• Metastatic castration-resistant prostate cancer (mCRPC)
  • Non-metastatic castration-resistant prostate cancer (nmCRPC)
  • Metastatic castration-sensitive prostate cancer (mCSPC)

Dose: OD 60 mg orally  (4 × 40 mg capsules or 2 × 80 mg tablets),Can be taken with or without food,
Continue concurrent ADT or maintain surgical castration

  • Capsules: 40 mg
  • Tablets: 40 mg, 80 mg
  • Take once daily at the same time
  • Swallow whole, do not crush or chew
  • Missed dose:
    • If missed, take as soon as remembered unless more than 12 hours have passed—then skip and resume next dose
  • Class: Androgen receptor inhibitor
  • Mechanism of Action:
    • Inhibits androgen receptor signaling by blocking:
      • AR nuclear translocation
      • DNA binding
      • Coactivator recruitment
    • ↓ Prostate cancer cell proliferation
  • Pharmacokinetics:
    • Metabolized by: CYP2C8 and CYP3A4
    • Half-life: ~5.8 days
    • Highly protein-bound, hepatically cleared
  • Fatigue
  • Hot flashes
  • Hypertension
  • Back pain
  • Diarrhea or constipation
  • Arthralgia
  • Headache
  • Pregnancy (in female partners; not used in women)
  • Hypersensitivity to enzalutamide or its components
  • Caution in patients with a history of seizures, brain metastases, or stroke
  • Strong CYP2C8 inhibitors (e.g., gemfibrozil):
    • ↓ enzalutamide dose to 80 mg daily
  • Strong CYP3A4 inducers (e.g., rifampin):
    • May ↓ enzalutamide efficacy
  • Enzalutamide induces CYP3A4, 2C9, and 2C19 → may ↓ effectiveness of:
    • Warfarin
    • Midazolam
    • Clopidogrel
    • Antiepileptics
  • Avoid concurrent use with medications lowering seizure threshold

                                   Drug Status

Availability
Pregnancy
Breastfeeding
Schedule
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Xtandi 40mg Capsule 112’s Astellas Pharma Harley’s Ltd