Erleada
Erleada (apalutamide) is a prescription pill used to treat certain types of prostate cancer in adults. It’s usually taken along with other hormone treatments or after you’ve had surgery to remove the testicles. You take it once a day by mouth, with or without food. Erleada (apalutamide) works by blocking testosterone, which helps slow the growth of prostate cancer. Common side effects include tiredness, joint pain, and rash.
What is Erleada (apalutamide)?
What is Erleada (apalutamide) used for?
- Metastatic prostate cancer that's hormone-sensitive
- Non-metastatic prostate cancer that's castration-resistant
How Erleada (apalutamide) works
Erleada (apalutamide) is an androgen receptor inhibitor. It works by blocking testosterone in prostate cancer cells. Since testosterone helps prostate cancer grow, this medication reduces its effects to slow or stop the cancer from growing or spreading.
Drug facts
Side effects of Erleada (apalutamide)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Metastatic prostate cancer:
- Rash (28%)
- Hot flashes (23%)
- High blood pressure (18%)
- Join pain (17%)
- Itchiness (11%)
Non-metastatic prostate cancer:
- Tiredness (39%)
- Rash (25%)
- High blood pressure (25%)
- Diarrhea (20%)
- Nausea (18%)
- Joint pain (16%)
- Weight loss (16%)
- Fall (16%)
- Hot flashes (14%)
- Fracture (12%)
- Reduced appetite (12%)
- Swelling in arms and legs (11%)
Less Common Side Effects
Metastatic prostate cancer:
- Diarrhea
- Muscle spasm
- Changes in taste
- Low thyroid hormone levels
- Lung problems
Non-metastatic prostate cancer:
- Low thyroid hormone levels
- Itchiness
- Heart failure
- Lung problems
Erleada (apalutamide) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart problems: chest pain, shortness of breath, rapid breathing, sweating, fatigue, dizziness, nausea, vomiting
- Stroke: sudden numbness or weakness, confusion, trouble talking, trouble seeing, dizziness, trouble walking
- Fractures: pain, swelling, bruising, tenderness, bleeding, numbness
- Seizures: sudden jerking or shaking, loss of consciousness, confusion, trouble speaking
- Severe skin reactions: rash, fever, swollen lymph nodes, blisters or sores, blistering or peeling skin
- Lung problems: shortness of breath, cough, fever
The following Erleada (apalutamide) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dry cough, shortness of breath or trouble breathing
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Increase in blood pressure
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Seizures
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Fatigue
- Hot flashes
- Joint pain
- Loss of appetite
Pros and cons of Erleada (apalutamide)
Pros
- Pill that’s taken by mouth once a day
- Recommended option for certain types of prostate cancer
- Can take with or without food
Cons
- Can cause a rash, which can take several months to go away
- Can raise your risk for seizures and fractures
- Requires regular blood tests and monitoring
Pharmacist tips for Erleada (apalutamide)
- You can take Erleada (apalutamide) with or without food. The important thing is to take it at the same time every day.
- You’ll usually take Erleada (apalutamide) with other hormone treatments, unless you’ve had surgery to remove both testicles. Don’t stop these treatments without talking to your oncologist.
- Swallow Erleada (apalutamide) tablets whole. Don’t cut, crush, or chew them.
- If you can’t swallow Erleada (apalutamide) tablets whole, you can dissolve them in non-carbonated water and then mix with orange juice, applesauce, or more non-carbonated water before swallowing or giving through a feeding tube. Be sure to follow the right directions to prepare for the 60 mg or 240 mg tablets.
- If you miss a dose of Erleada (apalutamide), take it as soon as you remember on the same day. Go back to your normal schedule the next day, but don’t take extra tablets to make up for the missed dose.
- Erleada (apalutamide) can raise your risk of heart or brain problems, like stroke or heart attack. Call your care team right away if you have sudden chest pain, shortness of breath, weakness, or trouble speaking.
- Erleada (apalutamide) can raise your risk of seizures. Avoid activities, like driving, where losing consciousness could be dangerous. Contact your care team right away if you ever have a seizure.
- Erleada (apalutamide) has been linked to more falls and broken bones. Be careful with activities that could put you at risk.
- Erleada (apalutamide) can cause rashes that might last for months. Let your care team know if you develop a rash.
- If your partner can become pregnant, use birth control such as condoms while taking Erleada (apalutamide) and for 3 months after your last dose. This medication might not be safe in pregnancy.
- Erleada (apalutamide) can affect your ability to have children. Don’t donate sperm while taking it or for 3 months after your last dose.
Common questions about Erleada (apalutamide)
No, Erleada (apalutamide) doesn’t cure cancer. Instead, it helps control prostate cancer by blocking testosterone, which the cancer needs to grow. This can slow down the cancer and keep it from spreading, but the medication doesn’t completely get rid of it.
No, Erleada (apalutamide) isn’t chemotherapy. Chemotherapy works by directly killing fast-growing cells, including cancer cells. Erleada (apalutamide) is a type of hormone therapy called an androgen receptor inhibitor, which blocks testosterone from helping prostate cancer grow and spread.
You usually take Erleada (apalutamide) every day for as long as it keeps your prostate cancer under control. In studies, some people took the medication for several years. There isn’t a set time limit, since treatment depends on how well it works for you and whether side effects become too hard to manage. Your oncologist will check your progress regularly and decide if you should keep taking it.
Hair loss isn’t a common side effect of Erleada (apalutamide). If you do notice changes in your hair while taking this medication, let your oncologist know.
It usually takes about 2 weeks for most of Erleada (apalutamide) to leave your body after a single dose. This time frame is based on the medication's half-life. The half-life is how long it takes for half the medication to leave your body. If you have more questions about how long Erleada (apalutamide) stays in your system, ask your oncologist.
Erleada (apalutamide) can start to work within the first few months of treatment. For some people, it might take a little longer. Your oncologist will check your blood tests and scans over time to see how well it’s working for you.
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Risks and warnings for Erleada (apalutamide)
Erleada (apalutamide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart attack and stroke
- Risk factors: High blood pressure | Diabetes | High cholesterol
Serious heart and brain problems, such as heart attack or stroke, have happened in people taking Erleada (apalutamide). Your risk is higher if you have high blood pressure, diabetes, or high cholesterol.
Call your care team or get emergency help right away if you notice warning signs such as sudden chest pain, shortness of breath, dizziness, weakness on one side of the body, trouble speaking, or vision changes.
Falls and fractures
- Risk factors: Older adults
Erleada (apalutamide) can raise your risk for falls and broken bones, especially if you’re an older adult. These problems can happen months or even years after starting the medication. Tell your oncologist if you develop bone pain or experience falls while taking this medication.
Seizures
- Risk factors: Past seizures | Taking other medications that can raise the risk of seizures
Though rare, Erleada (apalutamide) might put you at risk for seizures. In studies, seizures happened several months to years after starting treatment. Let your oncologist know if you have a history of seizures or are medications that raise the risk for seizures. You should know the risk of seizures and avoid activities where losing consciousness could put you or others in danger, such as driving or swimming alone.
Stop taking Erleada (apalutamide) and tell your oncologist right away if you think you've had a seizure while on treatment because most likely you’ll need to switch to a different medication to treat your prostate cancer. Some early symptoms of a seizure can include having a strange sense of taste or smell, anxiety, nausea, or a fluttering sensation.
Severe skin reactions
Serious and sometimes life-threatening skin reactions have happened in people taking Erleada (apalutamide). These include conditions such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). If one of these reactions is confirmed or is very serious, you’ll need to stop taking the medication for good.
Call your care team right away if you notice warning signs such as fever, flu-like symptoms, mouth sores, swollen lymph nodes, or a spreading skin rash.
Lung problems
Rare but serious lung problems, called interstitial lung disease (ILD) or lung inflammation, have happened in people taking Erleada (apalutamide). Call your care team right away if you notice new or worsening symptoms such as shortness of breath, cough, or fever.
Harm to unborn baby
It’s possible for Erleada (apalutamide) to harm an unborn baby. If your partner can get pregnant, use birth control such as condoms while taking this medication and for 3 months after your last dose. Let your oncologist know right away if your partner becomes pregnant during this time.
Erleada (apalutamide) dosage
Typical dosage for Erleada (apalutamide)
The typical dose is 240 mg taken by mouth once a day.
Your dose might be different if you experience side effects to this medication.
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