Androgen Receptor Inhibitor
Pregnancy: X
Enzalutamide
Brand names: Xtandi
Adult dose
Dose: 160 mg once daily
Route: oral
Frequency: once daily
Max: 160 mg/day
Take with or without food; seizure risk — use with caution in patients with risk factors; strong CYP inducer — many drug interactions
Paediatric dose
Route:
Not licensed in children
Dose adjustments
Renal
No dose adjustment required
Hepatic
No dose adjustment in mild-moderate impairment; caution in severe impairment
Clinical pearls
- AFFIRM trial: 4.8 month survival benefit in mCRPC post-docetaxel
- PREVAIL/PROSPER trials: extended use to non-metastatic and castration-sensitive disease
- Seizure risk 0.5% — review all concomitant medications for threshold-lowering drugs
Contraindications
- Women of childbearing potential
- Seizure disorder (relative CI)
- Concomitant strong CYP3A4 inhibitors without dose adjustment
Side effects
- Fatigue
- Hot flushes
- Hypertension
- Seizures (0.5%)
- Falls
- Cognitive impairment
- Neutropaenia
Interactions
- Strong CYP3A4/2C9/2C19 inducer — reduces warfarin, statins, anticonvulsants; avoid concomitant midazolam
Monitoring
- Seizure risk assessment
- BP
- FBC
- Drug interactions review
Reference: BNFc; BNF 86; NICE TA580; AFFIRM trial. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia