Enzalutamide Side Effects

Medically reviewed by Drugs.com. Last updated on May 3, 2024.

Applies to enzalutamide: oral capsule liquid filled, oral tablet.

Serious side effects of enzalutamide

Along with its needed effects, enzalutamide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking enzalutamide:

More common side effects

• back pain
• bloating or swelling of the face, arms, hands, lower legs, or feet
• blood in the urine
• blurred vision
• chest pain
• chills
• cough with mucus
• difficulty with breathing
• dizziness
• fever
• loss of bladder or bowel control
• nervousness
• painful or difficult urination
• pounding in the ears
• slow or fast heartbeat
• sore throat
• tingling of the hands or feet
• unable to move the legs
• unusual weight gain or loss

Less common side effects

• anxiety
• confusion or excitement
• depression
• fainting
• falling
• lightheadedness
• loss of memory
• memory or attention span problems
• nightmares or vivid dreams
• rapid, shallow breathing

Rare side effects

• seizures

Incidence not known

• headache
• hives, itching, skin rash
• hoarseness
• irritation
• joint pain, stiffness, or swelling
• redness of the skin
• swelling of the eyelids, face, lips, hands, or feet
• tightness in the chest
• trouble breathing or swallowing
• unusual drowsiness, tiredness, weakness, or feeling of sluggishness

Other side effects of enzalutamide

Some side effects of enzalutamide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

• body aches or pain
• bone pain
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• diarrhea
• difficulty having a bowel movement
• difficulty with moving
• dry throat
• ear congestion
• feeling of constant movement of self or surroundings
• feeling of warmth
• lack or loss of strength
• loss of voice
• muscle pain, stiffness, or weakness
• pain or tenderness around the eyes and cheekbones
• sensation of spinning
• stuffy or runny nose
• tender, swollen glands in the neck
• trouble sleeping

Less common side effects

• bloody nose
• dry skin
• frequent urination
• pale-colored urine

For healthcare professionals

Applies to enzalutamide: oral capsule, oral tablet.

Nervous system adverse events

• Very common (10% or more): Headache (12%), dizziness/vertigo (11%)
• Common (1% to 10%): Spinal cord compression and cauda equina syndrome, paresthesia, hypoesthesia, dysgeusia, restless legs syndrome
• Uncommon (0.1% to 1%): Seizures
• Postmarketing reports: Posterior reversible encephalopathy syndrome (PRES) (e.g., seizure, headache, lethargy, confusion, blindness, and other visual and neurological disturbances, with or without associated hypertension)^[Ref]

Cardiovascular

• Very common (10% or more): Hot flush (20%), peripheral edema (15%), hypertension (14%)^[Ref]

Dermatologic

• Common (1% to 10%): Pruritus, dry skin
• Postmarketing reports: Rash^[Ref]

Endocrine

• Common (1% to 10%): Gynecomastia^[Ref]

Gastrointestinal

• Very common (10% or more): Constipation (23%), diarrhea (22%)
• Common (1% to 10%): Hematuria, pollakiuria
• Postmarketing reports: Vomiting^[Ref]

Genitourinary

• Common (1% to 10%): Hematuria, pollakiuria^[Ref]

Hematologic

• Very common (10% or more): Neutropenia (15%)
• Common (1% to 10%): Thrombocytopenia
• Frequency not reported: Leukopenia^[Ref]

Hepatic

• Very common (10% or more): ALT elevations (10%)
• Common (1% to 10%): Bilirubin elevations^[Ref]

Metabolic

• Very common (10% or more): Decreased appetite (19%), decreased weight (12%)^[Ref]

Musculoskeletal

• Very common (10% or more): Back pain (29%), arthralgia (21%), musculoskeletal pain (15%)
• Common (1% to 10%): Muscular weakness, musculoskeletal stiffness^[Ref]

Other

• Very common (10% or more): Asthenia/fatigue (51%), falls (13%)
• Common (1% to 10%): Fall-related injuries^[Ref]

Psychiatric

• Common (1% to 10%): Insomnia, anxiety, hallucinations, mental impairment disorders^[Ref]

Respiratory

• Very common (10% or more): Upper respiratory tract infection (16%), dyspnea (11%)
• Common (1% to 10%): Lower respiratory tract and lung infection, epistaxis^[Ref]

Hypersensitivity

• Postmarketing reports: Face edema, tongue edema, lip edema, pharynx edema^[Ref]

Ocular

• Postmarketing reports: Blindness and other visual disturbances due to posterior reversible encephalopathy syndrome (PRES)^[Ref]

Frequently asked questions

• Does Xtandi lower prostate-specific antigen (PSA)?
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• What is Xtandi (enzalutamide) used for?

Further information

Enzalutamide side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer