6 mins read

Xtandi is used to treat certain types of prostate cancer. Common side effects include hot flashes, constipation, diarrhea, and muscle or joint pain. Xtandi needs to be swallowed whole. Talk to your health care provider if you have trouble swallowing this medicine. Xtandi may cause falls or seizures. Tell your health care provider right away if you experience a seizure, quickly worsening headache, confusion, or vision changes.

Uses

What is Xtandi used for?

Xtandi (enzalutamide) is commonly used to treat prostate cancer.

Xtandi may also be used for other conditions as determined by your health care provider.

How does Xtandi work (mechanism of action)?

Prostate cancer cells need certain hormones, called androgens, to grow. Xtandi blocks the effects of androgens, which can help slow the growth of prostate cancer.

How is Xtandi supplied (dosage forms)?

Dosage forms and strengths

  • 40 mg oral capsules
  • 40 mg oral tablets
  • 80 mg oral tablets

How should I store Xtandi?

Xtandi should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store it in a cool, dry place, with the container tightly closed.

Side Effects

What are the most common side effects of Xtandi?

The most common side effects of Xtandi are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Muscle or joint pain
  • Tiredness
  • Hot flashes
  • Constipation or diarrhea
  • Decreased appetite
  • Increased blood pressure
  • Bleeding problems, such as nosebleeds
  • Falls and broken bones (see below)
  • Headache

There may be other side effects of Xtandi that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Xtandi?

While less common, the most serious side effects of Xtandi are described below, along with what to do if they happen.

Severe Allergic Reactions. Xtandi may cause allergic reactions, which can be serious. Stop taking Xtandi and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Heart Disease. Taking Xtandi may increase the risk of having a heart attack or stroke. You may have a higher chance of a heart attack or stroke if you already have certain conditions, such as high blood pressure, diabetes, or high cholesterol. Get emergency help if you have any of the following symptoms.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech

Falls and Broken Bones. Xtandi may increase your risk of falling, which can lead to injuries and possibly broken bones. Tell your health care provider if you fall down. Follow any recommendations to reduce your fall risk. Tell your health care provider if you break a bone, and get a bone mineral density test if one is ordered for you.

Seizures. Xtandi may cause seizures. There are many different types of seizures, and some of them are not easy to recognize. Stop taking Xtandi and call your health care provider if you have any of the following signs that a seizure is happening or could happen.

  • Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
  • Stiffening of your arms and legs
  • Feeling anxious, nervous, confused, or a sense of dread
  • Feeling dizzy or lightheaded
  • Falling or losing consciousness

Posterior Reversible Encephalopathy Syndrome (PRES). Xtandi may cause a rare but serious disorder called PRES. PRES involves swelling and narrowing of blood vessels in your brain. If PRES is not treated, it can lead to a stroke. Call your health care provider right away if you have any of the following symptoms of PRES.

  • Changes in thinking or behavior
  • Confusion or hallucinations
  • Sudden decrease or change in vision 
  • Sudden severe headache
  • Seizures

Warnings & Precautions

Who should not use Xtandi?

Allergies to Ingredients. People who are allergic to any of the following should not take Xtandi.

  • Enzalutamide
  • Xtandi
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Xtandi.

What should I know about Xtandi before using it?

Do not take Xtandi unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not change your dose or stop taking Xtandi without talking to your health care provider.

Do not share Xtandi with other people, even if they have the same condition as you. It may harm them.

Keep Xtandi out of the reach of children.

Swallow Xtandi tablets and capsules whole. Do not chew, cut, crush, or dissolve them. Do not open the capsules.

Xtandi can cause harm to an unborn baby. If your partner is pregnant, use condoms during sex while taking Xtandi and for three months after your last dose. If your partner is able to get pregnant, use effective birth control while taking Xtandi and for three months after your last dose. 

Xtandi may affect your ability to get your partner pregnant. Talk with your health care provider if you have concerns about this.

What should I tell my health care provider before using Xtandi?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Xtandi is right for you.

In particular, make sure that you discuss any of the following.

Other Medicines and Supplements. Xtandi may interact with other medicines and supplements. Before taking Xtandi, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Heart problems
  • High blood pressure
  • Diabetes
  • High cholesterol levels
  • Seizures
  • Stroke
  • Osteopenia or osteoporosis
  • Brain injury or brain tumor

Pregnancy. People who can become pregnant are not usually prescribed Xtandi. Xtandi can cause harm to an unborn baby. Tell your health care provider if your partner is or plans to become pregnant.

Breastfeeding. People who can breastfeed are not usually prescribed Xtandi. It is not known if Xtandi passes into breast milk. Tell your health care provider if your partner is or plans to breastfeed.

How can I get more information about Xtandi?

For more information about Xtandi, you can visit the manufacturer’s website at www.xtandi.com or call them at 855-898-2634.

Interactions

Does Xtandi interact with foods or drinks?

There are no known interactions between Xtandi and foods or drinks.

It is unknown if drinking alcohol will affect Xtandi. The risk of tiredness may increase if you drink alcohol while taking Xtandi.

Does Xtandi interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

 In particular, make sure that you discuss if you are taking any of the following before taking Xtandi.

  • Gemfibrozil (Lopid), which is a medicine for high cholesterol
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis

Many other medicines may alter the blood levels of Xtandi, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Xtandi. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally take too much Xtandi?

If you or someone else has taken too much Xtandi, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Xtandi?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.