Xtandi (Enzalutamide)

Xtandi (Enzalutamide) Medication Information

Uses

Xtandi is a chemotherapy medication that can treat castration-resistant prostate cancer and metastatic castration-resistant prostate cancer.

Xtandi should only be prescribed by an oncologist (cancer specialist) or a healthcare provider with specialized oncology training.

Xtandi blocks androgen receptors, slowing the growth of prostate cancer cells.

Dosage

The standard dosage of Xtandi is 160 mg by mouth once daily. The dosage can be achieved with two 80 mg tablets, four 40 mg capsules, or four 40 mg tablets.

Take Xtandi exactly as prescribed by your doctor.

Xtandi should be prescribed with a gonadotropin-releasing hormone (GnRH) or in patients who have had a bilateral orchiectomy.

Side Effects

Common adverse reactions to Xtandi may include:

• Arthralgia
• Asthenia
• Back pain
• Constipation
• Decreased appetite
• Decreased white blood cell count
• Diarrhea
• Dizziness
• Dyspnea
• Falling
• Fatigue
• Headache
• Hot flash
• Hyperglycemia
• Hyperglycemia
• Hypertension
• Hyponatremia
• Musculoskeletal pain
• Nausea
• Peripheral edema
• Upper respiratory tract infection
• Weight loss

Precautions

Tell your doctor if you have a history of seizures before starting Xtandi.

Use caution if you have a history of ischemic heart disease.

Patients who take Xtandi have a high risk for falls (11%) and fractures (10%). Use caution if you have a history of fall risk.

Xtandi is toxic to a developing fetus. Males with female partners should use contraception when taking this drug.

This is not a full list of precautions; talk with your doctor about all precautions that apply to you.

Interactions

Xtandi has many potential drug-drug interactions. Speak with your doctor and pharmacist about all of the medications you are taking, including:

• Amiodarone
• Apalutamide
• Aprepitant
• Atazanavir
• Berotralstat
• Bexarotene
• Bortezomib
• Bosentan
• Brexpiprazole
• Carbamazepine
• Cariprazine
• Cenobamate
• Ceritinib
• Ceritinib
• Cimetidine
• Clarithromycin
• Cobicistat
• Conivaptan
• Crizotinib
• Crizotinib
• Cyclosporine
• Dabrafenib
• Darunavir
• Diltiazem
• Dronedarone
• Duvelisib
• Efavirenz
• Enzalutamide
• Erythromycin
• Eslicarbazepine
• Etravirine
• Fedratinib
• Fluconazole
• Fosamprenavir
• Fosaprepitant
• Fosphenytoin
• Grapefruit juice
• Idelalisib
• Imatinib
• Indinavir
• Isavuconazole (isavuconazonium sulfate)
• Itraconazole
• Ketoconazole
• Lefamulin
• Letermovir
• Lonafarnib
• Lopinavir
• Lorlatinib
• Lumacaftor
• Mifepristone
• Mitotane
• Modafinil
• Nafcillin
• Nefazodone
• Nelfinavir
• Netupitant
• Nilotinib
• Ombitasvir-paritaprevir-ritonavir
• Pexidartinib
• Phenobarbital
• Phenytoin
• Posaconazole
• Primidone
• Ribociclib
• Rifabutin​
• Rifampin (rifampicin)
• Rifapentine
• Ritonavir and ritonavir-containing coformulations
• Saquinavir
• Schisandra
• St. John's wort
• Telithromycin
• Tucatinib
• Verapamil
• Voriconazole

Storage

Store Xtandi capsules and tablets between 68°F to 77°F or close to room temperature.

Xtandi should be stored in a dry and tightly closed container.

Keep Xtandi in a child-resistant container away from children.

Pharmacist Tips

• Do not stop taking Xtandi without speaking with your doctor first.
• Do not chew, crush, or dissolve capsules or tablets. Xtandi should be swallowed whole with a full glass of water.
• If you miss your dose of Xtandi, take it as soon as you remember. If you miss a day, do not take a double dose.

Xtandi FAQs

What should I do if I take too much Xtandi?

Call your doctor immediately and go to the nearest emergency room.

What time of day should I take Xtandi?

Take it at the same time of day, irrespective of the time of day.

Do I have to take Xtandi with food?

No, it can be taken with or without food.

Related Products

• Androcur
• Casodex
• Zoladex
• Zytiga

References

1. Xtandi [package insert]. New York, NY: Astellas; 2020.