Anthropometric Measurements as Predictors of Low Birth Weight Among Tanzanian Neonates: A Hospital-Based Study
November 7, 2025
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Brand Name :
Erleada
(United States) [Available]Synonyms :
apalutamide
Class :
Antiandrogens, Antineoplastics
Brand Name :
Erleada
(United States) [Available]Synonyms :
apalutamide
Class :
Antiandrogens, Antineoplastics
Dosage forms and strengthsÂ
Tablet Â
240 mg Â
60 mgÂ
Metastatic/non-metastatic:
240
mg
Tablet
Orally 
once a day
in combination with continuous androgen deprivation therapy
Dose Adjustments
Grade 3 or higher toxicity: Hold the dosing temporarily until symptoms improve to grade 1 or lower and resume the dose with 120 to 180 mg. Cerebrovascular events, grade 3 or 4: discontinue the dosing Dermatologic toxicity: if not managed by oral antihistamines and topical corticosteroids, interrupt or reduce apalutamide dose until symptoms improve Fracture: manage with the use of bone-modifying agents Seizure: discontinue apalutamide dosing permanently Thyroid dysfunction: adjust/ reduce the dose initially, initiate thyroid replacement therapy if indicated
It may enhance the effect when combined with lonafarnib by affecting CYP3A4 metabolism
It may diminish the effect when combined with irinotecan liposomal by affecting CYP3A4 metabolism
when both drugs are combined, there may be a decreased effect of nilotinib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
abiraterone acetate and niraparibÂ
may increase the toxic effect of niraparib
It may diminish the levels when combined with tamsulosin by affecting CYP3A4 metabolism
the concentration of levomenol decreases in the serum when combined with apalutamide
cyclophosphamide effect of action decreased by affecting enzyme CYP3A4 metabolism.
when both drugs are combined, there may be a decreased effect of cabozantinib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased level of serum concentration of alpelisib  
on interacting with brentuximab vedotin, will decrease its effect by altering the intestinal/hepatic metabolism of CYP3A4 enzyme the drugs containing substrates of CYP3A4 should be avoided during the medication.
when both drugs are combined, there may be a reduced blood level of abemaciclib and result in less effectiveness in treating cancer  
when both drugs are combined, there may be an increased metabolism of erlotinib  
the effect of apalutamide is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism
when both drugs are combined, there may be a reduced level or effect of romidepsin by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased effect of apalutamide by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
apalutamide decreases the effect of ixazomib by altering intestinal/hepatic CYP3A4 enzyme metabolism
apalutamide decreases the effect of lapatinib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
apalutamide decreases the effect of fedratinib by altering the intestinal/hepatic CYP3A4 enzyme metabolism
apalutamide decreases the effect of gefitinib by altering the intestinal/ hepatic CYP3A4 enzyme metabolism
when both drugs are combined, there may be increase in both increase QTc interval 
when both drugs are combined, there may be increase in both increase QTc interval 
it will decrease the impact or level of regorafenib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
it decreases the effect or level of ruxolitinib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
it decreases the effect or level of dronabinol by altering the intestinal or hepatic metabolism
when both drugs are combined, there may be an increased risk of adverse effects 
may decrease the level by affecting hepatic enzyme CYP3A4 metabolism
may decrease the level by affecting hepatic enzyme CYP3A4 metabolism
may decrease the level by affecting hepatic enzyme CYP3A4 metabolism
it decreases by affecting the hepatic enzyme CYP3A4 metabolism
It may diminish the effect when combined with lumateperone by affecting CYP3A4 metabolism
It may diminish the levels when combined with tamsulosin by affecting CYP3A4 metabolism
When apalutamide is combined with levobupivacaine, there is a potential for a reduction in the concentration serum of levobupivacaine
When apalutamide is used together with fluconazole, this leads to reduction in the apalutamide metabolism
When apalutamide is used together with capsaicin, this leads to enhanced risk or seriousness of methemoglobinemia
may have an increased hypoglycemic effect when combined with hypoglycemic agents
may have an increased hypoglycemic effect when combined with hypoglycemic agents
may have an increased hypoglycemic effect when combined with hypoglycemic agents
may have an increased hypoglycemic effect when combined with hypoglycemic agents
may have an increased hypoglycemic effect when combined with hypoglycemic agents
cefpirome leads to a reduction in the rate of excretion of apalutamide which leads to increased level of serum
apalutamide leads to a reduction in the rate of excretion of chromous sulfate, which leads to an increased level of serum
apalutamide leads to a reduction in the rate of excretion of potassium acetate, which leads to an increased level of serum
the serum concentration of cholecystokinin may decrease when combined with apalutamide
apalutamide: it may decrease the serum concentration of cerivastatin
apalutamide may decrease the excretion rate of almasilate, leading to higher serum levels
when both drugs are combined, there may be a decreased level of serum concentration of etoposide   
when both drugs are combined, there may be a decreased levels of serum concentration of vinblastine  
when both drugs are combined, there may be an increased metabolism of paclitaxel 
increase the excretion and reduce the effects of daunorubicin
the effect of lenvatinib is decreased by apalutamide, thereby increasing elimination.
increase the excretion and reduce the effects of idarubicin
it decreases by affecting the hepatic enzyme CYP2C9 metabolism
may diminish the serum concentration
may enhance the serum concentration of CYP2C8 inhibitors
may increase the serum concentration when it is combined
It may diminish its effectiveness when combined with flotufolastat F-18
may have a decrease in excretion when combined with apalutamide
the rate of metabolism of roxadustat may be reduced
the rate of excretion of phosphoric acid may be decreased
may have an increased fluid-retaining effect when combined with androgens
may have an increased fluid-retaining effect when combined with androgens
may have an increased fluid-retaining effect when combined with androgens
may have an increased fluid-retaining effect when combined with androgens
the serum concentration of digitoxin can be decreased when it is combined with apalutamide
Androgen Deprivation Therapy Agents decrease the effect of diagnosis of flotufolastat F18
Androgen Deprivation Therapy Agents decrease the effect of diagnosis of piflufolastat F18
Actions and Spectrum: Â
Actions: Â
Androgen Receptor Binding:
Apalutamide works by attaching to the androgen pathway called the androgen receptor in cells related to the prostate. The androgen receptor on its part is a nuclear receptor that is activated when bound with androgens like the testosterone and dihydrotestosterone.Â
Frequency definedÂ
>10% (All Grades)Â
nmCRPCÂ
Diarrhea (20%)Â
Rash (24%)Â
Hypertension (25%)Â
Hyperkalemia (32%)Â
Fatigue (39%)Â
Lymphopenia (41%)Â
Leukopenia (47%)Â
Hyperglycemia (70%)Â
Anemia (70%)Â
mCSPCÂ
Hypertension (18%)Â
Hot flush (23%)Â
Fatigue (26%)Â
Decreased WBC (27%)Â
Rash (28%)Â
>10% (Grades 3-4)Â
nmCRPCÂ
Hypertension (14%)Â
1-10% (All Grades)Â
nmCRPCÂ
Heart failure (2.2%)Â
Cerebrovascular and ischemic heart disease (3.7%)Â
Pruritus (6.2%)Â
Hypothyroidism (8%)Â
1-10% (Grades 3-4)Â
nmCRPCÂ
Hyperglycemia (2%)Â
Hyperkalemia (2%)Â
Lymphopenia (2%)Â
Hypertriglyceridemia, nonfasting (2%)Â
Fracture (3%)Â
Rash (5%)Â
<1% (Grades 3-4)Â
nmCRPCÂ
Hypercholesterolemia, nonfasting (0.1%)Â
Appetite decreased (0.1%)Â
Leukopenia (0.3%)Â
Anemia (0.4%)Â
mCSPCÂ
Decreased WBC (0.4%)Â
Arthralgia (0.4%)Â
Pruritus (<1%)Â
Black Box Warning Â
None Â
Contraindication/Caution: Â
PregnancyÂ
HypersensitivityÂ
Severe Hepatic ImpairmentÂ
 Severe Renal ImpairmentÂ
Seizure RiskÂ
Cardiovascular DiseaseÂ
Pregnancy & breastfeeding:Â
Pregnancy consideration:  Â
Pregnancy category: AU TGA pregnancy category: DÂ
Breastfeeding warnings:  Â
No data is available regarding the excretion of drugs in breast milk. Â
Pregnancy category: Â
Pharmacology: A non-steroidal antiandrogen drug called apalutamide is mostly used to treat prostate cancer.Â
Pharmacodynamics:Â Â
Apalutamide is a nonsteroidal antiandrogen that ceases prostate cancer’s ability to utilize androgens. It works through selective binding to the androgen receptor (AR) thus reducing its activity. This inhibition counteracts the effects of androgens on the tissues of the prostate and thus block the expansion and proliferation of the prostate cancer cells requiring androgens for their growth.Â
Pharmacokinetics: Â
AbsorptionÂ
Oral absorption of apalutamide is effective and has a high bioavailability. You can take it with or without meals because food has not significantly affect on how well it absorbs.
DistributionÂ
Apalutamide is widely dispersed into tissues and throughout the body. Its broad dispersion across bodily tissues is indicated by its large volume of distribution (Vd). Â
MetabolismÂ
The liver is where apalutamide is mostly metabolized. The enzymes CYP2C8 and CYP3A4 are involved in the main metabolic pathways.
Elimination and excretion
Apalutamide have an elimination half-life of around three days.
Metabolites are the major way that it is eliminated, mostly through urine and feces.Â
Administration: Â
Apalutamide is administered orally in tablet form.Â
It is typically taken once daily, with or without food.Â
Patient information leaflet Â
Generic Name: apalutamideÂ
AH-puh-LOO-tuh–mideÂ
Why do we use apalutamide? Â
Apalutamide is used to treat castration-resistant prostate cancer, which is cancer that has not spread to other regions of the body but nevertheless progresses despite low testosterone levels.Â
It is also used for metastatic prostate cancer, which means that the cancer has spread to other parts of the body but can still be treated by reducing testosterone levels, though it is sensitive (castration-sensitive).Â
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