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Generic Name: enzalutamide (ENZ a LOOT a mide)
Brand Names: Xtandi
Xtandi (enzalutamide) is used to treat late-stage (metastatic) castration-resistant prostate cancer. Includes Xtandi side effects, interactions and indications.
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Drug Information:
Xtandi (enzalutamide) is an anti-androgen. It works in the body by preventing the actions of androgens (male hormones). Xtandi is used to treat prostate cancer. Xtandi may also be used for purposes not listed in this medication guide. Although not for use by women, Xtandi can cause birth defects if the mother or the father is taking this medicine. Use a condom and one other form of birth control to prevent pregnancy during your treatment, and for at least 3 months after your treatment ends. Xtandi may cause side effects on your spinal cord. Stop taking this medicine and call your doctor at once if you have severe low back pain, trouble walking or standing up, pain or weakness in your lower body, severe and worsening numbness or tingling, or sudden loss of bladder or bowel control. Learn more

Xtandi Side Effects

Xtandi Side Effects

Note: This document contains side effect information about enzalutamide. Some of the dosage forms listed on this page may not apply to the brand name Xtandi.

In Summary

Common side effects of Xtandi include: upper respiratory tract infection, headache, hot flash, laryngitis, nasopharyngitis, pharyngitis, rhinitis, and sinusitis. Other side effects include: lower respiratory tract infection, pneumonia, pulmonary infection, altered mental status, amnesia, bronchitis, cognitive dysfunction, falling, hypertension, hypoesthesia, and memory impairment. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to enzalutamide: oral capsule liquid filled

Along with its needed effects, enzalutamide (the active ingredient contained in Xtandi) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking enzalutamide:

More common

  • Back pain
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • blood in the urine
  • blurred vision
  • chest pain
  • chills
  • cough with mucus
  • difficulty with breathing
  • dizziness
  • fever
  • loss of bladder or bowel control
  • nervousness
  • painful or difficult urination
  • pounding in the ears
  • slow or fast heartbeat
  • sore throat
  • tingling of the hands or feet
  • unable to move the legs
  • unusual weight gain or loss

Less common

  • Anxiety
  • confusion or excitement
  • depression
  • fainting
  • falling
  • lightheadedness
  • loss of memory
  • memory or attention span problems
  • nightmares or vivid dreams
  • rapid, shallow breathing


  • Seizures

Incidence not known

  • Fast heartbeat
  • headache
  • hives, itching, skin rash
  • hoarseness
  • irritation
  • joint pain, stiffness, or swelling
  • redness of the skin
  • swelling of the eyelids, face, lips, hands, or feet
  • tightness in the chest
  • troubled breathing or swallowing
  • unusual drowsiness, tiredness, weakness, or feeling of sluggishness

Some side effects of enzalutamide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Body aches or pain
  • bone pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • diarrhea
  • difficulty having a bowel movement
  • difficulty with moving
  • dry throat
  • ear congestion
  • feeling of constant movement of self or surroundings
  • feeling of warmth
  • lack or loss of strength
  • loss of voice
  • muscle pain, stiffness, or weakness
  • pain or tenderness around the eyes and cheekbones
  • sensation of spinning
  • stuffy or runny nose
  • tender, swollen glands in the neck
  • trouble sleeping

Less common

  • Bloody nose
  • dry skin
  • frequent urination
  • pale-colored urine

For Healthcare Professionals

Applies to enzalutamide: oral capsule

Nervous system

Very common (10% or more): Headache (12%), dizziness/vertigo (11%)

Common (1% to 10%): Spinal cord compression and cauda equina syndrome, paresthesia, hypoesthesia, dysgeusia, restless legs syndrome

Uncommon (0.1% to 1%): Seizures

Postmarketing reports: Posterior reversible encephalopathy syndrome (PRES) (e.g., seizure, headache, lethargy, confusion, blindness, and other visual and neurological disturbances, with or without associated hypertension)


Very common (10% or more): Hot flush (20%), peripheral edema (15%), hypertension (14%)


Common (1% to 10%): Pruritus, dry skin

Postmarketing reports: Rash


Common (1% to 10%): Gynecomastia


Very common (10% or more): Constipation (23%), diarrhea (22%)

Common (1% to 10%): Hematuria, pollakiuria

Postmarketing reports: Vomiting


Common (1% to 10%): Hematuria, pollakiuria


Very common (10% or more): Neutropenia (15%)

Common (1% to 10%): Thrombocytopenia

Frequency not reported: Leukopenia


Very common (10% or more): ALT elevations (10%)

Common (1% to 10%): Bilirubin elevations


Very common (10% or more): Decreased appetite (19%), decreased weight (12%)


Very common (10% or more): Back pain (29%), arthralgia (21%), musculoskeletal pain (15%)

Common (1% to 10%): Muscular weakness, musculoskeletal stiffness


Very common (10% or more): Asthenia/fatigue (51%), falls (13%)

Common (1% to 10%): Fall-related injuries


Common (1% to 10%): Insomnia, anxiety, hallucinations, mental impairment disorders


Very common (10% or more): Upper respiratory tract infection (16%), dyspnea (11%)

Common (1% to 10%): Lower respiratory tract and lung infection, epistaxis


Postmarketing reports: Face edema, tongue edema, lip edema, pharynx edema


Postmarketing reports: Blindness and other visual disturbances due to posterior reversible encephalopathy syndrome (PRES)

Editorial References and Review

Medically reviewed by BestRx Medical Team Last updated on 1/1/2020.

Source: Drugs.com Xtandi