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  • Efficacy

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    Safety Information

    In the randomized clinical trial, seizure occurred in 0.9% of patients on XTANDI versus none on the placebo arm. There is no clinical trial experience with XTANDI in patients who have had a seizure, in patients with predisposing factors for seizure, or in patients using concomitant medications
    that may lower the
    seizure threshold.

    Please see Important Safety Information below.
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    Safety Information

    The most common adverse drug reactions (≥ 5%) were asthenia/fatigue, back pain, diarrhea, arthralgia,
    hot flush, peripheral edema, musculoskeletal pain, headache, upper respiratory infection, muscular weakness, dizziness, insomnia, lower respiratory infection, spinal cord compression and cauda equina syndrome, hematuria, paresthesia, anxiety,
    and hypertension.

    Please see Important Safety Information below.
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    Safety Information

    Grade 1-4 neutropenia occurred in 15% of patients on XTANDI (1% grade 3-4) and in 6% of patients on placebo (no grade 3-4). Grade 1-4 elevations in bilirubin occurred in 3% of patients on XTANDI and 2% of patients on placebo. One percent of patients treated with XTANDI compared to 0.3% of patients on placebo died from infections or sepsis.

    Please see Important Safety Information below.
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    Safety Information

    Avoid strong CYP2C8 inhibitors, as they can increase the plasma exposure to XTANDI. If coadministration is necessary, reduce the dose of XTANDI. Strong or moderate CYP3A4 or CYP2C8 inducers should also be avoided. XTANDI may decrease the plasma exposure of CYP3A4, CYP2C9, and CYP2C19 substrates with a narrow therapeutic index, and these drugs should be avoided. If XTANDI is coadministered with warfarin (CYP2C9 substrate), conduct additional INR monitoring.

    Please see Important Safety Information below.

Accessing
Xtandi

Get information on access, reimbursement, and specialty pharmacy providers at

1-855-8XTANDI (898-2634)

LEARN MORE ABOUT THE PROPOSED
MECHANISM OF ACTION OF XTANDI

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XTANDI Capsules

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Xtandi

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Indication

XTANDI is indicated for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) who have previously received docetaxel.

Important Safety Information

Contraindications  XTANDI (enzalutamide) capsules can cause fetal harm when administered to a pregnant woman based on its mechanism of action. XTANDI is not indicated for use in women. XTANDI is contraindicated in women who are or may become pregnant.

Warnings and Precautions  In the randomized clinical trial, seizure occurred in 0.9% of patients on XTANDI. No patients on the placebo arm experienced seizure. Patients experiencing a seizure were permanently discontinued from therapy. All seizures resolved. Patients with a history of seizure, taking medications known to decrease the seizure threshold, or with other risk factors for seizure were excluded from the clinical trial. Because of the risk of seizure associated with XTANDI use, patients should be advised of the risk of engaging in any activity where sudden loss of consciousness could cause serious harm to themselves or others.

Adverse Reactions  The most common adverse drug reactions (≥ 5%) reported in patients receiving XTANDI in the randomized clinical trial were asthenia/fatigue, back pain, diarrhea, arthralgia, hot flush, peripheral edema, musculoskeletal pain, headache, upper respiratory infection, muscular weakness, dizziness, insomnia, lower respiratory infection, spinal cord compression and cauda equina syndrome, hematuria, paresthesia, anxiety, and hypertension. Grade 1-­4 neutropenia occurred in 15% of XTANDI patients (1% grade 3-­4) and in 6% of patients on placebo (no grade 3-­4). Grade 1-4 elevations in bilirubin occurred in 3% of XTANDI

patients and 2% of patients on placebo. One percent of XTANDI patients compared to 0.3% of patients on placebo died from infections or sepsis. Falls or injuries related to falls occurred in 4.6% of XTANDI patients vs 1.3% of patients on placebo. Falls were not associated with loss of consciousness or seizure. Fall-related injuries were more severe in XTANDI patients and included non-pathologic fractures, joint injuries, and hematomas. Grade 1 or 2 hallucinations occurred in 1.6% of XTANDI patients and 0.3% of patients on placebo, with the majority on opioid-containing medications at the time of the event.

Drug Interactions: Effect of Other Drugs on XTANDI  Administration of strong CYP2C8 inhibitors can increase the plasma exposure to XTANDI. Coadministration of XTANDI with strong CYP2C8 inhibitors should be avoided if possible. If coadministration of XTANDI cannot be avoided, reduce the dose of XTANDI. Coadministration of XTANDI with strong or moderate CYP3A4 and CYP2C8 inducers can alter the plasma exposure of XTANDI and should be avoided if possible. Effect of XTANDI on Other Drugs  XTANDI is a strong CYP3A4 inducer and a moderate CYP2C9 and CYP2C19 inducer in humans. Avoid CYP3A4, CYP2C9, and CYP2C19 substrates with a narrow therapeutic index, as XTANDI may decrease the plasma exposures of these drugs. If XTANDI is coadministered with warfarin (CYP2C9 substrate), conduct additional INR monitoring.

Please see Full Prescribing Information for complete safety information.

References

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