Enzalutamide (Generic Name)

Other Name: Xtandi®

About This Drug

Enzalutamide is a drug used to treat prostate cancer. It is given by mouth.

Possible Side Effects (More Common)

  • Swelling of the hands or feet
  • Headache
  • Hot flashes
  • Loose bowel movements (diarrhea) that may last for a few days
  • Bone marrow depression (most often white blood cells)
  • Back pain
  • Muscle ache
  • Upper respiratory infection

Possible Side Effects (Less Common)

  • High blood pressure. Your doctor will check your blood pressure as needed.
  • Feeling dizzy
  • Dry skin
  • Blood in the urine
  • Muscle weakness
  • Tingling of the hands and/or feet
  • Nose bleeds
  • Seizures

Treating Side Effects

  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • Ask your doctor or nurse about medicine that is available to help stop or lessen the loose bowel movements and/or headaches.
  • If you are dizzy, get up slowly after sitting or lying.
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.
  • If you get dry skin, do not put anything on it unless your doctor or nurse says you may. Keep the area clean and dry. Ask your doctor for medicine if your dry skin bothers you.
  • If you get a nose bleed, sit with your head tipped slightly forward. Apply pressure by lightly pinching the bridge of your nose between your thumb and forefinger. Call your doctor if you feel dizzy or if the bleeding doesn’t stop after 10 to 15 minutes.

Important Information

  • You can take enzalutamide with or without food.  If you have nausea, take it with food.
  • Swallow the capsule whole. Do not chew, break, or crush it.
  • Missed dose: If you miss a dose, take the prescribed dose as soon as you remember that day.  If you miss your daily dose, take your prescribed dose at your normal time the next day.  Do not take more than one dose at a time.

Food and Drug Interactions

There are no known interactions with enzalutamide with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Feeling dizzy or lightheaded
  • Nausea or throwing up that stops you from eating or drinking
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or lightheadedness
  • Blood in the urine
  • Trouble breathing
  • Swelling of the hands or feet
  • Symptoms of a respiratory infection, such as cough, trouble breathing, or coughing up mucus
  • Seizures

Call your doctor or nurse as soon as possible if you have any of these symptoms:

  • Muscle pain or weakness
  • Nose bleeds
  • Extreme weakness that interferes with normal activities
  • Tingling of the hands and/or feet

Reproduction Concerns

  • Pregnancy warning:  This drug may cause very harmful effects on an unborn child. Enzalutamide is not approved for use in women and should never be used by women who are pregnant or who could become pregnant while taking the drug. 
    • Men should use effective means of birth control during the cancer treatment and for at least 3 months after treatment is done.
    • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Breast feeding warning:  Enzalutamide is not approved for use in women.

Revised September 2014

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