Xtandi Capsule: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Xtandi Capsule (enzalutamide) is a prescription medicine belonging to the androgen receptor inhibitor class. It is used to treat certain types of prostate cancer in adult men by blocking male hormones that help cancer cells grow. Studies have shown it can slow cancer growth and spread, and people taking it lived longer on average than those taking a placebo. It is taken as a once-daily dose and carries specific warnings, including an increased risk of seizures.

What is Xtandi Capsule

Xtandi is a prescription medicine used to treat adult men with certain types of prostate cancer. It contains the active ingredient enzalutamide and works by blocking male hormones that help prostate cancer cells grow.

Xtandi Capsule uses

• Treats prostate cancer that no longer responds to hormone therapy or surgery to lower testosterone (castration-resistant prostate cancer)
• Treats prostate cancer that has spread to other parts of the body and is still hormone sensitive (metastatic castration-sensitive prostate cancer)
• Treats prostate cancer that has not spread but is at high risk of spreading, in men who are hormone sensitive (non-metastatic castration-sensitive prostate cancer with biochemical recurrence at high risk of metastasis)

Benefits of Xtandi Capsule

• Can slow down the growth and spread of prostate cancer cells
• Studies showed people taking Xtandi lived longer on average than those taking a placebo
• Can delay the time before cancer spreads further or before new cancer treatment is needed

How Xtandi Capsule works

Xtandi blocks the activity of male hormones called androgens, such as testosterone. Prostate cancer cells need these hormones to grow and divide, so blocking them stops or slows the cancer from growing and spreading.

Xtandi Capsule dosage

Take your capsules at about the same time each day for the best effect and to help you remember. Swallow the capsules whole with a full glass of water; do not chew, dissolve, or open them before swallowing. You can take this medicine with or without food.

If you are a woman who is or may become pregnant, avoid handling damaged or opened capsules without protection such as gloves.

If you miss a dose at the usual time, take it as soon as you remember and then continue as normal. If you miss a whole day's dose, take your usual dose the next day. If you miss more than one day's dose in a row, talk to your doctor immediately. If it is almost time for your next dose, skip the missed dose and take the next one as scheduled. Do not take a double dose to make up for a missed one. Continue taking this medicine until your doctor tells you to stop.

Available forms and strengths

• Capsules
• Tablets

Side effects of Xtandi Capsule

Common

• Headache
• Weakness
• Tiredness
• Dizziness
• Breathlessness
• Chest pain
• Swelling of the hands, ankles or feet
• Rash
• Pain in back, muscles or joints
• Hot flushes
• Falls
• Broken bones
• Hallucinations
• Feeling anxious
• Dry skin
• Itching
• High blood pressure
• Constipation
• Diarrhoea
• Feeling sick
• Decreased appetite
• Difficulty remembering things
• Difficulty thinking clearly
• Forgetfulness
• Reduced concentration
• Feminization of breasts
• Change in sense of taste
• Difficulty swallowing this medicine

Serious

• Seizures
• Posterior Reversible Encephalopathy Syndrome (PRES)
• Choking
• Hypersensitivity (swelling of the face, tongue, lip, or throat)
• Ischemic heart disease
• Cancer as a result of previous treatment with radiation or chemotherapy

Warnings and precautions

• This medicine can increase the risk of seizures. If you have a seizure, your doctor may need to permanently stop your treatment.
• A rare brain condition called Posterior Reversible Encephalopathy Syndrome (PRES) has been reported, with symptoms like seizures, headache, confusion, or vision problems.
• This medicine can increase the risk of heart problems caused by reduced blood flow to the heart (ischemic heart disease).
• This medicine can increase your risk of falls and bone fractures. Your doctor may check your risk for these.
• Severe swallowing problems or choking can happen because of the size of the capsules or tablets. Swallow them whole with enough water.
• This medicine can cause serious allergic reactions, including swelling of the face, tongue, lip, or throat.
• This medicine may harm an unborn baby and cause loss of pregnancy. Male patients must use effective contraception during treatment and for 3 months after the last dose.
• This medicine must not be used by women. It can harm an unborn baby or cause loss of pregnancy. 
• Men having sex with a woman who could become pregnant must use a condom plus another effective birth control method during treatment and for 3 months after stopping.
• This medicine is not for use in women, including those who are breastfeeding. Talk to your doctor if you are breastfeeding or intend to breastfeed.
• Tell your doctor if you have kidney problems before using this medicine.
• Tell your doctor if you drink large amounts of alcohol regularly or occasionally, as this may increase your risk of seizures while taking this medicine.
• Be careful before driving or using machinery until you know how this medicine affects you, since it may cause seizures.

Storage

• Keep your capsules in the pack until it is time to take them
• If you take the capsules out of the pack they may not keep as well
• Keep your capsules in the original packaging in a cool dry place where the temperature stays below 25°C
• Do not take any capsule that is leaking, damaged, or shows signs of tampering
• A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines
• Store it in a cool dry place away from moisture, heat or sunlight; do not store it in the bathroom, near a sink, in the car, or on window sills
• Keep it where young children cannot reach it
• If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any medicine that is left over
• Do not throw away any medicines via wastewater or household waste
• If you no longer need to use this medicine or it is out of date, take it to any pharmacy for safe disposal
• Do not use this medicine after the expiry date

When to see a doctor

• Call your doctor right away or go to the Emergency Department if you have a seizure, loss of consciousness, worsening headache, confusion, blindness, or other vision problems.
• Stop taking this medicine and get medical help right away if you have swelling of the face, tongue, lip, or throat.
• Call your doctor or go to the nearest emergency room right away if you get chest pain or discomfort, or shortness of breath.
• Seek urgent medical attention if you think you have taken too much of this medicine, even if you feel fine, as you may be at higher risk of seizure.
• Call your doctor straight away if your partner becomes pregnant while you are taking this medicine.

Alternatives

• Bicalutamide
• Darolutamide
• Apalutamide