DESCRIPTION

 Xtandi containing Enzalutamide is also

categorized as an anti-androgen chemo
medicine. Xtandi 40mg is not self
medication; it is used under the knowledge
of medical oncologist.
XTANDI 40MG TABLET USES

 Xtandi 40mg tablets are prescribing for;

Metastatic or long lasting castration
resistant prostate cancer
XTANDI 40MG TABLET
MECHANISM
 Xtandi 40mg containing anti-androgen
agent like Enzalutamide, it expels an anti-
tumor activity in different
steps. Xtandi tablets are interfere in
androgen receptor signaling pathway,
which prohibiting androgen binding to
androgen receptors leads to androgen
receptor nuclear translocation inhibition
and interact with DNA.
 The major metabolite of Xtandi is N-
desmethyl Enzalutamide which is similar to
Enzalutamide activity. The anti-tumor
activity of Xtandi is exposed by depleting
the multiplication and persuades cell lysis
in prostate cancer cells.
PHARMACOKINETICS
 After an oral administration of Xtandi
40mg tablets (160mg of dose), undergoes
ADME process and exhibits activity. The
peak plasma concentration time of Xtandi
occurs at 1 hour with the range of 0.5 to 3
hours). The steady state of Xtandi occurs
in day 28. The volume of distribution
occur after single dose of Xtandi is
110LXtandi has highly bounds to the
human plasma protein with the range of
97 to 98%.
 The major metabolite of Enzalutamide is N-
desmethyl Enzalutamide has 95% bound to
human plasma protein. The most important
isoenzymes responsible for the metabolism of
Enzalutamide are CYP2C8 & CYP3A4.
CYP2C8 is involved in the formation of an
active metabolite N-desmethyl
Enzalutamide. Xtandi is majorly excreted
through liver metabolism, 71% of metabolite
present in urine and 14% in feces.
 The usual recommended dosage
of Xtandi is 160mg, but available
strength of Xtandiis 40mg. Four tablets
of Xtandi 40mg should be taken at a
time as a single dose.Xtandi tablet
should be administered with or without
food.
 Dosing alteration: In ≥ grade 3 toxicity
or extreme side effects: Postpone the
dose ofXtandi for 1 week or as far as
symptoms progress to ≤ grade 2,
continue at the same or reduced to
120mg or 80mg.
Concurrent use with strong CYP2C8 inhibitors:

 In case of combination with strong CYP2C8

inhibitors, diminish the dose of Xtandi to
80mg as a single dose. Concurrent use with
strong CYP3A4 inducers: In case of
combination with strong CYP3A4 inducers,
increasing the dose of Xtandi 160mg to
240mg as a single dose.
PRECAUTIONS
XTANDI 40MG TABLETS SAFETY
PRECAUTIONS
The major adverse effect during the therapy
of Xtandi tablets are;
 SEIZURE
Seizure may produce during the treatment
with Xtandi tablets, if seizure occurs the
treatment should be discontinued until
seizure resolved. To avoid this condition,
patient should be counsel about the problems
occurred during the therapy before starting the
treatment. Seizure may leads to loss of
consciousness.

 POSTERIOR REVERSIBLE
ENCEPHALOPATHY SYNDROME
PRES
Patient who are all taking Xtandi tablets
acquired PRES, is a neurological problem
produce symptoms like headache, lethargy,
confusion, loss of vision, other neurological
problems related with hypertension.
SIDE EFFECTS
XTANDI 40MG TABLETS CAUSING
SIDE EFFECTS
 Asthenia
 Peripheral edema
 Back pain, arthralgia
 Musculoskeletal pain
 Muscular weakness
 Musculoskeletal stiffness
 Diarrhea
 Headache
 Dizziness
 Spinal cord compression
 Caude equine syndrome
 Paresthesia
 Mental disorders
 Hypoesthesia
 Respiratory tract infections
 Hot flush
 Hypertension
 Insomnia
 Anxiety
 Hematuria
 Pollakiuria
 Non pathologic fractures
 Pruritus Dry skin
 Epistaxis
 The pregnancy category of Xtandi tablet
is X Xtandi tablets are contraindicated
to pregnancy conditions; it may cause
fetal harm even to death. Xtandi tablets
are contraindicated in lactation period,
breast feeding should not be
recommended.
STORAGE
 The storage condition of Xtandi tablets
container at 20°C to 25°C (68°F to
77°F). Container should be kept at dry
and cool place.
MISSED DOSE
 Xtandi is a chemo tablets, if patient fail
to take the dose of Xtandi tablets must be
consult with medical oncologist and take
the dose within a time. In any other way
the missed dose should be avoid and
follow the regular dosing schedule.
OVER DOSAGE
 In case of over dosage of Xtandi tablets,
patients must provided with some
supportive measures and discontinue the
therapy. The half life of Xtandi is occurs
for 5.8 days. Seizure is the major adverse
effect occurred due to over dosage
of Xtandi . Seizure is not described at
≤240mg daily; since three seizures occurs
at 360mg, 480mg and 600mg daily.
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