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Enzalutamide Side Effects

For the Consumer

Applies to enzalutamide: oral capsule liquid filled

Along with its needed effects, enzalutamide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking enzalutamide:

More common
  • Back pain
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • blood in the urine
  • blurred vision
  • chest pain
  • cough with mucus
  • difficulty with breathing
  • dizziness
  • fever or chills
  • loss of bladder or bowel control
  • nervousness
  • painful or difficult urination
  • pounding in the ears
  • slow or fast heartbeat
  • sore throat
  • tingling of the hands or feet
  • unable to move the legs
  • unusual weight gain or loss
Less common
  • Anxiety
  • confusion or excitement
  • depression
  • fainting
  • falling
  • lightheadedness
  • loss of memory
  • memory or attention span problems
  • nightmares or vivid dreams
  • rapid, shallow breathing
  • Seizures

Some side effects of enzalutamide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Body aches or pain
  • bone pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • diarrhea
  • difficulty having a bowel movement (stool)
  • difficulty with moving
  • dry throat
  • ear congestion
  • feeling of constant movement of self or surroundings
  • feeling of warmth
  • hoarseness
  • joint pain
  • lack or loss of strength
  • loss of voice
  • muscle pain, stiffness, or weakness
  • pain or tenderness around the eyes and cheekbones
  • redness of the face, neck, arms, and upper chest
  • sensation of spinning
  • stuffy or runny nose
  • tender, swollen glands in the neck
  • trouble sleeping
  • trouble with swallowing
  • unusual tiredness or weakness
Less common
  • Bloody nose
  • dry skin
  • frequent urination
  • itching skin
  • pale-colored urine

For Healthcare Professionals

Applies to enzalutamide: oral capsule

Nervous system

Very common (10% or more): Headache (up to 12.1%), dizziness/vertigo (up to 11.3%)
Common (1% to 10%): Spinal cord compression and cauda equina syndrome, paresthesia, mental impairment disorders, hypoesthesia, dysgeusia, restless legs syndrome
Uncommon (0.1% to 1%): Seizures
Postmarketing reports: Posterior reversible encephalopathy syndrome[Ref]

It is unknown how the drug may lower the seizure threshold; however, it may be related to the drug's ability to inhibit the activity of the GABA-gated chloride channel. The risk of seizure may be related to dose.

Mental impairment disorders included amnesia, memory impairment, cognitive disorder, and disturbance in attention.[Ref]


Very common (10% or more): Hot flush (up to 20.3%), peripheral edema (up to 15.4%), hypertension (up to 14.2%)[Ref]


Common (1% to 10%): Pruritus, dry skin[Ref]


Common (1% to 10%): Gynecomastia[Ref]


Very common (10% or more): Constipation (up to 23.2%), diarrhea (up to 21.8%)[Ref]


Common (1% to 10%): Hematuria, pollakiuria[Ref]


Very common (10% or more): Neutropenia (15%)
Common (1% to 10%): Thrombocytopenia
Frequency not reported: Leukopenia[Ref]


Very common (10% or more): ALT elevations (10%)
Common (1% to 10%): Bilirubin elevations[Ref]


Very common (10% or more): Decreased appetite (up to 18.9%), decreased weight (up to 12.4%)[Ref]


Very common (10% or more): Back pain (up to 28.6%), arthralgia (up to 21.4%), musculoskeletal pain (up to 15%)
Common (1% to 10%): Muscular weakness, musculoskeletal stiffness[Ref]


Fall-related injuries included non-pathologic fractures, joint injuries, and hematomas.[Ref]

Very common (10% or more): Asthenia/fatigue (up to 50.6%), falls (up to 12.7%)
Common (1% to 10%): Fall-related injuries[Ref]


Common (1% to 10%): Insomnia, anxiety, hallucinations[Ref]


Upper respiratory tract infection included nasopharyngitis, sinusitis, rhinitis, pharyngitis, and laryngitis. Lower respiratory tract and lung infection included pneumonia and bronchitis.[Ref]

Very common (10% or more): Upper respiratory tract infection (up to 16.4%), dyspnea (up to 11%)
Common (1% to 10%): Lower respiratory tract and lung infection, epistaxis[Ref]


1. "Product Information. Xtandi (enzalutamide)." Astellas Pharma US, Inc, Deerfield, IL.

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Some side effects of enzalutamide may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.