Finding out that you or someone you love has prostate cancer can bring many different emotions and questions to your mind. If your doctor has recommended a medicine called enzalutamide, often known by its brand name Xtandi, you may want to understand how it works and what to expect during your treatment.
It is completely normal to feel overwhelmed when facing a new diagnosis or starting a new medicine. This guide is here to break down everything you need to know in simple, clear language so you can feel confident and prepared every step of the way.
Key Takeaways at a Glance
- Enzalutamide (Xtandi) is a hormone therapy medicine used to treat specific types of prostate cancer.
- It works by blocking the effects of testosterone, which helps slow down or stop cancer cell growth.
- Take your medicine exactly as prescribed by your doctor, at the same time every day, without crushing or chewing the capsules.
- Always share a complete list of your other medicines and supplements with your doctor to avoid harmful drug interactions.
- Strict birth control measures are required during treatment and for three months after your last dose.
Know your body mass index (BMI) and weight classification
What is Enzalutamide?
Simply put, enzalutamide is a medicine that blocks the activity of testosterone in your body. Testosterone is a natural male hormone that helps some prostate cancer cells grow and multiply.
By stopping this hormone from reaching the cancer cells, the medicine helps slow down the growth of the disease. Doctors may also prescribe this medicine for other specific health conditions based on your unique medical history and treatment goals.
If you have any questions about why this specific medicine was chosen for you, do not hesitate to ask your doctor. Open communication helps ensure you feel fully supported throughout your care journey.
Things to Tell Your Doctor Before Starting Treatment
Before you take your first dose of enzalutamide, you must share your complete medical history with your doctor. Being completely open about your health helps your care team keep you safe.
Please let your doctor know right away if any of the health conditions listed in the table below apply to you.
| Medical Condition or Factor | Why It Matters for Your Care |
|---|---|
| Heart disease, high blood pressure, or high cholesterol | This medicine can affect your heart health, so your doctor needs to monitor your condition closely. |
| History of stroke or seizures | Enzalutamide can sometimes increase the risk of seizures, making your past medical history vital. |
| Head injuries or brain tumors | These conditions can also influence your risk of seizures while taking this treatment. |
| Bone problems or weakened bones | Hormone treatments can impact bone strength over time, requiring extra preventative care. |
| Allergies to enzalutamide, other medicines, foods, or dyes | Knowing your allergies helps prevent severe allergic reactions or unexpected complications. |
| Partner who is pregnant, planning pregnancy, or breastfeeding | Even though this medicine is for men, it can harm an unborn baby through bodily fluids. Strict precautions are necessary. |
How to Take This Medicine Properly
Enzalutamide is taken by mouth as a capsule. Always follow your doctor's exact instructions regarding your daily dose.
Try to take your medicine at the exact same time every day to keep a steady level of the drug in your body. Swallow the capsules whole with a glass of water.
Never crush, chew, or open the capsules. You can take this medicine with or without food, but if it upsets your stomach, taking it with a meal can help.
Continue taking this medicine for as long as your doctor recommends. Never stop taking your medicine on your own, even if you are feeling better.
What to Do If You Take Too Much
If you believe you have taken more than your prescribed dose of enzalutamide, you must act quickly. Call your local emergency services right away or go straight to the nearest emergency department.
In the US and Canada, call 911. In the UK, call 999. Take your medicine bottle with you so medical staff can see exactly what you took.
What to Do If You Miss a Dose
If you forget to take your scheduled dose, take it as soon as you remember on that same day. However, if it is almost time for your next regular dose, skip the missed dose entirely.
Never take two doses at the same time to make up for a forgotten one. Simply return to your normal dosing schedule the next day.
Potential Drug Interactions
Enzalutamide can interact with many other medicines. These interactions can change how well your treatment works or increase your risk of unwanted side effects.
Always give your doctor a complete list of everything you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Medicines You Should Avoid with Enzalutamide
Certain medicines should not be taken while you are on enzalutamide because they can cause severe interactions. Check with your doctor if you take any of the following:
- Artemether for malaria treatment.
- Antiviral medicines used for HIV or hepatitis, such as atazanavir, ritonavir, or rilpivirine.
- Certain antifungal medicines, such as voriconazole.
- Other specific prescription drugs, including lonafarnib, lorlatinib, lurasidone, praziquantel, and ranolazine.
Medicines That May Require Careful Monitoring
Other medicines can also interact with enzalutamide, meaning your doctor may need to adjust your doses or watch you more closely:
- Seizure medicines, such as carbamazepine or phenytoin.
- Blood thinners, such as clopidogrel or warfarin.
- Immune system medicines, such as cyclosporine, sirolimus, or tacrolimus.
- Stomach acid medicines like omeprazole.
- Antibiotics like rifampin.
- The herbal supplement St. John's Wort.
Important Note: This list of interactions is not exhaustive. Always disclose your complete lifestyle habits, including smoking and alcohol use, to your doctor.
Things to Watch Out For During Treatment
To ensure your treatment is working safely, attend all your scheduled clinic appointments and lab tests. Regular check-ups allow your doctor to track your progress.
If your symptoms do not improve or if you notice them getting worse, contact your doctor right away. Open communication helps your care team make timely adjustments.
Critical Safety Warning for Families
This medicine is never prescribed for women. Men taking enzalutamide must avoid fathering children during treatment and for at least three months after stopping the medicine. This medicine can cause severe harm to an unborn baby. Discuss reliable birth control methods with your doctor before starting treatment.
Possible Side Effects
Like all medicines, enzalutamide can cause side effects, though not everyone experiences them. Some side effects require immediate medical attention. This others are milder.
| Serious Side Effects (Call Doctor Right away) | Common Side Effects (Monitor and Report If Persistent) |
|---|---|
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This is not a complete list of all possible side effects. If you experience any unusual symptoms or physical changes that worry you, speak with your doctor promptly.
How to Store and Dispose of Your Medicine
Proper storage keeps your medicine safe and effective throughout your treatment.
- Store your medicine at room temperature, between 20°C and 25°C (68°F to 77°F).
- Keep the bottle tightly closed and protect it from moisture and direct heat.
- Keep all medicines safely locked away in a high cupboard, completely out of reach of children and pets.
- Never use medicine that has passed its expiration date printed on the label.
- Ask your pharmacist or doctor about safe medicine disposal programs in your local community. If no return program is available, ask your pharmacist how to dispose of unused capsules safely.
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