apalutamide
Other Name: Erleada®
- For treating prostate cancer
- Tell your health care team if you have or had significant medical condition(s), especially if you have / had:
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high blood pressure or high blood sugar
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high levels of fat or cholesterol in your blood
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heart disease or irregular heartbeat
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risk of falls or broken bones
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underactive thyroid (called hypothyroidism)
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seizures, brain injury, stroke, or brain tumors (non-cancerous or cancerous) or
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any allergies
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Remember to:
- Tell your health care team about all of the other medications you are taking.
- Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
Talk to your health care team about:
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How this medication may affect your sexual health.
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Symptoms such as hot flashes.
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How this medication may affect your ability to have a baby, if this applies to you.
This medication may harm an unborn baby. Tell your health care team if your partner is pregnant or becomes pregnant during treatment.
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If there is any chance that your partner may become pregnant, you and your partner together must use 2 effective forms of birth control at the same time until 3 months after your last dose. Tell your health care team if your partner is pregnant or becomes pregnant during treatment.
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This medication is usually taken once a day by mouth. Talk to your health care team about how and when to take your medication.
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Swallow whole with a glass of water, with or without food. If you cannot swallow your medication whole, talk to your health care team about what to do.
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Take the dose at about the same time each day.
- If you miss a dose, take your normal dose as soon as possible on the same day. Go back to your regular schedule on the following day. You should not take 2 doses or extra tablets to make up the missed dose.
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If you vomit (throw up) after taking your medication, talk to your health care team about what to do.
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Apalutamide is usually taken with another medication known as a gonadotropin-releasing hormone (GnRH) analogue, unless you had a surgery to remove your testicles in order to lower the amount of testosterone in your body. Your healthcare professional will tell you exactly how and when to take apalutamide and the GnRH analogue.
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If you take too much of your medication by accident, or if you think a child or a pet may have swallowed your medication, you must call the Ontario Poison Control Center right away at: 1-800-268-9017.
Will this medication interact with other medications or natural health products?
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This medication can interact with other medications, vitamins, foods and natural health products. Interactions can make the treatment not work as well or cause severe side effects.
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Tell your health care team about all of your:
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prescription and over-the-counter (non-prescription) medications and all other drugs, such as marijuana (medical or recreational)
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natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements
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Check with your health care team before starting or stopping any of them.
What to DO while on this medication:
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DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.
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DO wear shoes that have nonslip soles and some ankle support. Also try to stand up slowly after sitting or lying down to lower your chance of falling down.
What NOT to DO while on this medication:
- DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
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Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
- Keep this medication in the original packaging at room temperature (15°C to 30°C) in a dry place, away from heat and light. Keep out of sight and reach of children and pets.
- If your apalutamide tablets are provided to you in a bottle, the bottle contains silica gel desiccant to help keep your medication dry. Do not remove desiccant from the bottle.
How to safely touch oral anti-cancer medications
If you are a patient:
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Wash your hands before and after touching your oral anti-cancer medication.
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Swallow each pill whole. Do not crush or chew your pills.
If you are a caregiver:
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Wash your hands before and after touching the oral anti-cancer medication.
If there is a chance your partner may become pregnant:
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Wear nitrile or latex gloves when touching tablets, capsules or liquids.
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Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
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Throw out your gloves after each use. Do not re-use gloves.
What to do if oral anti-cancer medication gets on your skin or in your eyes
If medication gets on your skin:
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Wash your skin with a lot of soap and water.
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If your skin gets red or irritated, talk to your health care team.
If medication gets in your eyes:
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Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.
The following table lists side effects that you may have when getting apalutamide. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.
Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on apalutamide.
Common Side Effects (25 to 49 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Fatigue What to look for?
What to do?
Ask your health care team for the Fatigue pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
High blood pressure (May be severe) What to look for?
What to do?
If you have a severe headache get emergency help right away as it may be a sign your blood pressure is too high. |
Talk to your health care team if it does not improve or if it is severe |
Less Common Side Effects (10 to 24 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Rash; dry, itchy skin (May be severe) What to look for?
What to do? To prevent and treat dry skin:
Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away. |
Talk to your health care team if it does not improve or if it is severe |
Diarrhea What to look for?
What to do? If you have diarrhea:
Ask your health care team for the Diarrhea pamphlet for more information. |
Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day) |
Nausea and vomiting (Generally mild) What to look for?
To help prevent nausea:
If you have nausea or vomiting:
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Talk to your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if it is severe |
Low appetite, weight loss What to look for?
Ask your health care team for the Loss of Appetite pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
Mild joint, muscle pain or cramps What to look for?
What to do?
Ask your health care team for the Pain pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
Changes to your hormone levels Your treatment causes changes in the levels of testosterone in your body. This can affect your mood, energy levels or physical appearance, among other things. You may have many of these symptoms or none at all. Your symptoms may also change at different times in your treatment. What to look for? Hot flashes:
What to do? To help prevent hot flashes:
Hot flashes may improve over time. Talk to your health care team if this or any symptoms of low testosterone are bothersome for you. |
Talk to your health care team if it does not improve or if it is severe |
Bone pain; Bone loss or Bone fractures Your treatment may cause your bones to thin earlier than normal. Thin bones are weak and fragile. They may break easily from simple falls or movements. Your health care team may check your bone density (measure of how strong your bones are) with a bone scan. What to look for?
What to do? To help prevent bone loss and fractures
Get emergency medical help if you experience severe bone pain or are unable to move as these may be signs of a bone fracture. See our Bone Health pamphlet for more information. |
Talk to your health care team if it does not improve. Get emergency medical help if you have severe bone pain or are unable to move. |
Mild swelling What to look for?
What to do?
If you have swelling:
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Talk to your health care team if it does not improve or if it is severe |
Other rare, but serious side effects are possible. If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:
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Irregular heartbeat, shortness of breath, chest pain, fainting spells or swelling in your legs, ankles and belly
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Trouble with seeing, speaking or using your arms or legs
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Seizures
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Unusual weight gain which may be accompanied with: feeling tired or having low energy, dry skin, nails or hair that breaks easily, or sensitivity to cold
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Breathing problems, chest pain or cough up blood
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Redness, blistering and/or peeling of large areas of the skin and/or inside of the lips, eyes, mouth, nasal passages or genitals, along with fever, chills, headache, cough, body aches or swollen glands
Who do I contact if I have questions or need help?My cancer health care provider is: ______________________________________________ During the day I should contact:________________________________________________ Evenings, weekends and holidays:______________________________________________
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Other Notes:
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April 2024 Updated/Revised "Less Common Side Effects" section
For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.