Enzalutamide is a prescription anticancer medicine. Although it can be an important treatment for selected men with prostate cancer, it can also cause adverse reactions and clinically important interactions.
Treatment should be prescribed and supervised by an appropriately qualified healthcare professional.
Seizure Risk
One of the most important neurological safety considerations with enzalutamide is the possibility of seizures.
Patients should tell their doctor if they have:
- A previous seizure disorder
- A history of brain injury
- A history of stroke
- Other neurological conditions
- Medicines or circumstances that may increase seizure risk
A seizure occurring during treatment requires urgent medical assessment.
Ischemic Heart Disease
Ischemic heart disease has been identified as an important potential adverse effect associated with enzalutamide.
Patients with cardiovascular disease or cardiovascular risk factors should make sure their healthcare team knows about their history.
Symptoms such as chest pain, pressure, shortness of breath, sweating, or sudden weakness may require emergency assessment.
Blood Pressure
Hypertension can occur during enzalutamide treatment.
Healthcare professionals may monitor blood pressure during follow-up, particularly in patients with existing hypertension or cardiovascular risk factors.
Patients should continue any prescribed blood-pressure treatment unless their clinician tells them otherwise.
Falls and Fractures
Falls and fractures can be clinically important in men receiving prostate cancer treatment.
Risk can be affected by:
- Age
- Bone density
- Muscle strength
- Previous falls
- Other medicines
- Balance problems
- Cancer-related factors
Patients who experience repeated falls, significant weakness, or a suspected fracture should seek medical evaluation.
Posterior Reversible Encephalopathy Syndrome
A rare neurological condition known as posterior reversible encephalopathy syndrome, or PRES, has been associated with medicines in this therapeutic setting.
Potential symptoms can include:
- Seizure
- Headache
- Confusion
- Visual disturbance
- Altered mental status
Sudden neurological symptoms require urgent medical evaluation.
Hypersensitivity
Allergic or hypersensitivity reactions are possible.
Urgent medical attention is appropriate for:
- Facial swelling
- Lip or tongue swelling
- Throat swelling
- Difficulty breathing
- Severe rash
- Rapidly developing allergic symptoms
Patients should tell healthcare professionals about previous serious medicine allergies.
Drug Interactions
Enzalutamide can influence the metabolism and transport of other medicines.
This means it can reduce or otherwise alter exposure to some medicines that are taken at the same time.
Before treatment begins, patients should provide a complete medication list.
Include:
- Prescription medicines
- Non-prescription medicines
- Vitamins
- Minerals
- Herbal products
- Traditional medicines
- Supplements
Do not start a new medicine without checking whether it can be safely combined with enzalutamide.
Liver and Kidney Considerations
The patient’s overall health can influence medicine selection and monitoring.
Patients should tell their doctor about known liver or kidney disease and provide information about previous laboratory abnormalities.
The appropriate monitoring plan is determined by the treating clinician.
Reproductive Precautions
Enzalutamide is used for prostate cancer in men. Reproductive precautions should follow the official product information and the advice of the treating healthcare professional.
Patients should not assume that pregnancy-related precautions are unnecessary simply because the medicine is prescribed to a male patient.
Alcohol and Lifestyle
Patients should ask their healthcare professional whether alcohol is appropriate for them while receiving treatment.
Alcohol may worsen dizziness, fatigue, or problems with balance in some individuals and may also interact with other medicines or health conditions.
Driving and Machinery
Enzalutamide can be associated with fatigue, dizziness, and other effects that may affect alertness or physical function.
Patients should understand how the medicine affects them before driving or operating machinery.
Do Not Stop Treatment Abruptly Without Advice
A patient should not independently stop enzalutamide because of side effects.
Some adverse effects can be managed through medical treatment, dose interruption, or dose adjustment. The appropriate approach depends on the specific problem.
However, severe or emergency symptoms require prompt medical evaluation rather than waiting for the next appointment.
Safety Summary
Important safety issues to discuss with the treating healthcare professional include:
- Seizure history
- Cardiovascular disease
- Blood pressure
- Fall and fracture risk
- Neurological symptoms
- Current medicines
- Allergies
- Reproductive considerations
- Other chronic diseases
The official product information remains the primary source for complete warnings and precautions.