Xtandi (enzalutamide)
Hormone therapy pill (androgen receptor inhibitor) · Used for: Prostate cancer
💊 Taken by mouth · Hormone therapy pill (androgen receptor inhibitor)
Cliff notes
What it is: Hormone therapy pill (androgen receptor inhibitor).
How it's given: Capsules or tablets by mouth once a day.
How it works: Prostate cancer often uses male hormones (androgens like testosterone) to grow. Xtandi blocks the androgen receptor so the hormones can't drive the cancer.
Common side effects and what helps at home
| Side effect | What can help |
|---|---|
| Tiredness and weakness | Daily walks help. |
| Hot flashes | Keep cool, dress in layers. |
| Joint and back pain | Ask about safe pain relief. |
| Falls and fractures | Clear tripping hazards at home and ask about bone health. |
| High blood pressure | Checked at visits. |
Not everyone gets these. Your team may suggest other ways to manage them.
Call your care team now if you have:
- A seizure (call 911)
- Severe headache, confusion, or vision changes
- Chest pain or pressure, or signs of stroke (call 911)
- A fall or injury
- Swelling of the face, lips, tongue or throat, or trouble breathing (allergic reaction)
- Trouble swallowing or choking on the pills (a label warning tied to pill size; ask about smaller tablets)
Call 911 for trouble breathing, chest pain or signs of stroke.
🗓 What to expect
1️⃣ Before you start
- Ask your team for a written schedule and an after-hours phone number.
- Bring a list of all your medicines and supplements.
2️⃣ Each day on treatment
- Take it exactly as prescribed, at about the same time each day.
- Don't crush or split pills unless your team says it's OK.
- If you miss a dose, follow the label instructions or call your pharmacist.
3️⃣ Between doses
- Watch for the side effects below and use the checklist.
- Keep up with blood tests and visits.
- Call your team for anything in the red box.
✅ Side-effect checklist
Print this and check off what you notice so you can tell your team.
| Side effect | Noticed? | Notes for my team |
|---|---|---|
| Tiredness and weakness | ☐ | |
| Hot flashes | ☐ | |
| Joint and back pain | ☐ | |
| Falls and fractures | ☐ | |
| High blood pressure | ☐ |
Help paying for Xtandi
Official manufacturer program:
- Astellas Pharma Support SOLUTIONS: Benefits checks and copay help; the Astellas Patient Assistance Program for uninsured or low-income patients.
Copay cards are usually only for people with commercial (job or marketplace) insurance. If you have Medicare or Medicaid, look at free-drug programs and these independent foundations:
- PAN Foundation: Copays and coinsurance, including for people with Medicare, when a disease fund is open.
- HealthWell Foundation: Grants for copays, deductibles and premiums when a fund is open.
- CancerCare Co-Payment Assistance Foundation: Help with treatment copays for insured people under income limits.
- Good Days: Copay help and some travel costs.
- NeedyMeds: Free database of assistance programs, open to anyone.
📋 Medicare: Pills you take at home are usually covered by Medicare drug coverage (Part D). Part B covers some cancer drugs taken by mouth if the same drug comes in an injectable form. See Medicare and your cancer drugs.
More: Our guide to paying for cancer treatment.
🏷 Tips from the maker's patient site
Take it once a day at about the same time, with or without food. Swallow capsules or tablets whole with enough water, and don't chew, dissolve or open them. Men with partners who could become pregnant need birth control during treatment and for 3 months after.
Summarized in our words from xtandi.com, which follows the FDA-approved patient information.
💬 What experts are saying
Prostate cancer specialists on OncLive say tiredness is a common, real side effect of hormone drugs like Xtandi. Doctors look at how much it affects daily life and may adjust the dose to help, so describe your energy honestly at each visit.
Source: Fatigue Assessment and Dose Modification in Prostate Cancer Management (OncLive, February 3, 2026)
❓ Questions to ask your doctor
- What is the goal of this treatment for me?
- How will we know if it's working?
- Which side effects should I call about right away, and what number do I call after hours?
- Which medicines, vitamins or supplements should I avoid?
- Will this affect my ability to work, drive or care for my family?
- What will this cost me, and who can help me with coverage?
Support groups
- ZERO Prostate Cancer: Patient navigation (ZERO360), financial help and support
- CancerCare: Free counseling, support groups and financial help
- Cancer Support Community: Support groups, a helpline and the MyLifeLine online community
Common questions
How does Xtandi work?
It blocks the androgen receptor, which prostate cancer cells use to grow.
Does Xtandi cause fatigue?
Yes, tiredness is one of the most common side effects.
📄 The official FDA label for Xtandi, including its patient information section, is on DailyMed.
Written by the Cancer Side Effects Guide team from FDA labels and leading cancer centers. Not medical advice. · Last updated: October 15, 2026 · How we write