Xtandi: instructions for use, how to take, side effects

Xtandi is a drug manufactured by the pharmaceutical company Astellas.

Its active ingredient is Enzalutamide, which works by blocking the activity of androgen compounds (such as testosterone).

With this block, the drug can reduce growth and even cause the death of cells that cause tumors (cancerous).


What is Xtandi?

Xtandi is a reference medicine, presented in soft gelatine capsules to be swallowed whole.

It is indicated for the treatment of metastatic cases of prostate cancer (when the disease spreads to other parts of the body).

It is also used for non-metastatic cases of the disease, when the patient does not respond to other forms of treatment, such as castration.

In general, treatment with Xtandi lasts about 12 months. But this time can be increased or reduced according to each case, according to medical advice.

The medical recommendation must also be followed in relation to the recommended dose and other precautions during use.

What is Xtandi Astellas for?

Xtandi is indicated for the treatment of men with cancer of the prostate that has spread to other parts of the body (metastasis). The same drug can still be used in cases where the disease is not widespread but does not respond to other forms of treatment (such as castration) and has already received doses of Docetaxel.

Learn a little more about the disease that Xtandi fights:

Prostate cancer

Prostate cancer mostly affects men over 50.

Symptoms include pain when urinating and ejaculating, blood in the urine or sperm, drips during urination and difficulty maintaining an erection.

This disease can be diagnosed with digital rectal exam and other imaging exams by a urologist.

How to take?

All prescribed capsules should be taken at the same time of the day. For example, if the patient needs to take 4 soft pills and decide to do this after lunch, all 4 capsules must be taken one after the other or together.

It is important to say that Xtandi should not be chewed, broken or cut, that is, the capsule always needs to be swallowed whole.

This medication can be taken with or without food, depending on what is best for the patient.

What to do if you forget to take a dose?

In cases of missed dose, the patient should take it as soon as he remembers.

However, if it is close to the time of the next dose, the correct thing is to wait until it is time to take it.

You should not double the amount of Xtandi taken to make up for the missed dose or skip medication schedules on purpose.

It is worth remembering that it is necessary to talk to the medical team if the dose is forgotten or other doubts arise.

What does the label say about side effects?

Xtandi can cause fainting or involuntary loss of consciousness and therefore the patient should be instructed not to drive a vehicle or operate machinery.

Under normal conditions, seizures are extremely rare (4 per 1,000 people). Even so, if it happens, the doctor should be notified as soon as possible.

Other side effects are classified according to the chance of occurring:

Very common

Very common side effects happen in more than 10% of cases and include:

  • High pressure;
  • Tiredness;
  • Weakness (asthenia);
  • Heat waves;
  • Fractures.


Common adverse reactions affect 1 in 10 people using the drug. Between them:

  • Headache;
  • Forgetfulness;
  • Memory lapses;
  • Anxiety ;
  • Itch;
  • Breast enlargement in men (gynecomastia);
  • Obstruction in the arteries of the heart.


When side effects are classified as uncommon it means that 1 in 100 people can be affected. They include:

  • Decrease in blood cells;
  • Visual hallucinations;
  • Difficulty in reasoning.


Adverse reactions with unknown frequency cannot be estimated according to the data presented in research. The package insert indicates the following manifestations:

  • Motion sickness;
  • Vomiting,
  • Diarrhea;
  • Swelling of the face, mouth or throat;
  • Muscle or low back pain;
  • Muscle spasms;
  • Weakness;
  • Rash.

Because it is a new drug, it is possible that there are other side effects that are not listed in the package insert. If this is the case, the ideal is always to notify the doctor and the pharmaceutical company by the Customer Service (SAC).

What are the precautions before taking Xtandi?

The doctor should be informed if the patient has a history of injuries or brain tumors, strokes or alcoholism before prescribing Xtandi.

This is because, with the use of this drug, these complications can trigger seizures or a rare condition known as Posterior Reversible Encephalopathy Syndrome (PRES).

The medical professional should also be informed if the patient has kidney or liver (liver) complications.

In the formula of the remedy, there is sorbitol, a type of sugar. Thus, patients with diabetes   should pay attention when carrying out treatment.

Patients who are using other medications such as chemotherapy (Docetaxel, for example) or for the prevention of blood clots (such as Warfarin, Acenocumarol and Clopidogrel) should also inform this to the doctor.

That’s because they tend to increase the chances of seizures.

Can Xtandi be taken with other remedies?

It is important for patients to inform the doctor if they are using any medication, whether continuous or temporary, as some substances may interact with the action of Xtandi.

drug interaction occurs when a drug reduces or cancels the effects of other drugs.

Those who can interact with Xtandi are those used to treat:

  • Cholesterol (such as Genfibrozila , Atorvastatin , Simvastatin );
  • Pain (Tramadol);
  • Cancer ( Cabazitaxel );
  • Anxiety and schizophrenia ( Diazepam , Midazolam, Haloperidol );
  • Epilepsy ( Carbamazepine , Clonazepam , Phenytoin , Primidone , Valproic acid);
  • High blood pressure (Bisoprolol, Digoxin , Diltiazem , Felodipine, Nicardipine, Nifedipine , Propranolol , Verapamil );
  • HIV ( Indinavir , Ritonavir );
  • Sleep disorders (Zolpidem);
  • Gout ( Colchicine );
  • Bacterial infections ( Clarithromycin , Doxycycline);
  • Thyroid diseases (Levothyroxine);
  • Stomach complications (Omeprazole);
  • Cardiac rhythm (Quinidine, Procainamide, Amiodarone and Sotalol).

Other remedies can also increase the patient’s chances of having a seizure. They are used to:

  • Asthma and respiratory problems (such as Aminophylline and Theophylline);
  • Depression and Schizophrenia ( Clozapine , Olanzapine , Risperidone , Ziprasidone, Bupropion, Lithium , Chlorpromazine , Mesoridazine, Thioridazine , Amitriptyline, Desipramine, Doxepine, Imipramine, Maprotiline, Mirtazapine );
  • Pain (Pethidine, for example).

Can you have sex while using Xtandi?

The best person to answer this question is the urologist or oncologist who accompanies the case.

If there is no medical contraindication, the patient can have sex normally.

If you have sex with a woman who may become pregnant, it is necessary to use a condom ( condom ) throughout the treatment with Xtandi and for up to 3 months after stopping the medication.

If the patient has sex with a pregnant woman, it is essential to use a condom to protect the baby.

What is the price of Xtandi 40mg?

The box with 120 soft gelatin capsules of Xtandi 40 mg is sold for prices that vary approximately between R $ 12,999 and R $ 14,900 *

* Price researched at Consulta Remédios in January 2020. Prices may change. 

Where to buy Xtandi cheaper?

The tip to save when buying a medicine is simple: research the prices in several different chains and drugstores.

To help you with this task, there are some price comparison sites such as Consulta Remédios .

Just type in the product and the site itself already presents a list of where to buy Xtandi and the price of this medicine in several pharmaceutical establishments.

Does SUS provide Enzalutamide?

No. The Unified Health System (SUS) does not provide Enzalutamide, although justice has imposed the decision that the drug be provided, in some cases.

To obtain it free of charge, it is necessary to make an application before the Health Department of your municipality.

If the remedy is still denied, the ideal is to look for a lawyer and open a judicial project.

To carry out such procedures, some documents are necessary, such as the medical report that proves the need for the drug and a budget with the price of at least 3 different establishments that market the medicine.

How to make an Xtandi budget?

Patients who are going to go to court to try to obtain Xtandi need a medicine budget from 3 different pharmacies or drugstores.

The good news is that you can count on the advice of Consulta Remédios . But what is this?

Just fill in the details and in a few hours our team will send you a complete and personalized quote for your case.

Xtandi is used to treat some types of prostate cancer. When prescribed by a medical professional, it is a good way to treat patients and ensure more quality of life.

The newsroom of Hickey solution brings a lot of other information about medicines . Check out our posts !!!

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