Apalutamide

Say it: a-pa-LOO-ta-mide · Brand names: Erleada

Apalutamide is a hormone pill that blocks testosterone from reaching prostate cancer cells.

What it is

Prostate cancer cells have docking spots, called androgen receptors, that testosterone attaches to. Apalutamide blocks these docking spots so the cancer cannot use testosterone to grow. It is used along with a shot or pill that lowers testosterone.

Often used for

• prostate cancer that has spread and still responds to hormone treatment
• prostate cancer that has not spread but keeps growing despite low testosterone

How you get it

Apalutamide is a tablet you take by mouth once a day. You can take it with or without food. Your schedule may be different.

Common side effects and what helps

• Feeling tired. Rest and short walks can help.
• Skin rash. Use gentle soap and moisturizer, and tell your team about any new rash.
• High blood pressure. Your team will check it at your visits.
• Hot flashes. Dress in layers and keep cool drinks nearby.
• Joint pain. Gentle movement and warm baths may help.
• Diarrhea. Drink plenty of fluids and tell your team if it does not get better.
• Weight loss or less appetite. Try small meals and snacks through the day.
• Falls. Get up slowly, use night lights, and remove tripping hazards at home.

Call your care team right away if you have

• A rash with blisters, peeling skin, sores in the mouth or eyes, or a rash with fever
• A seizure
• Chest pain, sudden weakness or numbness on one side, trouble speaking, or a sudden severe headache
• New cough or trouble breathing that does not go away
• A fall, or bone pain after a fall

Before you start, tell your team

• If you have ever had a seizure, a stroke or a brain injury
• If you have heart disease, high blood pressure or high cholesterol
• If you have thyroid problems or take thyroid medicine
• All the medicines you take, including vitamins, herbs and supplements
• If your partner is pregnant or may become pregnant

Good to know

• Apalutamide can raise the risk of heart problems and strokes. Your team will watch your heart health.
• Rarely, it can cause serious skin reactions or lung inflammation.
• Falls and broken bones are more common. Your team may check your bone health.
• It can lower thyroid hormone. You may have blood tests to check your thyroid.
• Men should use a condom and their partner should use birth control during treatment and for 3 months after the last dose.

At home

• Take it once a day at about the same time, with or without food.
• Swallow the tablets whole. If you have trouble swallowing, ask your team about mixing them in applesauce.
• If you miss a dose, ask your care team what to do. Do not take two doses to make up for it.
• Store at room temperature in the original bottle, away from children and pets.

Questions to ask

• How will we know if it is working?
• What should I do if I get a rash?
• Do I need thyroid blood tests?
• What can I do to keep my bones strong?

Side effect guides

• Fatigue (tiredness)
• Diarrhea
• Appetite loss and weight loss
• Skin rash (including EGFR-inhibitor rash)
• Pain

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.