Erleada (apalutamide) is a brand-name oral tablet prescribed for certain types of prostate cancer in adults. As with other drugs, Erleada can cause side effects, such as fatigue, rash, diarrhea, and high blood pressure.

Erleada belongs to a drug class called androgen receptor blockers or anti-androgens. The drug is not available in a generic version.

Read on to learn about potential common, mild, and serious side effects of Erleada. For a general overview of the drug, including details about its uses, see this article.

Erleada can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Erleada in clinical trials:

  • fatigue
  • skin rash
  • weight loss
  • decreased appetite
  • joint pain*

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

Mild side effects can occur with Erleada. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Erleada’s prescribing information.

Mild side effects that have been reported with Erleada include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Erleada and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.
† An allergic reaction is possible after taking Erleada. However, it’s not clear whether this side effect occurred in clinical trials. To learn more, see the “Side effect specifics” section below.

Erleada may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Erleada’s prescribing information.

If you develop serious side effects while taking Erleada, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

* For more information about this side effect, see “Side effect specifics” below.
† An allergic reaction is possible after taking Erleada. However, it’s not clear whether this side effect occurred in clinical trials. To learn more, see the “Side effect specifics” section below.

Erleada may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

How much does Erleada cost? Are savings options available?

The price you’ll pay for Erleada can vary. Your cost may depend on your treatment plan and insurance coverage. To save money on your Erleada treatment, explore the coupon options below.

Is Erleada chemotherapy?

No, Erleada is not chemotherapy. It belongs to a group of drugs called androgen receptor blockers, also called anti-androgens.

Erleada works by keeping testosterone from binding to receptors (attachment sites) on prostate cancer cells. This helps stop the cancer cells from growing. Chemotherapy, on the other hand, works by interfering with cells’ ability to grow and reproduce. This affects all cells in the body, not just the cancer cells.

If you have questions about how Erleada compares with chemotherapy, talk with your doctor.

How long does it take for side effects to start?

It varies. Some side effects might develop right away after you start Erleada treatment, even after one or two doses. Examples include allergic reaction, fatigue, flushing, and appetite loss.

Other side effects might take longer to develop, such as some serious side effects. For example:

  • in clinical trials of people taking Erleada to treat metastatic prostate cancer, bone fractures were more likely to occur about 2 months after starting treatment. In people with nonmetastatic prostate cancer, fractures were more likely to happen after nearly a year of treatment.
  • in these studies, some people experienced seizures about 5 months or more after starting Erleada
  • if weight loss occurs, you might notice this over time, not right away

Keep in mind that everyone taking Erleada can have a different experience. If you have questions about what to expect with Erleada’s side effects, talk with your doctor or pharmacist.

Can Erleada cause long-term side effects?

Yes, it’s possible for Erleada to cause long-term side effects. Although not common, they can occur. Long-term side effects are side effects that start during treatment and continue for a long time, even after treatment ends. They can also start after someone has taken the drug for a long time.

Examples of long-term side effects include:

  • joint pain*
  • weight loss
  • cerebrovascular problems, such as stroke
  • seizures
  • cardiac side effects, such as ischemic heart disease and high blood pressure*

If you have concerns about long-term side effects while taking Erleada, talk with your doctor.

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

Is hair loss a side effect of Erleada?

No, you shouldn’t experience hair loss from taking Erleada. Hair loss wasn’t reported in the drug’s clinical trials.

However, other medications prescribed to treat prostate cancer, such as chemotherapy drugs, including cisplatin, may cause hair loss to occur. (Erleada is prescribed to treat certain types of prostate cancer.)

If you’re concerned about hair loss occurring during your treatment with Erleada, talk with your doctor or pharmacist.

Learn more about some of the side effects that Erleada may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Erleada.

Cardiac side effects

It’s possible for Erleada to cause cardiac side effects, such as high blood pressure or ischemic heart disease. High blood pressure was a common side effect in the drug’s clinical trials.

Ischemic heart disease is when you develop a blockage in the arteries in the heart. This condition, although rare, can be life threatening.

Symptoms of these cardiac side effects may include:

  • chest pain
  • shortness of breath
  • headache
  • nausea or vomiting

What you can do

Tell your doctor if you have a history of heart problems, including heart failure, heart attack, or stroke. They can help determine whether Erleada may be safe for you to take.

If you notice any symptoms of cardiac side effects during your treatment with Erleada, talk with your doctor right away. They can help determine what may be causing your symptoms to occur and make treatment recommendations.

Joint pain

Joint pain was one of the most common side effects reported in Erleada’s clinical trials. Symptoms of joint pain may include:

  • difficulty moving the joint
  • stiffness or swelling of the joint
  • difficulty straightening the joint

What you can do

If you experience joint pain during your treatment with Erleada, talk with your doctor. They may recommend taking an over-the-counter medication, such as acetaminophen (Tylenol) or ibuprofen (Advil), for joint pain that you may experience.

Nausea

In Erleada’s clinical trials, nausea was one of the most commonly reported side effects.

What you can do

If you develop nausea from taking Erleada, talk with your doctor or pharmacist. They may be able to recommend ways to reduce this side effect. For example, taking Erleada after eating may help to decrease nausea.

Allergic reaction

As with most drugs, Erleada can cause an allergic reaction in some people. However, it’s not clear whether this side effect occurred in clinical trials.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

Serious skin reactions are also possible. This can include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), or drug reaction with eosinophilia and systemic symptoms (DRESS). These reactions can cause a severe rash along with other symptoms, such as swelling, fever, flu-like symptoms, and mouth sores. These conditions are rare, but they can be life-threatening.

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Erleada. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Be sure to talk with your doctor about your health history before you take Erleada. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. These are known as drug-condition or drug-factor interactions. The conditions and factors to consider include:

Alcohol with Erleada

Alcohol isn’t known to interact with Erleada. However, it’s possible that drinking alcohol while taking Erleada may increase your risk of side effects. For example, both alcohol and Erleada may cause:

Talk with your doctor to find out how much alcohol, if any, may be safe for you to drink during your treatment with Erleada.

Pregnancy and breastfeeding while taking Erleada

It’s unknown whether it’s safe to take Erleada during pregnancy or while breastfeeding. This is because Erleada is used to treat prostate cancer in males and hasn’t been clinically trialed in people who can become pregnant or breastfeed.

Based on the way Erleada works in your body and animal studies, it may cause harm to a fetus or pregnancy loss.

It’s also important to note that Erleada may affect male fertility. Although this hasn’t been clinically trialed in humans, animal studies show that Erleada may decrease male fertility. However, animal studies don’t always indicate how a drug may work in humans.

Because of the risks of taking Erleada, the manufacturer of the drug recommends that males with partners who can become pregnant use birth control, such as condoms. It’s recommended to use birth control while taking the drug and for at least 3 months after stopping treatment.

If your sexual partner is pregnant or planning pregnancy, talk with your doctor about your birth control needs.

Note: Sex and gender exist on spectrums. Use of the terms “female” and “male” in this article refers to sex assigned at birth.

Most side effects of Erleada are mild, but serious side effects can occur as well.

If you’d like to learn more about Erleada, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Erleada. For details about other aspects of Erleada, refer to this article.
  • Cost. To learn about the cost of Erleada treatment, see this article.
  • Dosage. For dosage information about Erleada, review this article.
  • Drug comparison. To learn how Erleada compares with Xtandi, read this article.
  • Interactions. For information about Erleada’s interactions, you can see this article.
  • A look at prostate cancer. For details about prostate cancer, see our prostate cancer hub.

Disclaimer: Medical News Today 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.