Enzalutamide

Say it: en-za-LOO-ta-mide · Brand names: Xtandi

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

What it is

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

Often used for

• prostate cancer that has spread
• prostate cancer that keeps growing despite low testosterone
• prostate cancer with a rising PSA (prostate specific antigen) after surgery or radiation

How you get it

Enzalutamide is a capsule or 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 or weak. Rest and short walks can help.
• Hot flashes. Dress in layers and keep cool drinks nearby.
• Back, joint or muscle pain. Gentle stretching and warm baths may help.
• Less appetite. Try small meals and snacks through the day.
• Constipation or diarrhea. Drink plenty of fluids and tell your team if it does not get better.
• High blood pressure. Your team will check it at your visits.
• Dizziness or falls. Get up slowly, use night lights, and remove tripping hazards at home.

Call your care team right away if you have

• A seizure, or a short time when you black out
• Severe headache, confusion, vision changes, or a seizure, which can be signs of a rare brain swelling
• Chest pain or pressure, or pain in the arm, neck or jaw
• Swelling of the face, lips, tongue or throat, or trouble breathing
• A fall, or bone pain after a fall

Before you start, tell your team

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

Good to know

• Enzalutamide can raise the risk of seizures. Ask your team if it is safe to drive or do activities where losing consciousness could hurt you.
• It can raise the risk of heart problems. Your team will watch your blood pressure, cholesterol and heart health.
• Falls and broken bones are more common. Your team may check your bone health.
• Enzalutamide interacts with many medicines. Check with your team before starting anything new.
• 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 capsules or tablets whole. Do not chew, dissolve or open them.
• 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, away from children and pets.
• People who are pregnant or may become pregnant should not touch the pills without gloves.

Questions to ask

• Is it safe for me to drive while on this medicine?
• How will we know if it is working?
• Which of my other medicines could interact with it?
• What can I do to prevent falls?

Side effect guides

• Fatigue (tiredness)
• Diarrhea
• Constipation
• Appetite loss and weight loss
• 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.