cells need to grow.
Take 4 tablets once daily, at the same time each day, with water.
You can take enzalutamide with or without food.
Common side-effects include feeling tired, hot flushes, and high blood pressure.
Tell your doctor if you have had seizures, heart problems, or kidney/liver issues before taking.
Enzalutamide can harm an unborn child, so use effective birth control if having sex with a woman who could become pregnant.
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About enzalutamide
Type of medicine | An anti-androgen medicine |
Used for | Advanced prostate cancer |
Also called | Xtandi® |
Available as | Tablets |
In some men with prostate cancer, the cancer cells spread to parts of the body other than the prostate gland. 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.
Before taking enzalutamide
Back to contentsSome 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, as well as herbal and complementary medicines.
If you have ever had an allergic reaction to a medicine.
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How to take enzalutamide
Back to contentsBefore 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 tablets 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 tablets with a drink of water. Swallow the tablets whole - do not break or chew the tablets.
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.
Getting the most from your treatment
Back to contentsTry 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.
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Can enzalutamide cause problems?
Back to contentsAlong 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 weak | Take a rest when needed. Do not use tools or machines while affected. Take care moving about as this medicine can put you at risk of falls. |
Feeling hot and flushed | Try to keep as cool as possible by wearing light and airy clothes |
High blood pressure | Your doctor will be monitoring your progress and will check for this |
Common enzalutamide side-effects (these affect fewer 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 legs, an altered sense of taste | Speak with your doctor for advice |
Headache | Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know |
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist for further advice.
How to store enzalutamide
Back to contentsKeep all medicines out of the reach and sight of children.
Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Back to contentsImportant information about all medicines
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.
Report side effects to a medicine or vaccine
If you experience side effects, you can report them online through the Yellow Card website.

Unsure about mixing medicines?
Check for possible interactions between medicines, supplements and foods before taking them together.
Frequently asked questions
What specifically is advanced prostate cancer and how does enzalutamide fit into its treatment?
Advanced prostate cancer means that the cancer cells have spread from the prostate gland to other parts of the body. Enzalutamide is a hormone treatment, specifically an anti-androgen, used for this type of cancer. It works by blocking male hormones like testosterone that prostate cancer cells need to grow, thereby slowing the cancer's progression.
Are there any specific medical conditions that might prevent me from taking enzalutamide?
Yes, there are some conditions your doctor needs to know about. These include if you have ever had a seizure or are at risk of one, if you have heart or blood vessel problems, or any issues with your kidneys or liver function. It's also important to tell your doctor about any allergies you have.
What should I do if I accidentally miss a dose of enzalutamide?
If you forget to take a dose, you should take it as soon as you remember. However, if you don't remember until the following day, you should skip the forgotten dose. It's important not to take two doses together to try and make up for a missed one.
What precautions should I take regarding contraception while on enzalutamide, even if my partner is pregnant?
Enzalutamide can harm an unborn child. 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 still use a condom to protect the unborn child.
What are the common side effects of enzalutamide, and what should I do about them?
Very common side effects include feeling tired or weak, feeling hot and flushed, and high blood pressure. For tiredness, rest when needed and be careful moving around as it can increase the risk of falls. For hot flushes, try to stay cool by wearing light clothing. Your doctor will monitor your blood pressure. Less common side effects include anxiety, memory problems, itching, dry skin, breast enlargement, an urge to move your legs, an altered sense of taste, and headaches. For these, speak with your doctor for advice or, for headaches, drink water and ask your pharmacist about a painkiller.
How should I store enzalutamide tablets to ensure they remain effective and safe?
You should keep the tablets out of the reach and sight of children. Store them in a cool, dry place, away from direct heat and light.
What should I do if I think I've taken too much enzalutamide, or if I have old medication?
Never take more than your prescribed dose. If you suspect an overdose, you should go to the accident and emergency department of your local hospital immediately and take the medicine container with you. You should also not keep out-of-date or unwanted medicines; take them to your local pharmacy for safe disposal.
Further reading and references
- Manufacturer's PIL, Xtandi® 40 mg and 80 mg film-coated tablets; Astellas Pharma Ltd, The electronic Medicines Compendium. Dated April 2024.
- Medicines Complete BNF 89th Edition; British Medical Association and Royal Pharmaceutical Society of Great Britain, London.
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About the authorView full bio

Michael Stewart, MRPharmS
Medicine Leaflet Review Manager – Contractor, Pharmacist
BPharm (Hons), MRPharmS
Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.
About the reviewer

Sid Dajani
Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.
Article history
The information on this page is written and peer reviewed by qualified clinicians.
Next review due: 24 Apr 2027
18 May 2024 | Latest version

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