Is Xtandi (enzalutamide) chemotherapy?

Xtandi (enzalutamide) isn't chemotherapy. [Chemotherapy](https://www.goodrx.com/conditions/prostate-cancer/chemotherapy-for-prostate-cancer) works by directly killing fast-growing cells, including cancer cells. Xtandi (enzalutamide) is a type of hormone therapy called an [androgen receptor inhibitor](https://www.goodrx.com/classes/androgen-receptor-inhibitors), which blocks testosterone from helping prostate cancer grow and spread.

What foods should you avoid when taking Xtandi (enzalutamide)?

When you’re taking Xtandi (enzalutamide), avoid [grapefruit and grapefruit juice](https://www.goodrx.com/drugs/safety/grapefruit-juice-interactions#why-does-grapefruit-interact) because they can change how your body breaks down the medication and raise the risk of side effects. If you’re unsure about certain foods or supplements, check with your care team.

Can I drink coffee while taking Xtandi (enzalutamide)?

You can usually drink coffee while taking Xtandi (enzalutamide), but it’s a good idea to check with your oncologist first. Caffeine can make side effects like [diarrhea](https://www.goodrx.com/well-being/gut-health/why-does-coffee-make-you-poop) or [trouble sleeping](https://www.goodrx.com/well-being/diet-nutrition/what-time-stop-drinking-coffee) worse for some people. Ask your oncology care team how much coffee, if any, is safe for you.

Xtandi

enzalutamide

Used for Prostate Cancer

Xtandi (enzalutamide) is a prescription cancer medication used to treat certain types of prostate cancer in adults. It works by blocking testosterone, a hormone that many prostate cancers need to grow. You usually take a tablet or capsule once a day by mouth, often along with other hormone treatments or after surgery to remove the testicles. Common side effects include weakness or fatigue, back pain, and hot flashes.

Reviewed by:

Daisy Chau, PharmD

Jenny Zhang, PharmD, BCOP

Last reviewed on February 10, 2026

What is Xtandi (enzalutamide)?

What is Xtandi (enzalutamide) used for?

Prostate cancer that's castration-resistant
Metastatic prostate cancer that's hormone-sensitive
Non-metastatic prostate cancer that's hormone-sensitive, with a high risk of spreading

How Xtandi (enzalutamide) works

Xtandi (enzalutamide) 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.

When does Xtandi (enzalutamide) start working?Time passed since treatment started:

HOURS

DAYS

WEEKS

Initial effect

MONTHS

Full effect

Drug facts

Common Brands	Xtandi
Drug Class	Androgen receptor inhibitor
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Xtandi

Drug Class

Androgen receptor inhibitor

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Side effects of Xtandi (enzalutamide)

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

Muscle and joint pain
Feeling more tired than usual
Hot flashes
Constipation
Reduced appetite
Diarrhea
High blood pressure
Bleeding problems
Falls
Bone fractures
Headache

Less Common Side Effects

Dizziness
Nausea
Memory problems
Lung infections
Swelling
Trouble breathing
Blood in the urine
Anxiety
Dry skin
Itching
Enlarged breasts

Xtandi (enzalutamide) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

Seizures: sudden jerking or shaking, loss of consciousness, confusion, trouble speaking
Brain problem: headache, less alert, confusion, reduced eyesight, blurred vision
Allergic reactions: swelling face or tongue, trouble breathing
Heart problems: chest pain, shortness of breath, rapid breathing, sweating, fatigue, dizziness, nausea, vomiting
Fractures: pain, swelling, bruising, tenderness, bleeding, numbness

Source: DailyMed

The following Xtandi (enzalutamide) 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
Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
Loss of balance or coordination
Seizures
Sudden and severe headache, confusion, change in vision, seizures, which may be signs of posterior reversible encephalopathy syndrome (PRES)

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

Back pain
Constipation
Diarrhea
Hot flashes
Increase in blood pressure
Loss of appetite
Unusual weakness or fatigue

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Pros and cons of Xtandi (enzalutamide)

Pros

Pill that’s taken by mouth once a day
Can take with or without food
Recommended option for certain types of prostate cancer

Cons

Interacts with many medications
Can raise your risk for seizures and fractures
Requires regular blood tests and monitoring

Pharmacist tips for Xtandi (enzalutamide)

Xtandi (enzalutamide) can be taken with or without food. You can take it at any time of day, as long as you take it around the same time each day.
Swallow Xtandi (enzalutamide) capsules or tablets whole with water. Don’t open, crush, chew, or dissolve them. Tell your prescriber if you have trouble swallowing this pill. Their size has been linked to choking in some people.
If you miss a dose of Xtandi (enzalutamide), take it as soon as you remember before your next dose. Don’t take two doses at the same time.
You’ll usually take Xtandi (enzalutamide) along with other hormone treatments, unless you’ve had surgery to remove both testicles. Don’t stop those treatments without talking to your oncologist.
Xtandi (enzalutamide) can interact with certain medications, such as clarithromycin or rifampin. Tell your cancer care team about all medications, supplements, and over-the-counter products you use, and check before starting anything new.
Xtandi (enzalutamide) can raise your risk of seizures. void activities where fainting or loss of awareness could be dangerous, and call your care team right away if you have a seizure or pass out.
Xtandi (enzalutamide) has been linked to a higher risk of falls and broken bones. Be careful with activities where you could fall.
If your partner can become pregnant, use birth control such as condoms while taking Xtandi (enzalutamide) and for 3 months after your last dose. This medication might not be safe in pregnancy.

Common questions about Xtandi

Xtandi isn't chemotherapy. Chemotherapy works by directly killing fast-growing cells, including cancer cells. Xtandi is a type of hormone therapy called an androgen receptor inhibitor, which blocks testosterone from helping prostate cancer grow and spread.

When you’re taking Xtandi, avoid grapefruit and grapefruit juice because they can change how your body breaks down the medication and raise the risk of side effects. If you’re unsure about certain foods or supplements, check with your care team.

Xtandi can start lowering your prostate-specific antigen (PSA) within a few weeks, but it often takes a few months to see a clear drop. PSA is a protein in your blood that your cancer care team uses to track how active your prostate cancer is, and higher levels can mean the cancer is growing. Your care team will check your PSA regularly to see how well the medication is working for you.

You can take Xtandi at any time of day that works best for you. The most important thing is to take it at the same time every day to keep steady levels in your body. Many people choose morning or evening based on their routine, and you can take it with or without food.

Xtandi doesn’t usually cause hair loss. Most people don’t notice changes in their hair while taking it. If you do notice hair thinning or other changes, it could be related to hormone changes or other treatments, so let your oncologist know.

Yes. Xtandi can help people with certain types of prostate cancer live longer. For example, a large study in people with metastatic hormone-sensitive prostate cancer found that adding this medication to standard hormone-lowering treatment lowered the risk of death by about 30% over five years and led to a higher chance of being alive at five years compared with hormone-lowering therapy alone. The benefit can be different for each person, so your oncologist can help explain what this means for your specific situation.

You can usually drink coffee while taking Xtandi, but it’s a good idea to check with your oncologist first. Caffeine can make side effects like diarrhea or trouble sleeping worse for some people. Ask your oncology care team how much coffee, if any, is safe for you.

No, Xtandi doesn't need to be refrigerated. Store it at room temperature, away from heat and moisture, and keep it in its original container. If you have questions about storage, your pharmacist can help.

Risks and warnings for Xtandi (enzalutamide)

Xtandi (enzalutamide) 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.

Seizures

Risk factors: Taking other medications that can raise the risk of seizures | History of brain or head injury | Past stroke | Alzheimer's disease | Brain conditions | Fainting in the past year | Past seizures

Although it's rare, Xtandi (enzalutamide) might put you at risk for seizures. In studies, seizures happened anywhere from a few days to several years after starting treatment. Let your oncologist know if you have a history of seizures or are medications that raise the risk for seizures. Because of this risk, avoid activities where losing consciousness could be dangerous, such as driving or swimming alone.

Stop taking Xtandi (enzalutamide) and tell your oncologist right away if you think you've had a seizure. You’ll likely need to switch to a different medication to treat your prostate cancer. Early symptoms of a seizure can include a strange taste or smell, feeling anxious, nausea, or a fluttering feeling in your body.

Brain problem

In rare cases, people taking Xtandi (enzalutamide) have developed a brain condition called posterior reversible encephalopathy syndrome (PRES). If this happens, you’ll need to stop the medication. Get medical help right away if you have sudden severe headaches, confusion, vision loss or changes, behavior changes, or seizures.

Allergic reaction

Allergic reactions have happened in some people taking Xtandi (enzalutamide). These reactions can include swelling of the face, lips, tongue, or throat. If you notice any signs of an allergic reaction, stop taking the medication and get medical help right away. If the reaction is serious, you will need to stop the medication altogether.

Heart problems

Risk factors: High blood pressure | Diabetes | High cholesterol

Rarely, Xtandi (enzalutamide) can cause blocked arteries in the heart called ischemic heart disease. If this happens and your symptoms are severe, you’ll need to stop taking this medication. Call your oncologist right away if you have chest pain, chest discomfort during rest or activity, or shortness of breath, since these might be signs of heart problems.

Falls and fractures

Xtandi (enzalutamide) can raise your risk of falls and broken bones. These problems can happen days or even years after starting the medication. Tell your oncologist if you develop bone pain or experience falls while taking this medication.

Possible harm to unborn baby

Xtandi (enzalutamide) can harm an unborn baby. If your partner can get pregnant, use birth control, such as condoms, while you’re taking this medication and for 3 months after your last dose. Tell your oncologist right away if your partner becomes pregnant during this time.

Choking and trouble swallowing

Xtandi (enzalutamide) capsules or tablets can be large and can cause serious choking or trouble swallowing in some people. To lower this risk, swallow each capsule or tablet whole with plenty of water. If you have trouble swallowing pills, tell your oncologist.