What is Erleada (apalutamide)?

Erleada (apalutamide) is an antiandrogen medication used for the treatment of patients with prostate cancer that hasn’t spread (non-metastatic) and is not responding to treatment to lower the body’s level of testosterone (castration-resistant).1 Apalutamide was the first medication that was approved for non-metastatic, castration-resistant prostate cancer (NM-CRPC). Apalutamide is also approved for patients with prostate cancer that has spread (metastatic) but does respond to treatment to lower the body’s level of testosterone (castration-sensitive).

How does apalutamide work?

Apalutamide works by blocking hormones to prevent them from affecting the tumor. These hormones, known as androgens, include testosterone, which can cause the tumor to grow. The medical term for this type of medication is androgen receptor inhibitor. Patients who take apalutamide must also take a gonadotropin-releasing hormone (GnRH) agonist, or have had a bilateral orchiectomy (removal of the testicles).2

Does apalutamide have side effects?

Like any other medication, apalutamide can cause side effects in patients who take it. The most common side effects include:3

  • Fatigue, or severe tiredness
  • High blood pressure
  • Rash
  • Diarrhea
  • Weight loss
  • Joint pains
  • Falls
  • Hot flashes
  • Decreased appetite
  • Fractures

Patients may also experience changes in their lab work, including:3

  • Anemia (decreased hemoglobin)
  • Leukopenia (decreased white blood cell count)
  • Lymphopenia (decreased lymphocyte count)
  • Increased cholesterol
  • Increased blood sugars
  • Increased triglycerides
  • Increased potassium levels
  • Underactive thyroid

Patients who take apalutamide should be aware that they may be at an increased risk for falls and fractures. In a previous study, such falls were not caused by seizures and were not related to patients losing consciousness. However, patients on apalutamide may be at an increased risk of seizures.2 If you experience a seizure while taking apalutamide, your doctor will discontinue the medication permanently.

These are not all the possible side effects of apalutamide. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with apalutamide.

Talk to your doctor

You should tell your doctor and pharmacist about all of the medications you are on, not just the ones that they prescribe (including any prescription and over-the-counter medications, vitamins, and herbal supplements). Your doctor or pharmacist will let you know if any medications you are taking interfere with apalutamide. Patients should talk to their doctor if they have any questions, or if they have questions regarding their apalutamide regimen.

The National Cancer Institute estimated that approximately 248,000 men in the United States would be diagnosed with prostate cancer in 2021. Approximately 34,000 men were expected to die from prostate cancer in 2021. Apalutamide offers a treatment option for certain forms of prostate cancer and paves the way for other new prostate cancer treatments.3

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Last reviewed: July 2021