Cancer drugs A to Z list
Apalutamide is a type of hormone therapy. It is pronounced as a-pa-loo-ta-mide.
It is a treatment for some people with prostate cancer. You usually have apalutamide with another type of treatment to lower testosterone levels (androgen deprivation therapy or ADT).
Find out more about prostate cancer
Prostate cancer needs the male hormone to grow. Testosterone is also called an .
Apalutamide is a type of hormone drug called an . It stops testosterone from reaching the cancer cells. This can slow the growth of your cancer and may shrink it.
You take apalutamide as a tablet.
You swallow the tablet whole with a glass of water. Do not break, split or crush it. You can take it either with or without food.
If you cannot swallow the tablet talk to your pharmacist or nurse.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you miss a dose.
You take apalutamide once a day.
You continue taking apalutamide for as long as the treatment is working and you are not experiencing too many side effects.
You might have blood tests before starting treatment and during your treatment. They check your general health and might check your levels of blood cells and other substances in the blood.
Side effects can vary from person to person. They also depend on what other treatment you are having.
Your doctor, nurse, or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
you have severe side effects
your side effects aren’t getting any better
your side effects are getting worse
We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
You might feel very tired and as though you lack energy.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
Tell your healthcare team if you have joint pain. They might suggest taking painkillers that could help.
You might develop a skin rash and less commonly the skin might be itchy.
Rarely some people develop a reaction to apalutamide called lichenoid eruption. Symptoms include itchy, purple, flat skin changes that look like a rash.
Some people might develop a severe skin reaction, but it is not known how often this happens. This reaction may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish and your eyes may be more sensitive to light. This is serious and could be life threatening
Tell your doctor or nurse if you have any skin changes. They can give you medicines to help.
You might not feel like eating and may lose weight. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
Tell your doctor or nurse if you have headaches, nosebleeds, blurred or double vision or shortness of breath. You have your blood pressure checked regularly.
Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.
Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain . But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables.
Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
You might have an increased risk of falls and breaking your bones.
We have some tips for coping with hot flushes in men. This information also includes some of the possible treatments. Talk to your doctor if your hot flushes are hard to cope with. They might be able to prescribe you some medicines.
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
an increased risk of an infection due to low levels of white blood cells - symptoms include a temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is. Contact your advice line urgently if you think you have an infection
muscle spasms
hair thinning or hair loss
taste changes
high levels of fats such as cholesterol and triglycerides in the blood. You have regular blood tests to check this if you already have high levels of fat in the blood
including , narrowing or blockage of the arteries or a . Call 999 or go straight to your local Accident and Emergency department if you have chest pain or feel short of breath
a or a mini stroke – symptoms include drooping face, numbness or weakness on one side of the body, feeling confused and difficulty speaking. Call 999 if you have any of these symptoms
too little thyroid hormone (hypothyroidism), you may feel tired or cold, gain weight, feel sad or depressed or your voice may deepen
These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:
fits (seizures)
uncomfortable, twitchy, aching legs, which often feel worse at night or when you are resting (restless leg syndrome)
There isn't enough information to work out how often these side effects might happen. You might have one or more of them. They include:
changes to the heart beat shown on a heart trace ()
a widespread rash, high temperature and enlarged
lung changes including scarring of the lungs - symptoms can include shortness of breath, a dry cough and tiredness. Tell your doctor if you notice these symptoms
We have more information about side effects and tips on how to cope with them.
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
You may not be able to get someone pregnant after treatment with this drug. Talk to your doctor before starting treatment if you think you want to have a baby in the future. You may be able to store sperm before starting treatment.
This treatment might harm a baby developing in the womb. It is important not to get someone pregnant while you are having treatment and for 3 months afterwards.
You should also use a barrier method of contraception like condoms during sex whilst having treatment and for at least 3 months afterwards.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if your partner becomes pregnant while you're having treatment.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines and Healthcare products Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 02 Jul 2026
Next review due: 02 Jul 2029
Prostate cancer is cancer that starts in the prostate gland. The prostate gland is found at the base of the bladder and is about the size of a walnut.
Prostate cancer usually depends on testosterone to grow. Hormone therapy blocks or lowers the amount of testosterone in the body.
Get practical and emotional support to help you cope with a diagnosis of prostate cancer, and life during and after treatment.
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