recently started Erleada

I've had PC for 14 years and aside from the usual incontinence and loss of libido and sexual function my life has been relatively side effect free and good.  I've been on lupron for several years and the PSA started to rise in the past 12 months.  Dr. tried a suppliment to the Lupron which did not work (scared me) and, now, I'm on a new RX called Erleada.  This is a more 'serious' drug and VERY expensive.  I think I'm having SOME issues with nauseo and fatigue but I've also had a first time persistent sinus infection not related to anything and on a couple different courses of antibiotics which can cause nausea.  Now I feel I'm getting over the nausea and fatigue (feeling better than I have since early last summer (9 months ago).  My questions are:  are there others out there on Erleada?  If so, what are your experiences re side effects?  Lastly, does anyone know how much this drug actually costs to produce or what it costs in other countries.  The price is huge even though it was not developed by a drug company - developed by a consortium of researches, universities and govt. grants as I understand it.  That's all I have for now but would appreciate starting any other dialogues with others starting or on Erleada.  Thanks


  • VascodaGama
    VascodaGama Member Posts: 3,491 Member
    A newer more refined antiandrogen


    Welcome to the board. I wonder where you live. 9 month ago the Summer was at the southern hemisphere.

    Erleada (Apalutamide) is a new drug used as an antiandrogen to treat prostate cancer. In comparison with the traditional Casodex this newer drug is more complete. Apart from preventing the absorption of androgens by the cancerous cells, it tries to interfere with the production of typical hormones at the adrenal and thyroid glands as well as trying to avoid AR (androgen receptors) mutation. It works similarly to Xtandi but does not interfere with the production of dihydrotestosterone.

    The side effects of this antiandrogen are similar to any other but it is linked to a higher number of cases involving hypertension. The symptoms you listed above could be a cause of this drug as it uses the traditional CYP3A4 and CYP2C19 path ways (liver enzymes) to metabolize so that it risks interaction with other drugs or food. Nausea would be the result of such interactions. Your doctor should adjust the daily dose of Erleada to fit your metabolism.

    A cheaper but older similar antiandrogen is the Cyproterone acetate which also has some effect at the pituitary interfering to certain extent with testosterone production (not as perfect as the agonist Lupron). Fatigue, hypertension, rash, diarrhea, nausea, weight decreased, hot flush, decreased appetite, fracture, and peripheral edema are the list of side effects described at the site of the Pharma.

    You did not share details of your case, type of cancer and previous treatment protocols but this assumed Lupron refractory is usually dealt with an increase of the ADT protocol adding more blockades. Your doctor did well by starting the antiandrogen. You can request him to use the cheap Casodex and verify the results. Some oncologists add sort of cocktails of drugs to balance the patient lipids (improving the immune system). Supplements can be in the mixture too for the same principle, however one must be careful as some could be harmful.

    Congratulations for your long period as a survivor.

    Best wishes for continuing control.


  • Georges Calvez
    Georges Calvez Member Posts: 545 Member
    Drug information

    Hi there,

    This is not a bad site for drug information;