enzalutamide at a glance
Medicine class
Androgen receptor signalling inhibitor
Main use
Selected hormone-sensitive and castration-resistant prostate cancers
Food
May be taken with or without food
Administration
Swallow tablets whole with enough water; do not cut, crush or chew
What is enzalutamide used for?
UK-licensed uses in adult men include:
High-risk biochemical recurrence of non-metastatic hormone-sensitive prostate cancer when salvage radiotherapy is unsuitable, either alone or with androgen-deprivation therapy.
Metastatic hormone-sensitive prostate cancer, with androgen-deprivation therapy.
High-risk non-metastatic castration-resistant prostate cancer.
Metastatic castration-resistant prostate cancer before chemotherapy when symptoms are absent or mild, or after progression on or following docetaxel.
How does enzalutamide work?
Enzalutamide blocks androgen receptors and restricts their movement into the cell nucleus and binding to DNA. This reduces signals that promote prostate cancer cell growth.
enzalutamide preparations and strengths
Tablet
Route: Oral
Strengths: 40 mg
How to take enzalutamide
Follow the oncology team's instructions.
Swallow tablets whole with sufficient water.
Do not cut, crush or chew them.
They may be taken with or without food.
Ask the specialist team for advice if swallowing is difficult; choking has been reported.
Do not stop treatment without speaking to the prescriber.
enzalutamide side effects
Common or expected effects
- Tiredness or weakness
- Hot flushes
- Headache
- High blood pressure
- Falls and bone fractures
- Memory, attention or taste changes
- Anxiety
- Dry or itchy skin
- Breast enlargement, tenderness or nipple pain, particularly when used alone
Get urgent medical advice
- Seizure
- Worsening headache, confusion, blindness or other visual disturbance
- Blistering or peeling skin, target-like rash, mouth sores or fever
- Swelling of the face, lips, tongue or throat
- Chest pain or other symptoms suggesting reduced blood supply to the heart
- Unexpected bleeding, visible blood in urine or persistent urinary urgency
enzalutamide in pregnancy
Enzalutamide is not for use by women and is contraindicated during pregnancy because it may harm the developing baby or cause pregnancy loss. A man taking it should use a condom with a pregnant partner. With a partner who could become pregnant, a condom and another effective contraceptive method are required during treatment and for three months afterwards. Pregnant people should not handle broken or damaged tablets without protection.
enzalutamide while breastfeeding
Enzalutamide is not for use by women who are breastfeeding. It is unknown whether it enters human milk, so specialist advice is essential if exposure is suspected.
enzalutamide interactions
Enzalutamide affects several drug-metabolising enzymes and transporters. The full medication list should be reviewed before starting or stopping it.
Warfarin and acenocoumarol
Enzalutamide may reduce anticoagulant exposure; avoid where possible or arrange additional INR monitoring.
Gemfibrozil and other strong CYP2C8 inhibitors
These can substantially increase enzalutamide exposure and should generally be avoided or managed by the specialist.
CYP3A4, CYP2C9 or CYP2C19 substrates
Medicines including some statins, opioids, antiepileptics, corticosteroids and immunosuppressants may become less effective.
Common questions about enzalutamide
Answers are fully visible for fast scanning and source review.
Is enzalutamide chemotherapy?
No. It is an androgen receptor inhibitor, a type of hormone-targeted cancer treatment.
Can it be taken with food?
Yes. It may be taken with or without food.
Can the tablets be crushed or split?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.