Erleada
Erleada (apalutamide) is an oral medication used to treat certain types of prostate cancer. Erleada (apalutamide) is one of the recommended options for prostate cancer and is taken once a day. But it should be used in combination with another hormonal medication that targets GnRH (gonadotropin-releasing hormone), unless you’ve had surgery to remove both testicles (bilateral orchiectomy). Erleada (apalutamide) can cause a rash that can take several months to go away, which can be bothersome.
What is Erleada (apalutamide)?
What is Erleada (apalutamide) used for?
Advanced or metastatic prostate cancer (cancer that've spread to other areas)
How Erleada (apalutamide) works
Most prostate cancer cells need testosterone to grow and spread. Testosterone is a type of male sex hormone called an androgen.
Erleada (apalutamide) is an androgen receptor inhibitor (antiandrogen), a type of hormone therapy that works by blocking testosterone from binding to prostate cancer cells. Without testosterone, cancer cells won’t have the fuel they need to grow or spread.
Drug Facts
What are the side effects of Erleada (apalutamide)?
Common Side Effects
- Tiredness (up to 39%)
- Rash (up to 28%)
- Hot flashes (up to 23%)
- Diarrhea (20%)
- Nausea (18%)
- Headaches, changes to your vision, and other symptoms of high blood pressure (18%)
- Joint pain (up to 17%)
- Falls (16%)
- Weight loss (16%)
Other Side Effects
- Lower appetite
- Bone fractures
- Itchy skin
- Swelling in arms or legs
- Tiredness, weight gain, and other symptoms of low thyroid hormone
Serious Side Effects
- Seizures
- Heart problems: chest pain, racing heartbeat, shortness of breath, arm or shoulder pain, swelling of your legs or feet, sudden weight gain, sweating, fatigue, dizziness, nausea or vomiting
- Stroke: sudden numbness or weakness, confusion, trouble speaking, trouble seeing, dizziness, severe headache
Source: DailyMed
The following 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
Oral pill, taken once daily
Recommended option for certain types of prostate cancer
Can treat prostate cancer that is no longer responding to other hormonal therapies
Cons
Available as brand only, so can be expensive
Can cause a rash, which can take several months to go away
Can raise your risk for seizures
Pharmacist tips for Erleada (apalutamide)
Erleada (apalutamide) can be taken with or without food. It doesn’t matter what time of the day you take it, as long as you take it around the same time each day.
Swallow Erleada (apalutamide) tablets whole. Don’t cut, crush, or chew the tablets.
Erleada (apalutamide) isn't meant to be taken alone to treat prostate cancer. Typically, you should be taking it at the same time as a medication that targets a hormone called GnRH (e.g. Lupron Depot (leuprolide) or Firmagon (degarelix)), unless you’ve had surgery to remove both testicles. Check with your provider if you aren’t receiving a GnRH-targeting medication. Don’t stop taking these medications without talking to your healthcare provider first.
If you miss a dose of Erleada (apalutamide) and it’s not time for your next dose, take your missed dose as soon as possible. If it’s time for your next dose, skip the missed dose, and take your next dose at your next regularly scheduled time. Don't take two doses at the same time.
Be careful while driving, operating heavy machinery, or doing any activities that require a lot of focus and attention until you know how Erleada (apalutamide) affects you.
Erleada (apalutamide) can cause seizures and sudden loss of consciousness. If you experience a seizure while taking this medication, stop taking it and contact your provider.
If your partner is able to become pregnant, use appropriate birth control measures, such as condoms, while you’re taking Erleada (apalutamide), and for 3 months after your last dose. It’s possible for Erleada (apalutamide) to cause birth defects or pregnancy loss in female partners of males who are taking this medication. Talk with your provider if you have questions about birth control options for you and your partner.
Erleada (apalutamide) can affect your ability to have children. If you’re donating or thinking about donating sperm, you’ll need to stop while you’re taking and for 3 months after your last dose of Erleada (apalutamide).
Ask your healthcare provider or pharmacist about the best way to handle and dispose of this anticancer medication. These medications can be very harmful to people who handle or come into contact with them, so you need to get rid of them safely.
Frequently asked questions about Erleada (apalutamide)
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What are the 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.
Problems with blood vessels in the heart and brain
Risk factors: High blood pressure | High blood sugar | High cholesterol
Erleada (apalutamide) can cause the blood vessels around your heart and brain to narrow and make it difficult for enough blood or oxygen to reach these places. Though rare, this can lead to serious problems, including heart attacks and strokes. If you’re at risk for heart problems, your provider might monitor your blood pressure, blood sugar, or cholesterol more regularly while you’re taking Erleada (apalutamide). Let your provider know right away or seek medical help if you have chest pain, racing heartbeat, trouble breathing, arm or shoulder pain, sudden numbness or weakness, severe headache, or sudden confusion.
Falls and fractures
Risk factors: Older adults | Taking other medications that can affect your balance
Erleada (apalutamide) can put you at risk for falls and bone fractures, especially if you’re an older adult. This can happen months or even years after you start Erleada (apalutamide). Your provider might monitor you more closely if you’re at higher risk for falls and fractures and might prescribe medication to help strengthen your bones. Tell your provider if you develop bone pain or experience more falls while taking this medication.
Seizures
Risk factors: Taking other medications that can raise the risk of seizures | Past seizures | Other risk factors of seizures
Though rare, Erleada (apalutamide) might put you at risk for seizures. Seizures can occur as early as 6 months after you start taking this medication. Let your provider know if you have a history of seizures or conditions that raise your risk of seizures, or are taking medications that can make you more likely to have a seizure. Let your loved ones and caregivers know of this risk so they can help you and also get medical help if you do have a seizure. Stop taking Erleada (apalutamide) and tell your provider 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.
Possible harm to unborn baby
It’s possible for Erleada (apalutamide) to harm unborn babies.
If your partner is able to get pregnant, you should use birth control measures, such as condoms, while taking Erleada (apalutamide), and for 3 months after your last dose. Let your provider know right away if your partner becomes pregnant during this time.
Erleada (apalutamide) dosage forms
Typical dosing for Erleada (apalutamide)
The typical dose is 240 mg of Erleada (apalutamide) taken by mouth once a day.
What are alternatives to Erleada (apalutamide)?
Advanced or metastatic prostate cancer (cancer that've spread to other areas)
Castration-resistant prostate cancer that hasn’t yet spread to other areas of the body
Metastatic, hormone-sensitive prostate cancer, given together with a chemotherapy called docetaxel (Taxotere)
What is the latest news about Erleada (apalutamide)?
Erleada (apalutamide) images
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