Select a medication above to begin.
Xtandi
enzalutamide
Adult Dosing .
Dosage forms: CAP: 40 mg; TAB: 40 mg, 80 mg
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments
prostate CA
- [castration-resistant disease]
- Dose: 160 mg PO qd; Info: use w/ GnRH analog in patients w/o bilateral orchiectomy; do not open/dissolve cap; do not cut/crush/chew tab
- [metastatic castration-sensitive disease]
- Dose: 160 mg PO qd; Info: use w/ GnRH analog in patients w/o bilateral orchiectomy; do not open/dissolve cap; do not cut/crush/chew tab
- [non-metastatic castration-sensitive, high-risk disease]
- Dose: 160 mg PO qd; Info: for patients w/ biochemical recurrence; may suspend tx if PSA <0.2 ng/mL after 36wk tx; reinitiate when PSA 2 ng/mL or greater for patients w/ radical prostatectomy history or PSA 5 ng/mL or greater for patients w/ primary XRT history; do not open/dissolve cap; do not cut/crush/chew tab
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined
- HD/PD: not defined
hepatic dosing
- [no adjustment]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- caution: male patients of reproductive potential
- caution: seizure risk
- caution: cardiovascular disease risk
- caution: fracture risk
Drug Interactions .
Overview
enzalutamide
antiandrogen
- CYP2C8 substrate
- CYP3A4 substrate
- P-gp inhibitor, weak
- CYP2C9 inducer, moderate
- CYP2C19 inducer, moderate
- CYP3A4 inducer, strong
- hypertensive effects
- lowers seizure threshold
Contraindicated
- artemether/lumefantrine
- atazanavir
- colchicine
- doravirine
- elbasvir
- fostemsavir
- grazoprevir
- isavuconazonium
- lenacapavir
- lonafarnib
- lorlatinib
- lurasidone
- mavacamten
- nirmatrelvir
- pacritinib
- praziquantel
- ranolazine
- tipranavir
Avoid/Use Alternative
- abemaciclib
- abiraterone acetate
- acalabrutinib
- acoramidis
- adagrasib
- aldesleukin
- alfentanil
- alpelisib
- amifampridine
- apalutamide
- apixaban
- apremilast
- aprepitant
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- atogepant
- atrasentan
- avacopan
- avanafil
- avapritinib
- axitinib
- bedaquiline
- bictegravir
- bortezomib
- bosutinib
- brigatinib
- buprenorphine
- buspirone
- butalbital
- cabozantinib
- capivasertib
- capmatinib
- carbamazepine
- cariprazine
- ceritinib
- clarithromycin
- clozapine
- cobicistat
- cobimetinib
- codeine
- copanlisib
- crizotinib
- dabigatran
- daridorexant
- darolutamide
- dasatinib
- defactinib
- deflazacort
- desogestrel (contraceptive)
- deuruxolitinib
- dexamethasone
- diazoxide
- dienogest (contraceptive)
- dihydrocodeine
- diltiazem
- dolutegravir
- dordaviprone
- doxorubicin
- dronedarone
- drospirenone (contraceptive)
- duvelisib
- elacestrant
- elexacaftor/tezacaftor/ivacaftor
- eliglustat
- elvitegravir
- encorafenib
- ensartinib
- entrectinib
- epinephrine inhaled
- erdafitinib
- erlotinib
- estradiol (contraceptive)
- ethinyl estradiol (contraceptive)
- ethynodiol (contraceptive)
- etonogestrel (contraceptive)
- everolimus
- fedratinib
- felodipine
- fenfluramine
- fentanyl
- fexinidazole
- finerenone
- flibanserin
- fosamprenavir
- fosaprepitant
- fosphenytoin
- fostamatinib
- fruquintinib
- furosemide
- futibatinib
- ganaxolone
- gemfibrozil
- gepirone
- gepotidacin
- gilteritinib
- glasdegib
- glecaprevir
- hydrocodone
- ibrexafungerp
- ibrutinib
- idelalisib
- imatinib
- imlunestrant
- iohexol
- irinotecan
- isradipine
- istradefylline
- itraconazole
- ivabradine
- ivacaftor
- ivosidenib
- ixabepilone
- ixazomib
- ketoconazole
- lapatinib
- larotrectinib
- lazertinib
- lefamulin
- lemborexant
- leniolisib
- letermovir
- levoketoconazole
- levonorgestrel (contraceptive)
- levonorgestrel (post-coital contraceptive)
- linagliptin
- lopinavir/ritonavir
- lumacaftor/ivacaftor
- lumateperone
- lurbinectedin
- macitentan
- maraviroc
- maribavir
- mavorixafor
- medroxyprogesterone (contraceptive)
- meperidine
- methadone
- midazolam
- midodrine
- midostaurin
- mifepristone
- mitapivat
- mitotane
- mobocertinib
- naldemedine
- naloxegol
- nefazodone
- nelfinavir
- nerandomilast
- neratinib
- netupitant
- nevirapine
- nicardipine
- nifedipine
- nilotinib
- nimodipine
- nintedanib
- nirogacestat
- nisoldipine
- norelgestromin (contraceptive)
- norethindrone (contraceptive)
- norgestimate (contraceptive)
- norgestrel (contraceptive)
- olaparib
- oliceridine
- olutasidenib
- omaveloxolone
- osimertinib
- oxycodone
- palbociclib
- paliperidone
- palovarotene
- panobinostat
- pazopanib
- pemigatinib
- pentobarbital
- pexidartinib
- phenobarbital
- phenytoin
- pimavanserin
- pirtobrutinib
- ponatinib
- pralsetinib
- pretomanid
- primidone
- quinine
- quizartinib
- regorafenib
- remibrutinib
- repotrectinib
- revumenib
- ribociclib
- rifabutin
- rifampin
- rilpivirine
- rilzabrutinib
- rimegepant
- ripretinib
- ritlecitinib
- ritonavir
- rivaroxaban
- roflumilast
- rolapitant
- romidepsin
- samidorphan
- sebetralstat
- segesterone (contraceptive)
- selpercatinib
- selumetinib
- simvastatin
- siponimod
- sirolimus
- sirolimus albumin-bound
- sonidegib
- sorafenib
- sotorasib
- sparsentan
- St. John's wort
- stiripentol
- sufentanil
- sunitinib
- sunvozertinib
- suzetrigine
- tadalafil
- taletrectinib
- tamoxifen
- tasimelteon
- tazemetostat
- temsirolimus
- tezacaftor/ivacaftor
- thiotepa
- ticagrelor
- tivozanib
- tofacitinib
- tolvaptan
- topotecan
- toremifene
- trabectedin
- tramadol
- tretinoin
- triazolam
- tucatinib
- ubrogepant
- ulipristal (post-coital contraceptive)
- upadacitinib
- valbenazine
- vandetanib
- vanzacaftor/tezacaftor/deutivacaftor
- velpatasvir
- vemurafenib
- venetoclax
- verapamil
- vinblastine
- vincristine
- vinorelbine
- voclosporin
- vonoprazan
- vorapaxar
- voriconazole
- voxilaprevir
- zaleplon
- zanubrutinib
- zolpidem
- zongertinib
- zuranolone
Monitor/Modify Tx
- acebutolol
- afatinib
- albuterol
- albuterol inhaled
- aliskiren
- almotriptan
- amiloride
- aminophylline
- amitriptyline
- amlodipine
- amphetamine
- angiotensin II
- aprocitentan
- arformoterol inhaled
- aripiprazole oral
- armodafinil
- asciminib
- atenolol
- atomoxetine
- atorvastatin
- atropine ophthalmic
- avatrombopag
- azilsartan medoxomil
- belumosudil
- benazepril
- benzphetamine
- betamethasone
- betaxolol
- bevacizumab
- bismuth subsalicylate
- bisoprolol
- brexpiprazole
- budesonide
- bumetanide
- bupropion
- butorphanol
- caffeine
- caffeine citrate
- calcitriol
- candesartan cilexetil
- cannabidiol
- cannabis
- captopril
- carfilzomib
- carvedilol
- celecoxib
- chlorothiazide
- chlorthalidone
- cholecalciferol (vitamin D3)
- clevidipine
- clobazam
- clonidine
- cocaine
- corticotropin
- cortisone
- crinecerfont
- cyclophosphamide
- cyclosporine
- danazol
- darbepoetin alfa
- desmopressin
- desvenlafaxine
- dexmethylphenidate
- dextroamphetamine
- diclofenac
- diclofenac topical
- diethylpropion
- diflunisal
- digoxin
- dihydroergotamine
- disopyramide
- dobutamine
- dopamine
- doxapram
- doxazosin
- doxercalciferol
- dronabinol
- droxidopa
- edoxaban
- eletriptan
- enalapril
- enalaprilat
- enfortumab vedotin
- ephedra
- ephedrine injection
- ephedrine oral
- epinephrine
- eplerenone
- epoetin alfa
- eptinezumab
- eravacycline
- erenumab
- ergotamine
- esketamine
- esmolol
- estetrol (contraceptive)
- ethacrynic acid
- ethosuximide
- etodolac
- etrasimod
- exemestane
- fenoldopam
- fenoprofen
- fingolimod
- fludrocortisone
- flurbiprofen
- formoterol inhaled
- fosinopril
- fremanezumab
- frovatriptan
- galcanezumab
- gefitinib
- glimepiride
- guanfacine
- haloperidol
- hoodia
- hydralazine
- hydrochlorothiazide
- hydrocortisone
- hydroxocobalamin IV
- ibuprofen
- ifosfamide
- imipramine
- indapamide
- indomethacin
- iopamidol
- irbesartan
- ketamine
- ketoprofen
- ketorolac
- labetalol
- lanreotide
- leflunomide
- lenvatinib
- levalbuterol inhaled
- levomilnacipran
- licorice
- lisdexamfetamine
- lisinopril
- losartan
- luspatercept
- macimorelin
- magnesium salicylate
- meclofenamate
- mefenamic acid
- meloxicam
- methamphetamine
- methoxy polyethylene glycol-epoetin beta
- methyldopa
- methylergonovine
- methylphenidate
- methylprednisolone
- methyltestosterone
- metoclopramide
- metolazone
- metoprolol
- milnacipran
- minoxidil
- mirabegron
- mirtazapine
- modafinil
- moexipril
- morphine
- nabumetone
- nadolol
- naproxen
- naratriptan
- nateglinide
- naxitamab
- nebivolol
- niraparib
- norepinephrine
- nortriptyline
- olmesartan medoxomil
- olodaterol inhaled
- osilodrostat
- oxaprozin
- oxcarbazepine
- oxymetazoline nasal
- oxytocin
- ozanimod
- paltusotine
- perampanel
- perindopril
- phendimetrazine
- phenoxybenzamine
- phentermine
- phentolamine
- phenylephrine
- phenylephrine injection
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- pindolol
- piroxicam
- pitolisant
- ponesimod
- prazosin
- prednisolone
- prednisone
- propranolol
- pseudoephedrine
- quetiapine
- quinapril
- quinidine (antiarrhythmic)
- ramipril
- ramucirumab
- repaglinide
- risperidone
- rizatriptan
- ropinirole
- rotigotine transdermal
- salmeterol inhaled
- salsalate
- seladelpar
- sildenafil
- solriamfetol
- spironolactone
- sulindac
- sumatriptan
- tacrolimus
- tagraxofusp
- talazoparib
- telmisartan
- tenofovir alafenamide
- tenofovir disoproxil
- terazosin
- terbutaline
- teriflunomide
- testosterone
- theophylline
- tiagabine
- timolol
- tolmetin
- torsemide
- trametinib
- trandolapril
- trazodone
- triamcinolone
- triamterene
- vadadustat
- valsartan
- vamorolone
- vasopressin
- venlafaxine
- vilanterol inhaled
- vilazodone
- viloxazine
- vortioxetine
- warfarin
- yohimbe
- zavegepant
- ziv-aflibercept
- zolmitriptan
- zonisamide
Caution Advised
- abrocitinib
- acetazolamide
- albendazole
- alprazolam
- amiodarone
- bosentan
- brentuximab vedotin
- brivaracetam
- bromocriptine
- busulfan
- carisoprodol
- cenobamate
- chlorambucil
- chloroquine
- citalopram
- clindamycin
- clomipramine
- clonazepam
- clopidogrel
- clorazepate
- dabrafenib
- dapsone
- darunavir
- deferasirox
- dexlansoprazole
- diazepam
- domperidone
- donepezil
- drospirenone (hormone replacement)
- efavirenz
- elagolix
- erythromycin
- escitalopram
- eslicarbazepine acetate
- esomeprazole
- estradiol (hormone replacement)
- estrogens, conjugated (hormone replacement)
- estrogens, esterified (hormone replacement)
- eszopiclone
- ethinyl estradiol (hormone replacement)
- etoposide
- etravirine
- felbamate
- fesoterodine
- finasteride
- fluvastatin
- gabapentin
- glyburide
- hydroxychloroquine
- isotretinoin
- lacosamide
- lamotrigine
- lansoprazole
- levetiracetam
- levonorgestrel (hormone replacement)
- levonorgestrel intrauterine device (contraceptive)
- lorazepam
- lovastatin
- magnesium citrate
- medroxyprogesterone (hormone replacement)
- mefloquine
- methsuximide
- montelukast
- nafcillin
- norethindrone (hormone replacement)
- olanzapine
- omeprazole
- ondansetron
- ospemifene
- paclitaxel
- paroxetine
- pibrentasvir
- polatuzumab vedotin
- polyethylene glycol
- polyethylene glycol/electrolytes
- pregabalin
- progesterone (hormone replacement)
- progesterone vaginal (hormone replacement)
- promethazine
- propafenone
- quinidine (CYP2D6 inhibitor)
- ramelteon
- red yeast rice
- rifapentine
- riociguat
- rufinamide
- ruxolitinib
- selegiline
- sertraline
- sodium picosulfate
- solifenacin
- sulfate bowel prep
- suvorexant
- telisotuzumab vedotin
- terbinafine
- tinidazole
- tisotumab vedotin
- topiramate
- treosulfan
- valproic acid
- vigabatrin
Adverse Reactions .
Serious Reactions
- seizures
- posterior reversible encephalopathy syndrome
- infection, severe
- ischemic heart disease
- fractures
- hypersensitivity reaction
- Stevens-Johnson syndrome
- erythema multiforme
- toxic epidermal necrolysis
- drug reaction w/ eosinophilia and systemic symptoms
- acute generalized exanthematous pustulosis
- dysphagia, severe
Common Reactions
- asthenia
- fatigue
- hot flashes
- back pain
- diarrhea
- musculoskeletal pain
- HTN
- arthralgia
- constipation
- appetite decr.
- dizziness
- vertigo
- headache
- respiratory infection
- fractures
- peripheral edema
- insomnia
- gynecomastia
- mental impairment
- nausea
- weight decr.
- hematuria
- breast tenderness
- dyspnea
- muscular weakness
- hemorrhage
- hyperglycemia
- Hgb decr.
- neutrophils decr.
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Pregnancy/Lactation .
Pregnancy
Clinical Summary
N/A; drug unlikely to be used during pregnancy based on indication
Individuals of Reproductive Potential
avoid pregnancy by using effective contraception during tx and x3mo after D/C in male patients
Lactation
Clinical Summary
N/A; drug unlikely to be used while breastfeeding based on indication
Pharmacology .
Metabolism: liver; CYP450: 2C8 (primary), 3A4 substrate; Info: active metabolite
Excretion: urine 71% (minimally unchanged), feces 14% (0.4% unchanged); Half-life: 5.8 days (parent drug), 7.8-8.6 days (active metabolite)
Subclass: Hormonal Oncologics, Antiandrogens
Mechanism of Action
binds and inhibits androgen receptors
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.