Enzalutamide (Xtandi®)


Indications for Prior Authorization:

  • Metastatic castration-resistant prostate cancer

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

  • Must have prior treatment with docetaxel
  • Must have castration resistant prostate cancer (progression after either GnRH therapy or bilateral orchiectomy)

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 drug 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 0.9% in clinical trial


6 months


Last review date: October 22, 2018