Apaluda

Indications

Apalutamide is a hormone-blocking cancer medicine used in men with prostate cancer: non-metastatic castration-resistant prostate cancer at high risk of spreading, and metastatic hormone-sensitive prostate cancer. It is normally used together with treatment that lowers testosterone (androgen deprivation therapy).

How It Works

Prostate cancer cells use male hormones (androgens such as testosterone) to grow. Apalutamide blocks the androgen receptor, stops the hormone signal from reaching the cell nucleus and so slows or stops cancer growth.

Dosage and Administration

Take by mouth exactly as prescribed by the cancer specialist, usually once a day, with or without food, swallowing tablets whole. Testosterone-lowering treatment is usually continued at the same time. The doctor may pause or lower the dose if side effects occur.

Interactions

• Apalutamide speeds up the breakdown of many medicines and can make them less effective, such as Warfarin, Omeprazole, some statins, Midazolam, Clopidogrel and some antiepileptics.
• Strong CYP2C8 or CYP3A4 inhibitors such as Gemfibrozil or Itraconazole may raise its levels.
• Medicines that prolong the QT interval need care.

Contraindications

• Allergy to apalutamide.
• Not for use in women or children.

Side Effects

Common effects include tiredness, skin rash, hot flushes, high blood pressure, joint pain, diarrhoea, weight loss, falls and bone fractures, low thyroid function and raised cholesterol.

Get urgent medical help for a seizure, a severe or blistering skin rash, chest pain, signs of a stroke such as sudden weakness on one side or trouble speaking, fainting, or a fall with suspected fracture.

Pregnancy and Lactation

This medicine is not used in women. It may harm an unborn baby: men with a partner who is or could become pregnant should use a condom and another effective contraceptive during treatment and for 3 months after the last dose. Men should not donate sperm during this time.

Precautions and Warnings

• Tell the doctor about seizures, heart disease, high blood pressure or a history of falls.
• Bone health checks and fall prevention are advised.
• Thyroid tests, blood pressure and cholesterol may be checked regularly.

Overdose

There is no specific antidote. Seek medical help; treatment is supportive with monitoring.

Therapeutic Class

Antineoplastic, androgen receptor inhibitor (anti-androgen).

Storage

Store below 30°C in the original pack to protect from moisture, away from light and out of the reach of children.