Enzalutamide (Xtandi®)


Indications for Prior Authorization:

  • Castration-resistant prostate cancer (CRPC)

Patients must meet the following criteria for the indication(s) above:

  • Must have castration resistant prostate cancer (progression after either GnRH therapy or bilateral orchiectomy)
  • In those who have not had bilateral orchiectomy: Xtandi® will be used concomitantly with a GnRH analog

The Following Conditions Do Not Meet the Criteria for Use as Established by the WHA P&T Committee:

  • All non-FDA approved uses not listed in the approved indications
  • Drug is not indicated for use in women


  • 160 mg orally once daily
  • Avoid co-administration with a strong CYP2C8 inhibitor
    • If strong CYP2C8 inhibitor cannot be avoided reduce dose to 80 mg PO daily


  • Enzalutamide is a strong enzyme inducer, CYP3A4, CYP2C9, CYP2C19. Will reduce plasma concentrations of drug such as warfarin and omeprazole.
  • Seizure risk is 0.5% in clinical trials


6 months


Last review date: April 16, 2019

WHA is closely monitoring the Coronavirus Disease 2019 (COVID-19). Learn more about COVID-19.