xtandi 2d
Brand name: Xtandi®
IUPAC: 4-[3-[4-cyano-3-(trifluoromethyl)phenyl]-5,5-dimethyl-4-oxo-2-sulfanylideneimidazolidin-1-yl]-2-fluoro-N-methylbenzamide
FDA approval: Yes

How Xtandi Is Given: 

  • Taken as a capsule by mouth. 

  • Take with or without food at the same time each day with a full glass of water 

  • Swallow the capsule whole. Do not crush, chew or dissolve capsules. 

  • If you miss a dose, take it as soon as you remember that day. If you miss a day, do not double your dose the next day. Just skipped the missed dose. Call your healthcare provider if you are not sure what to do. 

  • Store Xtandi at room temperature (68-77 degrees F or 20-25 degrees C). 

  • Keep the container closed tightly, dry, and out of the reach of children. 

  • The amount of Xtandi that you will receive depends on many factors. Your doctor will determine your dose and schedule. 


Xtandi is a hormone therapy. It is classified as an "anti-androgen”. Treatment of metastatic castration resistant prostate cancer (prostate cancer that is resistant to medical or surgical treatments that lower testosterone) who have previously received docetaxel.  

Enzalutamide is an androgen receptor inhibitor that acts on different steps in the androgen receptor signaling pathway. Enzalutamide has been shown to competitively inhibit androgen binding to androgen receptors and inhibit androgen receptor nuclear translocation and interaction with DNA. A major metabolite, N-desmethyl enzalutamide, exhibited similar in vitro activity to enzalutamide. Enzalutamide decreased proliferation and induced cell death of prostate cancer cells in vitro, and decreased tumor volume in a mouse prostate cancer xenograft model.

Side effects:

Common (occurring in greater than 30%) side effects for patients taking Xtandi include fatigue. Less common (occurring in 10-29%) side effects for patients receiving Xtandi include: back pain, joint aches, musculoskeletal pain; diarrhea; hot flashes; peripheral edema (swelling in your hands, arms, legs, or feet); low white blood cell count; headache; upper respiratory tract infection; dizziness; and muscle weakness. 

Not all side effects are listed above. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms. Among the uncommon side effects, patients taking Xtandi should be aware that there is a risk for seizures in patients taking this medication. Although it occurs in less than 1% of patients, they should be aware of the risk when engaging in any activity where sudden loss of consciousness could cause serious harm to themselves or others.