Skip to main content


Generic name: enzalutamide [ ENZ-a-LOOT-a-mide ]
Brand name: Xtandi
Dosage forms: oral capsule (40 mg), oral tablet (40 mg; 80 mg)
Drug classes: Antiandrogens, Hormones / antineoplastics

Medically reviewed by Philip Thornton, DipPharm. Last updated on Mar 2, 2022.

What is enzalutamide?

Enzalutamide is a prescription medicine used to treat prostate cancer in men who have received surgery or hormone therapy to lower testosterone.

Enzalutamide is sometimes used when the cancer no longer responds to treatment, but has not spread to other parts of the body.

Enzalutamide is also used when the cancer has responded to treatment and has spread to other parts of the body (metastatic).

It is not known if enzalutamide is safe and effective in children or females.


Although not for use by women, enzalutamide can cause birth defects if the mother or the father is taking this medicine. Use a condom and one other form of birth control to prevent pregnancy while using this medicine, and for at least 3 months after your last dose.

Before taking this medicine

You should not use enzalutamide if you are allergic to it.

To make sure enzalutamide is safe for you, tell your doctor if you have ever had:

Enzalutamide can harm an unborn baby or cause birth defects, even if the father is taking this medicine.

  • If your sex partner is pregnant, always use a condom during sex.

  • If your sex partner could become pregnant, use effective birth control to prevent pregnancy. Keep using birth control for at least 3 months after you stop taking enzalutamide.

  • Tell your doctor at once if a pregnancy occurs while you are taking this morning.

Although this medicine is not for use by women, enzalutamide should not be taken by a woman who is breastfeeding a baby.

How should I take enzalutamide?

Take enzalutamide exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Take the medicine at the same time each day, with or without food.

You may need to take 2 to 4 tablets at a time to get a full dose.

Swallow the enzalutamide pill whole. Do not break, chew, or crush a tablet. Do do not chew, open, or dissolve a capsule.

Use all medications as directed and read all medication guides you receive. Do not change your dose or dosing schedule without your doctor's advice.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Dosing information

Usual Adult Dose for Prostate Cancer:

160 mg (four 40 mg capsules) orally once a day

-This drug can be taken with or without food.
-Swallow capsules whole. Do not chew, dissolve, or open the capsules.
-Patients receiving this drug should also receive a gonadotropin-releasing hormone (GnRH) analog concurrently or should have had bilateral orchiectomy.

Use: Metastatic and non-metastatic castration-resistant prostate cancer

What happens if I miss a dose?

Take the missed dose as soon as you remember. If you forget your dose for the entire day, skip the missed dose and go back to your regular schedule the next day. Do not take two doses in one day.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose could cause you to have a seizure.

What should I avoid while taking enzalutamide?

Enzalutamide can increase your risk of seizure. Avoid any activity that could be dangerous if you have a seizure or lose consciousness.

Avoid driving or hazardous activity until you know how enzalutamide will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Even without dizziness, taking enzalutamide could increase your risk of falls or bone fractures. Avoid activities or situations that may lead to injury or falls.

Enzalutamide side effects

Stop taking this medicine and get emergency medical help if you have signs of an allergic reaction to enzalutamide: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using enzalutamide and call your doctor at once if you have:

  • dizziness, spinning sensation;

  • a seizure (black-out or convulsions);

  • confusion, thinking problems, severe headache, vision problems;

  • weakness, loss of consciousness;

  • red or pink urine;

  • heart problems - chest pain, shortness of breath (even with mild exertion);

  • increased blood pressure - severe headache, blurred vision, pounding in your neck or ears, anxiety, nosebleed; or

  • signs of a lung infection - fever, cough with yellow or green mucus, stabbing chest pain, wheezing, feeling short of breath.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common enzalutamide side effects may include:

  • feeling weak or tired;

  • constipation, diarrhea;

  • loss of appetite;

  • flushing (redness, hot feeling);

  • back pain, joint pain; or

  • high blood pressure.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect enzalutamide?

Enzalutamide can increase your risk of having a seizure, especially if you also use certain other medicines for infections, swelling or inflammation, asthma, hormone replacement, diabetes, depression, or mental illness.

Many drugs can interact with enzalutamide. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Popular FAQ

A decrease in prostate-specific antigen (PSA) levels is seen in some men with advanced prostate cancer who are treated with Xtandi (enzalutamide).

Levels of PSA in the blood can become elevated when there is a problem with the prostate, such as when prostate cancer develops. Monitoring PSA levels in the blood is one of the methods used to determine how prostate cancer is responding to treatment with Xtandi. Continue reading

Xtandi (enzalutamide) is an androgen receptor inhibitor or anti-androgen. Androgens are a group of hormones, which includes testosterone, that stimulate prostate cancer cells to grow.

Xtandi works by blocking the action of androgens at the androgen receptor - reducing how often androgens can connect with the receptor - which helps prevent prostate cancer cells from growing and spreading. Continue reading

Xtandi (enzalutamide) is used to treat three forms of advanced prostate cancer including:

  1. Non-metastatic castration-resistant prostate cancer (nmCRP)
  2. Metastatic castration-resistant prostate cancer (mCRPC)
  3. Metastatic castration-sensitive prostate cancer (mCSPC)
Continue reading

More FAQ

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use enzalutamide only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.