Erleada (apalutamide) is a brand-name oral tablet that’s 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. 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:

  • Cerebrovascular problems, such as stroke. Symptoms may include:
    • numbness or weakness of the face, arm, or leg
    • trouble talking
    • difficulty seeing
    • trouble walking
  • Risk of falling and bone fractures. Symptoms may include:
    • bone pain
    • swelling
    • difficulty walking
  • Seizures. Symptoms may include:
    • uncontrolled movements of the arms or legs
    • suddenly falling
    • loss of consciousness
  • Severe rash. Symptoms may include:
    • fever
    • swollen lymph nodes
    • blistering or peeling of the skin
  • Cardiac side effects, such as ischemic heart disease and high blood pressure*
  • Severe allergic reaction.†

* 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.

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

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:

Heart disease. If you have a history of heart disease, such as heart attack or heart failure, be sure to tell your doctor before starting treatment with Erleada. It’s possible for this medication to increase your risk of certain cardiac problems. And if you already have heart disease, taking Erleada may make your condition worse. Your doctor can help determine whether Erleada may be safe for you.

Falls or bone fractures. If you have a history of falls or bone fractures, tell your doctor before starting treatment with Erleada. This medication may increase your risk of falling, which can increase your risk of bone fractures. Talk with your doctor to find out whether Erleada may be a safe treatment option for you.

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 may be better options for you.

High blood pressure. Erleada may increase your blood pressure. If you already have high blood pressure, taking this medication can increase your blood pressure more, which can be dangerous. Your doctor may recommend managing your blood pressure with a different medication before starting treatment. They can help determine whether Erleada is a safe treatment option for you.

Seizures. It’s possible for Erleada to cause seizures. If you have a history of seizures, or if you have a seizure disorder such as epilepsy, be sure to tell your doctor before starting Erleada. They can help determine if this medication may be a safe treatment option for you. In some cases, your doctor may recommend more frequent monitoring of your seizure disorder.

Brain injury, tumor, or stroke. If you have a history of brain injury, brain tumor, or stroke, be sure to tell your doctor before starting treatment with Erleada. This medication, although the risk is rare, may increase your risk of certain brain injuries, such as stroke. If you have a history of brain injury, tumor, or stroke, you may be at an increased risk of these side effects occurring. In this case, your doctor can help determine whether Erleada may be a safe treatment option for you.

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 not known whether Erleada may be safe to take during pregnancy. This is because Erleada is used to treat prostate cancer and hasn’t been clinically trialed in females* who can become pregnant.

Based on the way Erleada works in your body and animal studies, it may cause harm to a developing fetus or pregnancy loss. However, animal studies don’t always indicate what may happen in humans.

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 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 contraception. Contraception is recommended while taking the drug and for at least 3 months after stopping treatment. Examples of effective contraception include oral contraceptives or condoms.

In addition, it’s not known whether Erleada may be safe to take while breastfeeding. It’s not known whether the drug may pass into breast milk or what effects the drug may have on a child who is breastfed.

If you’re pregnant, planning to become pregnant, or breastfeeding, talk with your doctor if you or your partner is taking Erleada.

* 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.
  • Drug comparison. To learn how Erleada compares with Xtandi, read 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.