Apalutamide (ERLEADA)

Prostate cancer, non-metastatic castration-resistant

Prostate cancer, metastatic castration-sensitive

Prostate cancer, non-metastatic castration-resistant

• Dose – Oral: 240 mg once daily continuously until disease progression or unacceptable toxicity
• Given in combination with androgen deprivation therapy (ADT)

Prostate cancer, metastatic castration-sensitive

• Dose – Oral: 240 mg once daily continuously until disease progression or unacceptable toxicity
• Given in combination with androgen deprivation therapy (ADT)

Available as 60 mg and 240 mg film-coated tablets. Tablets can be dissolved for patients unable to swallow them, please discuss with your pharmacy team. Store at room temperature.

Antiandrogen

Take with or without food

If a dose is missed, patients should be instructed not to take the missed dose but to resume with the next scheduled dose.

Common: Hypothyroidism, Abdominal pain, Diarrhea, Fatigue, Hypercholesterolemia, Hyperglycemia, Hyperkalemia, Hypertriglyceridemia, Rash, Hypertension.

Less Common: Falls, Fracture, Seizure, Severe cutaneous reactions, Cardiac events.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential, platelets, creatinine, sodium, potassium, blood pressure, TSH, PSA.

‍During treatment: PSA, blood pressure.

If clinically indicated: TSH, creatinine, sodium, potassium, ECG.

• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Seizures can occur in patients receiving apalutamide. Advise patients of the risk of seizures during apalutamide treatment and of the risk of engaging in activities where sudden loss of consciousness could cause serious harm to themselves or others.

BC Cancer. BC Cancer Drug Manual. Apalutamide. Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Apalutamide_monograph.pdf. Updated January 1, 2024. Accessed January 22, 2024.

Lexicomp. Apalutamide Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at: https://online-lexi-com.qe2a-proxy.mun.ca/lco/action/doc/retrieve/docid/patch_f/6615150?cesid=1TH5PV5YJl1&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3DApalutamide%26t%3Dname%26acs%3Dfalse%26acq%3DApalutamide. Updated January 29, 2024. Accessed January 30, 2024.

Cancer Care Ontario. Apalutamide Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/57146. Updated December 2023. Accessed January 22, 2024.Janssen Inc. ERLEADA® Product Monograph. Toronto, Ontario. Date of preparation July 3, 2018.