Xtandi, or Enzalutamide, is used to treat cancer of the prostate. It belongs to a class of drugs known as androgen receptor inhibitors, which target the androgen receptor, which plays an essential role in prostate cancer development.

It occurs when prostate cancer persists despite suppressed testosterone levels, which usually fuel cancer growth.

In addition to blocking the androgen receptor, Xtandi is a magnet for male hormones such as testosterone. Prostate cancer cells are effectively inhibited from growing and multiplying when Xtandi blocks this receptor.

Once a day, this medication is taken by mouth as a capsule. There is only one strength available: 40 mg.

Warnings and Precautions

Xtandi, a medication primarily prescribed for the treatment of prostate cancer, is a potent drug with significant therapeutic benefits. However, like any pharmaceutical product, it comes with its own set of warnings and precautions that patients and healthcare providers must be aware of.

  1. Liver Function: Xtandi may affect your liver function. Your healthcare provider will monitor your liver enzymes regularly. If you notice symptoms such as yellowing of the skin or eyes, dark urine, or persistent nausea, inform your doctor immediately.
  2. Seizures: Some individuals using Xtandi have reported experiencing seizures. If you have a history of seizures or are at risk, discuss this with your healthcare provider.
  3. Allergic Reactions: Allergic reactions to Xtandi are rare but possible. If you develop symptoms such as rash, itching, swelling, severe dizziness, or difficulty breathing, seek medical attention promptly.
  4. Falls and Fractures: Xtandi may increase your risk of falls and fractures. Take precautions to prevent accidents, especially if you have pre-existing bone issues.
  5. Hypertension: Xtandi can lead to high blood pressure. Monitor your blood pressure regularly and follow your doctor’s recommendations for managing it.
  6. Pregnancy and Breastfeeding: Xtandi can harm an unborn baby. If you or your partner is pregnant or planning to become pregnant, or if you are breastfeeding, inform your healthcare provider.
  7. Proper Dosage: Take Xtandi exactly as prescribed by your healthcare provider. Do not alter the dosage or stop taking it without consulting your doctor.
  8. Regular Check-ups: Stay committed to regular check-ups with your healthcare team. They will monitor your progress and make necessary adjustments to your treatment plan.
  9. Inform Your Healthcare Provider: Always keep your healthcare provider informed about any side effects, changes in your health, or concerns you may have while taking Xtandi.

Side Effects

Understanding the potential side effects of this drug is crucial for making informed decisions about your treatment.

Common Side Effects

  1. Fatigue: Many patients report feeling tired or experiencing a lack of energy while taking Xtandi. This fatigue can vary in intensity but is a frequent complaint.
  2. Hot Flashes: Xtandi may cause hot flashes, similar to those experienced during menopause. These sudden sensations of warmth can be uncomfortable but are usually not severe.
  3. Headaches: Some individuals may experience headaches as a side effect of Xtandi. These headaches can range from mild to moderate in intensity.
  4. Joint Pain: Xtandi can lead to joint pain and stiffness. This discomfort can affect daily activities, but it’s typically manageable.

Rare Side Effects

  1. Allergic Reactions: In rare cases, individuals may experience allergic reactions to Xtandi. Symptoms can include rash, itching, swelling, severe dizziness, or difficulty breathing. If you notice any of these symptoms, seek immediate medical attention.
  2. Seizures: Although uncommon, some patients have reported experiencing seizures while taking Xtandi. If you have a history of seizures, it’s essential to discuss this with your healthcare provider.
  3. Liver Problems: Xtandi may lead to liver problems in rare instances. Signs of liver issues can include yellowing of the skin or eyes (jaundice), dark urine, and persistent nausea or vomiting. Promptly inform your doctor if you notice these symptoms.

Severe Side Effects

  1. Heart Problems: In extremely rare cases, Xtandi may cause heart problems, such as an irregular heartbeat. If you experience chest pain, rapid or pounding heartbeat, or severe dizziness, seek immediate medical attention.
  2. Lung Problems: Some individuals may develop lung problems, such as difficulty breathing or coughing up blood. While this is highly uncommon, it should be reported to your healthcare provider immediately.
  3. Neurological Symptoms: Xtandi can rarely cause neurological symptoms, including confusion, weakness, or difficulty speaking. If you encounter any of these issues, seek medical help promptly.


Xtandi, a revolutionary medication, has garnered significant attention for its effectiveness in treating prostate cancer. However, before embarking on your Xtandi journey, it’s crucial to comprehend the various interactions it may have with other substances.

Drug Interactions

  1. Antiarrhythmic Medications: Xtandi may interact with antiarrhythmic drugs, potentially altering their effects. It’s advisable to consult your healthcare provider if you are taking such medications concurrently.
  2. Antifungal Medications: Some antifungal drugs may interact with Xtandi. Your doctor can guide you on managing this interaction or adjusting your medication regimen.
  3. HIV Medications: If you are on HIV medications, consult your healthcare professional to ensure they do not interfere with Xtandi’s effectiveness.
  4. Blood Thinners: Xtandi may interact with blood thinners. It’s crucial to monitor your blood clotting parameters if you are prescribed both types of medications.

Herbal Interactions

  1. Saw Palmetto: This herbal remedy, commonly used for prostate health, may interact with Xtandi. Discuss its use with your healthcare provider.
  2. St. John’s Wort: If you’re taking St. John’s Wort, inform your doctor, as it can potentially affect Xtandi’s performance.

Food Interactions

  1. Grapefruit: Grapefruit and its juice can interfere with the metabolism of Xtandi. It’s advisable to avoid consuming grapefruit products while on this medication.
  2. High-Fat Meals: Xtandi may be better absorbed when taken with a meal that contains a moderate amount of fat. Discuss your dietary preferences with your healthcare provider to ensure optimal drug absorption.


Xtandi, a powerful medication used in the treatment of prostate cancer, requires careful dosing to ensure its effectiveness while minimizing the risk of side effects.

Initial Dosage

When beginning Xtandi therapy, it’s crucial to follow the initial dosing guidelines meticulously. The standard starting dose for Xtandi is 160 mg, which equals four 40 mg soft gelatin capsules, taken once daily. It’s generally recommended to take Xtandi with food, preferably a meal, to enhance its absorption and reduce the likelihood of stomach upset.

Maintenance Dosing

After initiating your Xtandi treatment, the next step is to maintain a consistent dosing schedule. Patients are advised to continue taking their daily 160 mg dose with food, ensuring that the treatment’s effectiveness remains optimized. Consistency is key when it comes to prostate cancer therapy, so make it a routine part of your daily life.

Missed Dose

Life can get busy, and occasionally, you might forget to take your Xtandi dose. If this happens, don’t panic. Here’s what to do:

  1. If you remember within 12 hours: Take your missed dose immediately and continue with your regular dosing schedule.
  2. If more than 12 hours have passed: Skip the missed dose and return to your regular dosing time the next day. Never take a double dose to compensate for a missed one.


While adhering to your dosing schedule, it’s essential to be aware of the potential risks of overdose. Taking more Xtandi than prescribed can lead to severe side effects. If you suspect an overdose or experience symptoms like dizziness, fainting, or severe fatigue, seek immediate medical attention. Always keep your medication out of reach of children and pets to prevent accidental ingestion.


In the world of pharmaceuticals, ensuring the effectiveness and safety of medications is of paramount importance. Xtandi, a medication used in the treatment of prostate cancer, is no exception. Proper storage of Xtandi is crucial to maintain its integrity and efficacy.

  • Temperature: Xtandi should be stored at room temperature, ideally between 68°F to 77°F (20°C to 25°C). Avoid extreme temperatures, as exposure to heat or cold can degrade the medication. Do not refrigerate or freeze Xtandi.
  • Moisture: Keep Xtandi in its original packaging, and ensure that the container is tightly closed when not in use. Moisture can damage the medication, so it’s crucial to protect it from humidity. Avoid storing Xtandi in the bathroom or other areas with high moisture levels.
  • Light: Xtandi should be stored in a dark place, away from direct sunlight. Exposure to light can cause the medication to break down and lose its effectiveness. Keeping it in its original packaging or a light-resistant container is advisable.
  • Keep Out of Reach of Children and Pets: As with any medication, Xtandi should be stored in a place that is inaccessible to children and pets. Accidental ingestion can have serious consequences.
  • Check Expiry Date: Always check the expiration date on the medication’s packaging. Do not use Xtandi if it is past its expiry date.
  • Do Not Transfer: Xtandi should be kept in its original container. Do not transfer it to pill organizers or other containers, as this can lead to contamination or degradation.
  • Consult Your Pharmacist: If you have any questions or concerns about storing Xtandi, don’t hesitate to consult your pharmacist. They can provide specific guidance based on your individual circumstances.
  • Medication Disposal: When you no longer need Xtandi or it has expired, dispose of it properly as per local regulations. Do not flush it down the toilet or throw it in the trash.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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