Oncura

Enzalutamide (Xtandi): what to expect

Prostate CancerTaken continuously — no infusion cycle8 effects documented

A daily pill for prostate cancer, generally well tolerated. The common effects are tiredness, hot flashes, and higher blood pressure; some people notice more falls, and bone-thinning raises fracture risk over time. Seizures are a rare risk your team will ask about.

Oral enzalutamide taken every day, continuously (an androgen-receptor blocker), usually alongside ongoing hormone therapy (ADT). Effects build from the first weeks and persist while on the drug; onset is measured in weeks-months, not infusion cycles. Fracture risk is CUMULATIVE over months-years.

Get help straight away — this is true on any regimen, on any day.

A temperature of 100.4°F (38°C) or higher during treatment can mean a serious infection while your blood counts are low. Call your team or go to the ER — do not wait it out.

Also urgent: trouble breathing or chest pain · swelling of the face, lips or throat · new confusion or fainting · shaking chills · not being able to keep fluids down.

This is standing guidance shown to everyone. Nothing on this page is based on anything about you, and nobody is monitoring you.

What is reported

This regimen is taken continuously, so effects are described in the terms their sources use rather than by cycle day.

Fatigue

first weeks; ongoing

Tiredness or low energy is the most common effect, usually starting in the first weeks and continuing while on the drug. Pacing activities, light exercise, and good sleep help.

reported by about 47% of people; severe in 3.4% · from Enzalutamide

Hot flashes

early; ongoing

Sudden warmth, flushing, or sweating — an expected effect of lowering testosterone. Dressing in layers, keeping cool, and limiting caffeine/alcohol help.

reported by about 18% of people · from Enzalutamide

High blood pressure (hypertension)

weeks-months; ongoing

Blood pressure can rise on treatment. Your team checks it regularly and treats it with medicine if needed.

Call your team: Severe headache, vision changes, or chest pain.

reported by about 14% of people; severe in 7% · from Enzalutamide

Falls

throughout treatment

Some people fall more often on this drug (linked to dizziness, tiredness, or weakness). Removing trip hazards, using good lighting, and rising slowly help.

reported by about 13% of people; severe in 1.6% · from Enzalutamide

Fractures

cumulative; median ~420 days to onset

Bone thinning raises the risk of fractures, which builds over months-years (and overlaps with hormone-therapy bone loss). Weight-bearing exercise, calcium/vitamin D, and sometimes a bone-protecting medicine help; your team may check bone density.

reported by about 9% of people; severe in 2.1% · from Enzalutamide

Diarrhea

Loose or frequent stools, usually mild. Hydration and anti-diarrheal medicine as advised help.

reported by about 17% of people · from Enzalutamide

Memory or concentration changes

weeks-months; may build over time

Some people notice trouble with memory or concentration (sometimes called 'brain fog'). It's usually mild and generally improves if the drug is stopped. Mention it to your team.

reported by about 6% of people · from Enzalutamide

Seizure (rare)

can occur any time on treatment

Uncommon but important: enzalutamide slightly raises seizure risk, more so if you have other risk factors. Tell your team about any history of seizures, head injury, or medicines that lower the seizure threshold.

Call your team urgently: Any seizure, blackout, or sudden confusion — seek urgent care.

reported by about ~0.5-0.9% of people · from Enzalutamide

Where this comes from

  1. S1. Enzalutamide (Xtandi) FDA prescribing information — FDA label
  2. S2. Beer TM, PREVAIL (chemo-naïve mCRPC) (2014) — PMID 24881730
  3. S3. Scher HI, AFFIRM (post-docetaxel mCRPC) (2012) — PMID 22894553

A window appears here only where a retrievable document ties it to a drug in this regimen. Where nothing could be found, the window was removed rather than estimated — so a missing time is an honest gap, not an oversight.

Track your own cycle in Oncura →

Free, no account, nothing leaves your device.