Care During Chemotherapy and Beyond


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Trade Name: Xtandi®

Enzalutamide is the generic name for the trade name drug Xtandi®. In some cases, health care professionals may use the trade name Xtandi® when referring to the generic drug name enzalutamide.

Drug Type:

Enzalutamide is a hormone therapy. It is classified as an "anti-androgen”. (For more detail, see “How enzalutamide Works” below)

What Enzalutamide Is Used For:

  • Treatment of castration resistant prostate cancer (prostate cancer that is resistant to medical or surgical treatments that lower testosterone).
  • Treatment of metastatic castration-sensitive prostate cancer.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Enzalutamide Is Given:

  • Taken as a capsule by mouth.
  • Take with or without food at the same time each day with a full glass of water
  • Swallow the capsule whole. Do not crush, chew or dissolve capsules.
  • If you miss a dose, take it as soon as you remember that day. If you miss a day, do not double your dose the next day. Just skipped the missed dose. Call your healthcare provider if you are not sure what to do.
  • Store enzalutamide at room temperature (68-77 degrees F or 20-25 degrees C).
  • Keep the container closed tightly, dry, and out of the reach of children.
  • The amount of enzalutamide that you will receive depends on many factors. Your doctor will determine your dose and schedule.

Side Effects:

Important things to remember about the side effects of enzalutamide:

  • Most people will not experience all of the enzalutamide side effects listed.
  • Enzalutamide side effects are often predictable in terms of their onset, duration, and severity.
  • Enzalutamide side effects will improve after therapy is complete.
  • Enzalutamide side effects may be quite manageable. There are many options to minimize or prevent the side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following side effects are common (occurring in greater than 30%) for patients taking enzalutamide:

These are less common (occurring in 10-29%) side effects for patients receiving enzalutamide:

Not all side effects are listed above. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms. Among the uncommon side effects, patients taking enzalutamide should be aware that there is a risk for seizures in patients taking this medication. Although it occurs in less than 1% of patients, they should be aware of the risk when engaging in any activity where sudden loss of consciousness could cause serious harm to themselves or others.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4º F (38º C) or higher, chills (possible signs of infection)

Always inform your health care provider if you experience any unusual symptoms.

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Diarrhea (4-6 episodes in a 24-hour period)
  • Unusual bleeding or bruising
  • Extreme fatigue (unable to carry on self-care activities)
  • Swelling of the legs, feet, arms, or hands
  • If you have difficulty thinking, confusion
  • If you have falls, dizziness
  • Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, or painful urination.
  • Pink-tinged or blood in urine
  • Feeling very tired or weak (unable to carry on self-care activities)

Always inform your health care provider if you experience any unusual symptoms.


  • Before starting enzalutamide treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). There are potential drug interactions with enzalutamide.
  • If you are on warfarin (Coumadin), your blood tests (INR) may need to be monitored more closely.
  • Be sure to tell your health care provider if you have any history of seizures, brain injury, stroke, or brain tumors.
  • Do not receive any kind of immunization or vaccination without your doctor’s approval.
  • Pregnancy category X (Enzalutamide may cause fetal harm when given to a pregnant woman.) It is not indicated for women. This drug must not be given to a pregnant woman or a woman who intends to become pregnant.
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking enzalutamide. Barrier methods of contraception, such as condoms, are recommended while on treatment and for at least 3 months after the last dose.

Self-Care Tips:

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
  • Wash your hands often.
  • If you are experiencing hot flashes, wearing light clothing, staying in a cool environment, and putting cool cloths on your head may reduce symptoms. Consult you health care provider if these worsen, or become intolerable.
  • Avoid contact sports or activities that could cause injury.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Maintain your normal physical activity as you are able.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing

You will be checked regularly by your doctor while you are taking enzalutamide, to monitor side effects and check your response to therapy. Periodic blood work will be obtained to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor. If you are on warfarin (Coumadin), your INR blood tests may be monitored more often.

How Enzalutamide Works:

Normally in prostate cells there are androgen receptors. Androgens bind with these receptors to aid in the growth of these cells. Anti-androgens interfere with the ability of the receptors to bind with the androgens which then decreases the ability of the prostate cancer cells to grow. Enzalutamide also prevents the androgens from working within the prostate cancer cells.

Enzalutamide is categorized as an antiandrogen. Antiandrogens are substances that block the effects of testosterone. Cancer of the prostate depends on the male hormone testosterone or related androgens for its growth. If the amount of androgens are reduced it is possible to slow down or shrink the cancer.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice. is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit