If you have prostate cancer, your doctor may suggest treatment with Erleada. It’s a prescription drug that’s used in adults with certain kinds of prostate cancer.

Prostate cancer affects the prostate, which is a small gland located under the bladder in males.*

To learn more about the drug’s uses, see the “What is Erleada used for?” section below.

* In this article, we use the term “males” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Erleada basics

Erleada contains the active drug apalutamide. (The active drug is the ingredient that makes a medication work.) Erleada is a kind of drug called an anti-androgen.

Erleada comes as tablets (pills) that you swallow. It’s not available as a generic.

Keep reading to learn about Erleada’s side effects, cost, dosage, and more.

Like most drugs, Erleada may cause mild or serious side effects. The lists below describe some of the more common side effects that Erleada may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Erleada. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Erleada can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Erleada’s prescribing information.

Mild side effects of Erleada that have been reported include:

  • changes in the way things taste
  • decreased appetite
  • diarrhea
  • fatigue (low energy) or weakness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • joint pain
  • muscle spasms
  • nausea
  • rash*
  • swelling in your hands, feet, lymph nodes, or genitals
  • weight loss

* To learn more about this side effect, see “Side effect focus” below.

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Erleada can occur, but they aren’t common. If you have serious side effects from Erleada, call your doctor right away. But if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects of Erleada that have been reported include:

* For more information about this side effect, see “Side effect focus” below.

Side effect focus

Learn more about some of the side effects Erleada may cause.

Rash

Taking Erleada may cause a skin rash, as well as other skin-related side effects. A rash was one of the more common side effects reported in studies of the drug.

In a few cases, people have stopped taking Erleada due to having a rash.

In studies, the most common kind of rash Erleada caused was maculopapular rash. This rash often appears as bumps on your skin, along with discoloration. As well as a rash, people taking Erleada in studies also reported these skin-related side effects:

What might help

Call your doctor right away if you develop a rash while taking Erleada. Keep in mind that a rash may be a symptom of an allergic reaction, a serious side effect that Erleada may cause. To learn about other symptoms of an allergic reaction, see “Allergic reaction” below.

If you experience a rash during Erleada treatment, your doctor will likely recommend treatment for this side effect. Examples of rash treatments used by people who had this side effect in studies include:

Your doctor may lower your Erleada dose if you develop a rash. Or they may have you temporarily or permanently stop taking the drug. Temporarily stopping Erleada treatment may cause the rash to go away, but it may come back if you start taking the drug again.

Heart disease

Erleada can cause a kind of heart disease in some people. Heart disease wasn’t a common side effect seen in studies. But in rare cases, heart disease caused by Erleada has led to death. If you have concerns about your risk of heart disease with Erleada, talk with your doctor.

Symptoms of heart disease can include:

Having certain other medical conditions can raise your risk of heart disease if you take Erleada. These include:

What might help

Before prescribing Erleada, your doctor will review your medical history to determine your risk of heart disease. If you have another condition that raises your risk of this side effect, your doctor will likely make sure the other condition is well managed before prescribing Erleada. Your doctor will also monitor you for symptoms of heart disease while you’re taking Erleada.

Bone fracture

Erleada can weaken your bones and muscles. In some cases, taking Erleada can result in a bone fracture (broken bone). But this side effect wasn’t a common side effect seen in studies of the drug.

Symptoms of a bone fracture can include any of the following where the fracture occurs:

  • bruising
  • discoloration of the skin
  • not being able to move or put weight on the affected bone
  • pain
  • swelling

What might help

During your Erleada treatment, your doctor will monitor your risk of fractures. This includes assessing your risk of falls (which can lead to broken bones).

If you’re at risk of fractures, your doctor will likely check the health of your bones with a bone density test. This will then determine whether you need to take a drug to help strengthen your bones during Erleada treatment.

Seek medical care right away if you think you have a broken bone while taking Erleada. Then, talk with your doctor about whether you should continue taking Erleada.

Allergic reaction

Some people may have an allergic reaction to Erleada. But these reactions weren’t common in Erleada’s studies.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Erleada. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

Save on your Erleada prescription

Use your insurance to pay as little as $- through Erleada:’s manufacturer savings card.

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If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Erleada manufacturer’s website to see if they have support options.

You can also check out this article to learn more about saving money on prescriptions.

Your doctor will recommend the dosage of Erleada that’s right for you. Below are commonly prescribed dosages, but always take the dosage your doctor prescribes.

Form and strength

Erleada comes as tablets that you swallow. It’s available in one strength: 60 milligrams (mg).

Recommended dosage

You’ll likely take four Erleada tablets once per day.

Questions about Erleada’s dosage

Below are some common questions and answers about Erleada’s dosage.

  • What if I miss a dose of Erleada? If you miss a dose of Erleada, try to take the missed dose as soon as you remember. But if it’s the next day when you remember, skip the missed dose and take your next dose at the regular time. You should not take more than one dose of Erleada at a time or in one day.
  • Will I need to take Erleada long term? Yes. If you and your doctor agree that Erleada is working well for you, you’ll likely take the drug long term.
  • How long does Erleada take to work? Erleada begins working as soon as you take a dose. But it’s not known how long it takes to begin affecting cancer cells. The drug may begin to block hormones such as testosterone after a few days to a few weeks.

Find answers to some commonly asked questions about Erleada.

How does Erleada work?

How a drug works is referred to as its mechanism of action. Erleada works to treat prostate cancer by blocking certain hormones called androgens, such as testosterone. Androgens are hormones that encourage prostate cells to grow, including cancerous prostate cells. Blocking androgens causes the prostate cancer cells to die and stops them from spreading in your body.

If you’d like to learn more about how Erleada works, talk with your doctor or pharmacist.

Will Erleada cure my cancer?

No, Erleada doesn’t cure cancer. There currently isn’t a cure for cancer, including prostate cancer.

But drugs such as Erleada can help people live longer without their cancer worsening or spreading. It can also delay the need for chemotherapy (traditional drugs prescribed to treat cancer).

If you have other questions about what to expect from Erleada treatment, talk with your doctor.

Is Erleada a chemotherapy drug?

No, Erleada isn’t a chemotherapy drug. It’s a kind of hormone therapy that works by reducing the levels of androgen hormones, including testosterone, in your body.

In comparison, chemotherapy drugs work by attacking cells in your body that grow rapidly. This includes cancer cells, but it also includes healthy that are rapidly growing. Because of this, chemotherapy often causes many side effects, such as hair loss or mouth sores.

According to American Cancer Society guidelines, drugs such as Erleada may be prescribed with chemotherapy in certain people with prostate cancer. To learn more about the treatment option that’s right for you, talk with your doctor.

Erleada is used in adults with the following conditions:

  • Metastatic, castration-sensitive prostate cancer. “Metastatic” means the cancer has spread beyond your prostate to other parts of the body. “Castration-sensitive” means the cancer may be treated with drugs that lower the testosterone level in your body.
  • Nonmetastatic, castration-resistant prostate cancer. “Nonmetastatic” means the cancer hasn’t spread beyond your prostate. “Castration-resistant” means treatments that lower the testosterone level in your body don’t work to treat the cancer.

Prostate cancer affects the prostate, which is a small gland located under the bladder in males.*

Erleada treats prostate cancer by blocking certain hormones called androgens, such as testosterone. Androgens are hormones that encourage prostate cells to grow, including cancerous prostate cells. Blocking androgens causes the prostate cancer cells to die, and it stops them from spreading in your body.

If you’ve had surgery to remove your testicles, you’ll likely take Erleada alone. If you haven’t had this surgery, you’ll take Erleada with other drugs to treat your prostate cancer. To learn more, see “How is Erleada taken?” below.

* In this article, we use the term “males” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Both Erleada and Zytiga are prescribed to treat prostate cancer in adults, but they may be used to treat different types. They also both come as tablets that you swallow.

To find out more about these drugs, check out this side-by-side comparison. You can also talk with your doctor about the treatment that’s right for your condition.

Erleada and Xtandi are both drugs that treat prostate cancer in adults. They work the same way to treat cancer, which is by blocking the hormone testosterone. They both come as pills that you swallow. But these drugs do differ in some ways.

See this article to learn more about how Erleada and Xtandi compare. Also, ask your doctor if one of these drugs may be right for you.

Your doctor will explain how you should take Erleada. They will also explain how much to take and how often. Be sure to follow your doctor’s instructions.

Taking Erleada

Erleada comes as tablets that you swallow.

Accessible medication containers and labels

If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:

  • have large print
  • use braille
  • contain a code you can scan with a smartphone to change the text into audio

Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.

Also, if you’re having trouble opening your medication bottles, let your pharmacist know. They may be able to put Erleada in an easy-open container. Your pharmacist may also recommend tools to help make it simpler to open the drug’s container.

Taking Erleada with other drugs

Erleada may be used with other drugs to treat prostate cancer. If you haven’t had surgery to remove your testicles to treat prostate cancer, you’ll take Erleada with a kind of drug called a gonadotropin-releasing hormone (GnRH) analog.

Examples of GnRH analogs include:

Your doctor can tell you more about other medications you may take with Erleada.

Questions about taking Erleada

Below are common questions about taking Erleada.

  • Can Erleada be chewed, crushed, or split? No, you should not chew, crush, or split Erleada tablets. They should be swallowed whole. If you have trouble swallowing pills, talk with your doctor or pharmacist. You may also mix the tablets in 4 ounces (oz) of applesauce, but do not crush the tablets. If you want to take Erleada with applesauce, talk with your doctor or pharmacist for instructions, or check out the drug’s full prescribing information.
  • Should I take Erleada with food? You may take Erleada doses with or without food.
Questions for your doctor

You may have questions about Erleada and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Erleada affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

There are important considerations to discuss with your doctor before you begin treatment with Erleada. It’s important that you tell your doctor about your overall health and any medical conditions you may have.

You should also tell your doctor about all medications you take, including any over-the-counter medications. They’ll want to check for any interactions with Erleada.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Erleada, be sure to tell your doctor about all medications you take, including prescription and over-the-counter kinds. Also, describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Erleada.

Interactions with drugs or supplements

Erleada can interact with several kinds of drugs. These drugs include:

This list does not contain all kinds of drugs that may interact with Erleada. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Erleada.

Warnings

Erleada may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Erleada. Factors to consider include those in the list below.

  • Heart disease. Erleada can cause heart disease and, in some cases, may lead to a heart attack. If you already have heart disease, taking Erleada could make your condition worse. Your doctor can determine whether Erleada is safe for you to take.
  • Diabetes. If you have diabetes, you have a higher risk of developing heart disease from Erleada. Your doctor can help determine whether Erleada is safe for you to take.
  • High cholesterol. People with high cholesterol have a higher risk of developing heart disease during Erleada treatment. If you have high cholesterol, talk with your doctor about whether Erleada is right for you.
  • Past stroke, brain injury, or brain tumor. In rare cases, Erleada can cause a stroke or ministroke. You may have a higher risk of this side effect if you’ve had a stroke, brain tumor, or brain injury in the past. Talk with your doctor about whether Erleada is a safe treatment option for you.
  • Seizures. In rare cases, Erleada can cause seizures. You may have a higher risk of this side effect if you already have seizures or epilepsy. Your doctor can help determine whether Erleada is safe for you to take.
  • Allergic reaction. If you’ve had an allergic reaction to Erleada or any of its ingredients, your doctor will likely not prescribe Erleada. Ask your doctor what other medications are better options for you.

Erleada and alcohol

It should be safe to drink alcohol during Erleada treatment. But drinking large amounts of alcohol can cause many of the same side effects as Erleada.

Drinking alcohol while taking Erleada can raise your risk of:

  • diarrhea
  • falls
  • fatigue (low energy)
  • nausea

If you drink alcohol, talk with your doctor about how much may be safe to drink during Erleada treatment.

Pregnancy and breastfeeding

Erleada is not intended for use in females.* Erleada is prescribed to treat prostate cancer. Prostate cancer affects the prostate, which is a small gland located under the bladder in males*.

If you’re a male taking Erleada who has a sexual partner that may become pregnant, you should use birth control, such as condoms, during treatment. You’ll need to continue using birth control for at least 3 months after your last dose of Erleada. If you have other questions about Erleada and pregnancy, talk with your doctor.

*In this article, we use the terms “females” and “males” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Do not take more Erleada than your doctor prescribes. Taking more than this can lead to serious side effects.

What to do in case you take too much Erleada

Call your doctor if you think you’ve taken too much Erleada. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

If you’re considering treatment with Erleada, talk with your doctor or pharmacist. Ask questions to help feel comfortable about the risks and benefits of taking this drug. Some examples of questions you may want to ask include:

  • What should I know about alternative drugs for Erleada?
  • Does Erleada cause sexual side effects?
  • How will I know if Erleada is working for me?
  • Will I need to have lab tests done while taking Erleada? If so, how often will I have them done?

You can also learn more about treatments for prostate cancer.

Q:

If I have side effects from Erleada, is there a lower dosage I can try?

Anonymous

A:

Yes, in most cases. Depending on the side effect and how severe it is, you may be able to try a lower dose of Erleada.

The usual Erleada dosage is four tablets taken once per day. If you experience side effects that bother you or are serious, your doctor will most likely have you temporarily stop taking Erleada. Once side effects go away or become less bothersome, you’ll start taking Erleada again. But your doctor may lower your dosage to two or three tablets taken once per day.

If you experience a serious side effect, such as a life threatening allergic reaction, your doctor will most likely have you permanently stop taking Erleada. If this happens, your doctor can talk with you about other treatment options for your condition.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.