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Androgen Receptor Inhibitor (Specialist Oncology Drug)

Apalutamide

Brand names: Erleada

Apalutamide is an oral androgen receptor inhibitor used in prostate cancer, including non-metastatic castration-resistant and metastatic hormone-sensitive disease, alongside androgen deprivation therapy.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It binds the androgen receptor and inhibits androgen binding, receptor nuclear translocation, and DNA binding, thereby suppressing androgen-driven prostate cancer growth.

Prescribing in practice

  • Serious skin reactions, falls and fractures, and seizures are recognised risks, so assess fracture and seizure risk and counsel patients accordingly.
  • It is a strong enzyme inducer and has clinically important drug interactions, so review co-medications carefully.
  • Cardiovascular events and hypertension can occur and should be monitored.

Monitoring

Monitor for skin reactions, falls and fractures, seizures, cardiovascular events and blood pressure, and review concomitant medicines for interactions.

Counselling the patient

  • Report any severe rash, blistering, or skin peeling promptly.
  • Take care to reduce falls; report any blackout or seizure.
  • Tell pharmacists and doctors you take this drug, as it interacts with many medicines.

Evidence & guidelines

Use is supported by the SPARTAN and TITAN trials and relevant NICE guidance; consult the SPC for interactions and monitoring.

Reference: NICE TA585 (Apalutamide for non-metastatic castration-resistant prostate cancer, 2019); NICE TA740 (mCSPC, 2021); SPARTAN trial (NEJM 2018); TITAN trial (NEJM 2019); EAU Prostate Cancer Guidelines (2024); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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