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Apalutamide is used to treat:

– Metastatic castration-sensitive prostate cancer

– Non-metastatic castration-resistant prostate cancer

Dose and Schedule

Taking Apalutamide as directed is essential for the effectiveness of your treatment. Please follow these key points:

  • Usual dose:
    • 240 milligrams (4 tablets) to be taken by mouth at a scheduled time once daily.
  • Apalutamide can be taken with or without food but simultaneously each day.
  • Swallow Apalutamide tablets whole—do not crush, cut, or dissolve them. If you cannot swallow the tablets, consult your doctor for alternative options.
  • If you miss a dose:
    • Do not take an extra dose or double dose.
    • Simply take your next dose at the regularly scheduled time.
    • Record any missed doses and inform your doctor during your next visit.
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Drug and Food Interactions

  • Drug Interactions:
    • Apalutamide interacts with many medications. Inform your doctor of all prescription drugs, over-the-counter medicines, vitamins, and herbal products you are using.
  • Consultation:
    • Speak to your doctor or pharmacist before starting any new medications, supplements, or receiving vaccines.
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Storage and Handling

  • Store Apalutamide at room temperature (below 25°C) in a dry location away from light.
  • Keep the medication out of reach of children and pets.
  • Leave the tablets in their original packaging until ready for use.
  • If possible, take Apalutamide yourself.
  • If someone else handles the medication:
    • They should wear gloves when handling the tablets.
  • Dispose of unused Apalutamide responsibly:
    • Please do not throw it in the trash or flush it down the sink/toilet.
    • Return unused medication to your practice or pharmacy for safe disposal.
  • When traveling:

Place the tablets in a sealed plastic bag. Ask your pharmacist if any additional precautions are needed.

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Side Effects of Apalutamide

Note: You may not experience all the side effects listed below. A blood test will be done before starting a new cycle of Apalutamide to monitor your health.

Possible Side Effects and Management

Decreased white blood cells (WBCs) and increased infection risk– Wash hands frequently, especially before meals and after using the bathroom. – Avoid crowds and people with infections, fevers, or flu. – Maintain good personal hygiene. Notify your doctor if you experience: – Fever (above 38°C), chills, sore throat, or burning during urination.
Decreased haemoglobin (anaemia)– Rest as needed and aim for 7–8 hours of sleep each night. – Balance work and rest. Notify your doctor if you experience: – Shortness of breath, chest discomfort, dizziness, or palpitations.
Changes in liver and kidney function, electrolytes, or cholesterolBlood tests will monitor these changes. Notify your doctor if you experience: – Weakness or fatigue – Headaches – Swelling in legs or feet – Red or brown urine – Yellowing of the skin or whites of the eyes.
Fatigue– Stay as active as possible, but rest when needed. – Engage in light activity daily. – Plan activities for times when you feel more energetic.
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Handling Body Fluids and Waste

As Apalutamide remains in your body for several days, some of the drug may be present in body fluids (e.g., urine, stool, sweat, or vomit). Follow these instructions to ensure safety for yourself, others, and the environment:

  • Pregnant women should avoid contact with anything contaminated by body fluids.
  • Always close the toilet lid and flush twice after use.
  • Clean any soiled toilet surfaces before others use them.
  • Wash hands with soap and water after using the toilet.
  • Caregivers should wear gloves when cleaning bedpans or soiled linens/clothing.
  • Wash soiled clothing/linens separately from other laundry.
  • Use disposable pads, nappies, or sheets if necessary to absorb body waste.
  • Wash exposed skin or contaminated areas with soap and water.
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Pregnancy, Sexual Activity, and Contraception

  • Men taking Apalutamide should not get a partner pregnant during treatment.
  • Men and women of childbearing potential must use effective contraception during therapy and for at least 3 months after the last dose.
  • Inform your doctor immediately if your partner becomes pregnant.
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Compiled by : Karin Mouton

Registered Oncology Nurse

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