Xtandi (Enzalutamide): Side Effects, Drug Interactions, Uses

Xtandi (Enzalutamide) is a medication designed to offer hope and improved outcomes for prostate cancer patients. 

In this article, we’ll explore how Xtandi works, its potential side effects, strategies to reduce those side effects, interactions to be aware of, and answer some frequently asked questions.

How Xtandi (Enzalutamide) Works for Prostate Cancer

Xtandi, with the generic name Enzalutamide, is a medication specifically designed to treat prostate cancer. 

It falls under the category of androgen receptor inhibitors, which means it targets the androgen receptor in prostate cancer cells.

Prostate cancer is often driven by the male hormone testosterone. Testosterone binds to and activates the androgen receptor, promoting the growth and spread of cancer cells. 

Xtandi works by blocking this interaction. It inhibits the androgen receptor, preventing testosterone from fueling the cancer’s growth.

This inhibition helps slow down the progression of the disease and can even lead to tumor shrinkage.

Get Your FREE PSA Lowering Diet Plan!

  • Naturally lower PSA levels
  • Reduce nighttime trips to the bathroom
  • Enjoy better bladder control and urine flow

By clicking “Download Now”, I agree to Ben's Natural Health Terms and Conditions and Privacy Policy.

Side Effects of Xtandi

As with any medication, Xtandi may cause side effects. It’s important to note that not everyone will experience these side effects, and their severity can vary from person to person. 

Below, we’ve listed some common side effects associated with Xtandi, along with explanations and tips on how to reduce them:


Feeling extremely tired is a common side effect of Xtandi. To combat fatigue, try to get plenty of rest, engage in light physical activity, and maintain a balanced diet.

Hot Flashes

Xtandi can cause sudden feelings of warmth and sweating. Dressing in layers and avoiding hot beverages and spicy foods may help manage hot flashes.


Some people may experience headaches when taking Xtandi. Staying hydrated and using over-the-counter pain relievers, as recommended by your healthcare provider, can provide relief.


If you’re dealing with constipation, ensure you’re drinking enough water, consuming fiber-rich foods, and staying active. Your doctor may also suggest over-the-counter remedies.


In some cases, Xtandi can lead to diarrhea. Stay hydrated and avoid high-fiber or greasy foods that may exacerbate this side effect.


Nausea is another potential side effect. Eating smaller, more frequent meals and avoiding strong odors can help manage nausea.


Xtandi may cause swelling, particularly in the hands and feet. Elevating the affected areas and wearing loose-fitting clothing can provide relief.

Read your Xtandi package insert for a full list of side effects from the manufacturer.

How to Reduce Xtandi’s Side Effects

Managing the side effects of Xtandi (Enzalutamide) is an essential aspect of your prostate cancer treatment journey. Here are some effective strategies to consider:

Stay Well-Hydrated

Drinking plenty of water is a simple yet powerful way to mitigate several side effects associated with Xtandi. 

Adequate hydration can help alleviate hot flashes, prevent constipation, and reduce the severity of nausea. 

Maintain a Balanced Diet

Proper nutrition is vital during prostate cancer treatment. A balanced diet that includes a variety of fruits, vegetables, whole grains, and lean proteins provides essential nutrients to support your overall well-being. 

Talk To Your Healthcare Provider

Effective communication with your healthcare team is crucial. Don’t hesitate to discuss any side effects you experience, no matter how minor they may seem. 

Follow Your Medication Schedule

Taking Xtandi as prescribed by your doctor is of paramount importance. Consistency in your medication schedule ensures its effectiveness in managing prostate cancer. It also contributes to a more predictable experience with side effects.

Engage in Light Exercise:

Gentle physical activity can have a positive impact on your overall well-being during Xtandi treatment. 

Activities like the following can boost your energy levels, alleviate fatigue, and improve mood:

  • Walking
  • Yoga
  • Tai chi 

Consider Support Groups

Prostate cancer can be emotionally challenging, and dealing with side effects may be overwhelming at times. 

Connecting with others who are going through similar experiences can provide valuable emotional support and practical advice for managing side effects. 

prostate health supplements

Interactions with Xtandi

Xtandi Drug Interactions

Xtandi can interact with several medications, potentially affecting its efficacy or leading to adverse effects. 

It’s crucial to provide your healthcare provider with a complete list of all the medications you’re currently taking, including prescription drugs, over-the-counter medications, and any herbal or dietary supplements. 

Here are some important drug interactions with Xtandi (Enzalutamide) to be aware of:

Seizure Medications

Xtandi may interact with drugs commonly used to treat seizures, such as phenytoin or carbamazepine. 

These interactions can alter the levels of Enzalutamide in your bloodstream, potentially reducing its effectiveness. 


Rifampin, an antibiotic often used to treat tuberculosis and other infections, can significantly reduce the levels of Xtandi in your body. 

This medication interaction may lead to Enzalutamide becoming less effective in managing prostate cancer. 

Chemotherapy Agents

Xtandi is typically not used in combination with certain chemotherapy agents without careful consideration by your healthcare provider. 

Combining Enzalutamide with specific chemotherapy drugs may increase the risk of side effects or impact the effectiveness of either treatment. 

Medical Conditions Contraindicated with Xtandi

Before starting Xtandi, it’s crucial to discuss your medical history with your healthcare provider. Certain medical conditions may make Xtandi unsuitable for you, and alternative treatment options may be considered. 

Here are some medical conditions to highlight:

History of Seizures

Xtandi may lower the seizure threshold, meaning it could increase the risk of seizures in people with a history of seizure disorders. 

If you have a history of seizures or epilepsy, your doctor will carefully weigh the potential risks and benefits of Enzalutamide and may explore alternative treatment options.

Other Medical Conditions

In addition to a history of seizures, it’s essential to inform your healthcare provider about any other medical conditions you have, such as liver problems or kidney disease. 

These conditions may influence the suitability of Xtandi as a treatment option or require dosage adjustments.

Taking Foods, Supplements And Herbs With Xtandi

While there are no specific foods, supplements, or herbs that are strictly contraindicated with Xtandi, it’s advisable to maintain a balanced and healthy diet during your treatment. 

Here are some dietary considerations with Xtandi (Enzalutamide):

Balanced Diet

Eating a balanced diet that includes a variety of fruits, vegetables, whole grains, and lean proteins can help support your overall health during prostate cancer treatment. 

Nutrient-rich foods can contribute to your well-being and may aid in managing potential side effects.

Consult Your Healthcare Provider

If you’re considering making significant dietary changes or adding new supplements or herbs to your regimen while taking Xtandi, it’s essential to consult your healthcare provider first. 

They can offer guidance and ensure that any dietary modifications or supplements are safe and won’t negatively interact with your treatment.


How long can a cancer patient take Xtandi? 

The duration of Xtandi treatment varies from patient to patient and depends on individual factors. Your healthcare provider will determine the most appropriate treatment duration for your specific case.

Is Xtandi a chemo medication?

No, Xtandi is not a chemotherapy medication. It belongs to a class of drugs known as androgen receptor inhibitors and works differently from traditional chemotherapy.

Can Xtandi cure prostate cancer?

Xtandi is not typically considered a curative treatment for prostate cancer. Instead, it aims to slow the progression of the disease, manage symptoms, and improve the patient’s quality of life.


Xtandi (Enzalutamide) is a medication for prostate cancer. Understanding how this medication works, being aware of potential side effects, and proactively managing your treatment can empower you to navigate your prostate cancer journey more effectively. 

While Xtandi can be highly effective, it can also bring about side effects. By being aware of potential side effects, you can better prepare and take proactive steps to manage them. Implement strategies to manage side effects effectively. 

For example, if you experience fatigue, consider incorporating light exercise into your routine and maintaining a well-balanced diet. 

If you experience side effects that are bothersome or interfere with your daily life, don’t hesitate to reach out to your healthcare provider. 

They can offer guidance and adjustments to your treatment plan or recommend supportive therapies to alleviate discomfort.

Explore More

bicalutamide casodex

Bicalutamide (Casodex): Uses, Side Effects, Interactions.


  1. Bennett, Lunawati L., and April Ingason. “Enzalutamide (Xtandi) for patients with metastatic, resistant prostate cancer.” Annals of Pharmacotherapy 48.4 (2014): 530-537.
  2. Cao, Brent, et al. “Adverse Events and Androgen Receptor Signaling Inhibitors in the Treatment of Prostate Cancer: A Systematic Review and Multivariate Network Meta-analysis.” European Urology Oncology (2023).
  3. van Haarst, Aernout, et al. “Rifampin drug–drug–interaction studies: reflections on the nitrosamine impurities issue.” Clinical Pharmacology & Therapeutics 113.4 (2023): 816-821.

Top Products

Total Health


Glucose Control