Apalutamide

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About This Drug

Apalutamide is used to treat cancer. It is given orally (by mouth).

Possible Side Effects

  • Tiredness
  • High blood pressure
  • Rash
  • Nausea
  • Weight loss
  • Loose bowel movements (diarrhea)
  • Pain in the joints
  • Hot flashes or sudden skin flushing may happen. You may also feel warm or red.
  • Decreased appetite (decreased hunger)
  • Fall and fractures
  • Swelling of your legs, ankles and/or feet
  • Decrease in the number of white blood cells. This may raise your risk of infection.
  • Decrease in red blood cells. This may make you feel more tired.
  • Increase in your cholesterol and triglyceride levels
  • Blood sugar levels may change. If you have diabetes, changes may need to be made to your diabetes medication.
  • Electrolyte changes

 

Note:  Each of the side effects above was reported in 10% or greater of patients treated with apalutamide. Not all possible side effects are included above.

Warnings and Precautions

  • Seizure. Common symptoms of a seizure can include confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. There are other less common symptoms of seizures. If you or your family member suspects you are having a seizure, call 911 right away.
  • This drug increases your risk of falls and fractures

Important Information

  • Do not donate sperm during your treatment or for 3 months after your cancer treatment. 

How to Take Your Medication

  • Swallow the medicine whole with or without food. Take this medicine at the same time each day.
  • Missed dose: If you miss a dose, take it as soon as you think about it if it is on the same day and continue with regular dosing schedule the following day.
  • If you vomit a dose, take your next dose at the regular time, and contact your physician.  Do not take 2 doses at the same time and do not double up on the next dose.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine

Treating Side Effects

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • If you have diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • To help with weight loss, drink fluids that contribute calories (whole milk, juice, soft drinks, sweetened beverages, milkshakes, and nutritional supplements) instead of water.
  • Include a source of protein at every meal and snack, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements.
  • To help with decreased appetite, eat high caloric food such as pudding, ice cream, yogurt and milkshakes.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • If you get a rash, do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • If you have diabetes, keep good control of your blood sugar level. Tell your nurse or your doctor if your glucose levels are higher or lower than normal.

Food and Drug Interactions

  • There are no known interactions of apalutamide with food.
  • Check with your doctor or pharmacist about all other prescription or over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with apalutamide. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or and new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Fatigue that interferes with your daily activities 
  • Feeling dizzy or lightheaded 
  • A headache that does not go away
  • Blurry vision or other changes in eyesight
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength of a feeling of being dizzy
  • Lasting loss of appetite of rapid weight loss of five pounds in a week
  • Weight gain of 5 pounds in one week (fluid retention)
  • New rash and/or itching
  • Rash that is not relieved by prescribed medicine
  • If you have a fall
  • Abnormal blood sugar
  • Unusual thirst, passing urine often, headache, sweating, shakiness, irritability 
  • Symptoms of a seizure such as confusion, blacking out, passing out, loss of hearing or vision, blurred vision, unusual smells or tastes (such as burning rubber), trouble talking, tremors or shaking in parts or all of the body, repeated body movements, tense muscles that do not relax, and loss of control of urine and bowels. If you or your family member suspects you are having a seizure, call 911 right away.
  • If you think you may have impregnated your partner.

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Apalutamide is not indicated for use in women. Men with female partners of childbearing potential should use effective methods of birth control during your cancer treatment and for 3 months after your cancer treatment. If your partner is pregnant, use a condom during your cancer treatment and for 3 months after your cancer treatment. Let your doctor know right away if you think you may have impregnated your partner.
  • Breastfeeding warning: It is not known if this drug passes into breast milk. Apalutamide is not indicated for use in women.
  • Fertility Warning: In men, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm banking.

New February 2018

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services.  The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication.  The dose, method of administration and contraindications for any administered medication should be confirmed before use.  UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.