As with other drugs, Erleada (apalutamide) can cause side effects, such as fatigue, rash, diarrhea, and high blood pressure. If side effects become difficult to tolerate, talk with your doctor or pharmacist.
Erleada (apalutamide) is a brand-name oral tablet prescribed for certain types of prostate cancer in adults.
If you have problems with side effects from Erleada, talk with your doctor or pharmacist. They can suggest ways to manage them or recommend other prostate cancer treatment options. Do not stop taking Erleada without consulting your doctor first.
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 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.”
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 people taking Erleada have reported include:
- fatigue
- skin rash
- weight loss
- decreased appetite
- flushing
- diarrhea
- swelling of hands or feet
- nausea*
- joint pain*
- mild allergic reaction*
These side effects may be temporary, lasting a few days to weeks. However, if they 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. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Erleada and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.
* For more information about this side effect, see the “Side effect specifics” section.
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Erleada may cause serious side effects. The following list 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 this medication, 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
- difficulty seeing, talking, or 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 skin rash, including life threatening skin reactions called Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). Symptoms may include:
- fever
- blistering or peeling of the skin
- swollen lymph nodes
- Cardiac side effects, such as ischemic heart disease and high blood pressure*
- Interstitial lung disease or pneumonitis, both of which are potentially life threatening lung problems.† Symptoms include:
- shortness of breath
- cough
- unexplained weight loss
* For more information about this side effect, see the “Side effect specifics” section.
† Interstitial lung disease and pneumonitis were not reported in Erleada studies, but they have been reported since the drug came on the market.
Here are some frequently asked questions about Erleada’s side effects and their answers.
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 a cell’s 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 Erleada 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 for 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 those 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.”
Does Erleada cause hair loss?
No, you shouldn’t experience hair loss from taking Erleada. There were no reports of this side effect in the drug’s clinical trials.
However, other medications prescribed to treat prostate cancer, such as chemotherapy drugs, including cisplatin, may cause hair loss. (Erleada is prescribed to treat certain types of prostate cancer.)
If you’re concerned about hair loss during your treatment with Erleada, talk with your doctor or pharmacist.
Learn more about some of the side effects Erleada may cause. To find out how often side effects occurred in clinical trials, see the drug’s prescribing information.
Cardiac side effects
It’s possible for Erleada to cause cardiac side effects, such as high blood pressure and 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 and 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 and suggest treatment options.
Joint pain
Joint pain was one of the most common side effects reported in Erleada’s clinical trials. Symptoms may include:
- stiffness or swelling of the joint
- difficulty moving or 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).
Nausea
Nausea was one of the most common side effects reported by people taking Erleada in the drug’s clinical trials.
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:
Serious skin reactions are also possible. This can include SJS, TEN, and 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 starting 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, such as heart attack or heart failure
- history of falls or bone fractures
- previous allergic reaction to this or a similar drug
- high blood pressure
- seizures
- history of brain injury, brain tumor, or stroke
- interstitial lung disease or pneumonitis
Alcohol with Erleada
Alcohol is not known to interact with Erleada. However, it’s possible that drinking alcohol while taking this medication may increase your risk of side effects. For example, both alcohol and Erleada may cause:
- fatigue
- flushing
- nausea
- falling
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 is 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.
* In this article, we use the term ”male” to refer to someone’s sex assigned at birth. To learn more about this topic, see this article comparing sex and gender.
Most side effects of Erleada are mild, but serious side effects can occur. If you’d like to learn more about this medication and its side effects, talk with your doctor or pharmacist.
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 this medication, including how Erleada compares with similar drugs, refer to this in-depth Erleada article.
- Cost. To learn about the price of treatment, check out this Erleada cost article.
- Dosage. For dosing information, see this Erleada dosage article.
- Interactions. For information about potential drug interactions, refer to this Erleada interactions 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.