Second-generation androgen receptor antagonist
Darolutamide
Brand names: Nubeqa
Adult dose
Dose: 600mg BD with food
Route: Oral
Frequency: BD
Clinical pearls
- NICE TA660 / TA805: nmCRPC and mHSPC (with ADT ± docetaxel)
- ESMO prostate cancer; NICE NG131
- Lower BBB penetration → fewer CNS effects vs alternatives
Contraindications
- Pregnancy (no female indication)
- Severe hepatic impairment
- Hypersensitivity
Side effects
- Fatigue
- Falls
- Fractures
- Ischaemic heart disease
- Hyperglycaemia
- Increased bilirubin/AST/ALT
- Less CNS toxicity (seizures/mood) than enzalutamide / apalutamide
Interactions
- Strong CYP3A4 inducers
- BCRP inhibitors
- Statins (rosuvastatin levels increased)
Monitoring
- LFTs
- BP
- Bone health
- CV risk factors
Reference: BNF; NICE TA660; NICE TA805; NICE NG131; ESMO; SmPC; https://bnf.nice.org.uk/drugs/darolutamide/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators