← All drugs
Drug · FAERS side-effect profile with label screen

Enzalutamide side effects: what 58,425 FDA adverse event reports show

Enzalutamide · Xtandi · 1,125 reaction terms · 173,495 drug–reaction co-reports · data 2026-09-14
Share: X Facebook Reddit Email

Drug class

Androgen Receptor Inhibitor

FDA label (Established Pharmacologic Class) · compare the class

Brand names

Xtandi

openFDA label

Who reports

58,425 reports · 62% serious · 11,360 with death outcome · 1% female

openFDA FAERS counts, all years, deduplication not applied

Used for

XTANDI ® is indicated for the treatment of patients with: • castration-resistant prostate cancer (CRPC) • metastatic castration-sensitive prostate cancer (mCSPC) • non‑metastatic castration‑sensitive prostate cancer (nmCSPC) with biochemical recurrence.

FDA label, Indications and Usage

What it is

Enzalutamide is an androgen receptor inhibitor.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 2Labeled (related wording) 6Likely indication confounding 4Reporting / coding artifact 4Lab value / disease marker 5Not in label — unassessed 19
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,085 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Arrhythmia induced cardiomyopathy22369.9
203.4–672.6ROR 370.1 · calibrated p 6e-11 ✓
156.8 EB05 109.1 · IC025 +4.5
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Not in label — unassessedserious n=22 · 100% clinicianno trial arm names this drug
Prostatic specific antigen increased4,344164.4
158.8–170.3ROR 177.6 · calibrated p 1e-9 ✓
112.5 EB05 109.7 · IC025 +6.7
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 23.9 (22.4–25.6)
Lab value / disease markerserious PRR 103.3 · 70% consumerno trial arm names this drug
Hereditary optic atrophy1489.9
50.0–161.6ROR 89.9 · calibrated p 2e-6 ✓
65.7 EB05 41.6 · IC025 +3.5
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Not in label — unassessedserious n=14no trial arm names this drug
Prostatic specific antigen abnormal19984.4
72.3–98.4ROR 84.6 · calibrated p 4e-7 ✓
67.9 EB05 60.3 · IC025 +5.6
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 15.7 (11.9–20.6)
Lab value / disease markerserious n=134no trial arm names this drug
Brca1 gene mutation1573.6
42.2–128.3ROR 73.6 · calibrated p 5e-6 ✓
56.9 EB05 36.6 · IC025 +3.5
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Not in label — unassessedserious n=14no trial arm names this drug
Hormone-refractory prostate cancer18165.4
55.8–76.6ROR 65.6 · calibrated p 3e-6 ✓
55.0 EB05 48.6 · IC025 +5.3
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 9.9 (7.7–12.6)
Likely indication confounding
shares a disease stem with the indications wording
serious n=180no trial arm names this drug
Brca2 gene mutation1356.0
31.2–100.5ROR 56.0 · calibrated p 3e-5 ✓
45.5 EB05 28.3 · IC025 +3.2
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Not in label — unassessedserious n=12no trial arm names this drug
Product size issue61246.6
42.9–50.7ROR 47.1 · calibrated p 2e-5 ✓
41.3 EB05 38.6 · IC025 +5.2
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 187.2 (117.2–299.2)
Reporting / coding artifactserious n=288 · 71% consumerno trial arm names this drug
Prostate cancer metastatic31236.8
32.7–41.3ROR 37.0 · calibrated p 9e-5 ✓
33.3 EB05 30.3 · IC025 +4.8
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 5.9 (5.1–7.0)
Likely indication confounding
term in indications; also in warnings
serious n=312no trial arm names this drug
Prostatic specific antigen decreased3536.3
25.7–51.5ROR 36.4 · calibrated p 1e-4 ✓
32.5 EB05 24.4 · IC025 +3.9
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 9.2 (5.3–15.8)
Lab value / disease markerserious n=20 · 71% consumerno trial arm names this drug
Prostate cancer recurrent5535.2
26.7–46.5ROR 35.3 · calibrated p 1e-4 ✓
31.8 EB05 25.4 · IC025 +4.2
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 5.2 (3.6–7.6)
Likely indication confounding
shares a disease stem with the indications wording
serious n=55no trial arm names this drug
Bladder tamponade1721.4
13.1–34.9ROR 21.4 · calibrated p 0.003 ✓
19.7 EB05 12.8 · IC025 +2.9
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Not in label — unassessedserious n=17no trial arm names this drug
Malignant neoplasm progression5,46820.3
19.8–20.8ROR 22.3 · calibrated p 0.001 ✓
19.3 EB05 18.8 · IC025 +4.2
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 40.0 (37.1–43.1)
Reporting / coding artifactserious PRR 18.3no trial arm names this drug
Foreign body in respiratory tract7020.0
15.7–25.4ROR 20.0 · calibrated p 0.002 ✓
18.9 EB05 15.4 · IC025 +3.7
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Not in label — unassessedserious n=34 · 74% consumerno trial arm names this drug
Metastases to bladder1519.9
11.8–33.5ROR 19.9 · calibrated p 0.004 ✓
18.3 EB05 11.4 · IC025 +2.7
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Not in label — unassessedserious n=15no trial arm names this drug
Hot flush (hot flashes)3,88219.4
18.8–20.1ROR 20.8 · calibrated p 0.002 ✓
18.5 EB05 18.0 · IC025 +4.2
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 27.0 (25.0–29.1)
Labeled adverse reaction
exact term
serious PRR 17.1 · 87% consumerno trial arm names this drug
Nephrostomy1618.4
11.1–30.4ROR 18.4 · calibrated p 0.005 ✓
16.9 EB05 10.6 · IC025 +2.7
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Not in label — unassessedserious n=16no trial arm names this drug
Blood testosterone increased8214.1
11.3–17.6ROR 14.2 · calibrated p 0.010 ✓
13.5 EB05 11.2 · IC025 +3.3
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 7.3 (5.2–10.1)
Lab value / disease markerserious n=47no trial arm names this drug
Retroperitoneal lymphadenopathy2014.1
9.0–22.1ROR 14.1 · calibrated p 0.013 ✓
12.9 EB05 8.4 · IC025 +2.6
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 4.6 (2.5–8.3)
Not in label — unassessedserious n=19no trial arm names this drug
Blood testosterone abnormal4214.0
10.3–19.0ROR 14.0 · calibrated p 0.011 ✓
13.2 EB05 10.0 · IC025 +3.0
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 8.0 (5.0–12.8)
Lab value / disease markerserious n=28no trial arm names this drug
Foreign body in throat11213.7
11.3–16.5ROR 13.7 · calibrated p 0.011 ✓
13.1 EB05 11.2 · IC025 +3.3
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Not in label — unassessedserious n=112 · 89% consumerno trial arm names this drug
Metastases to pelvis2313.5
8.9–20.5ROR 13.5 · calibrated p 0.014 ✓
12.5 EB05 8.3 · IC025 +2.7
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 12.7 (6.0–26.6)
Not in label — unassessedserious n=23no trial arm names this drug
Prostatic pain1513.5
8.0–22.6ROR 13.5 · calibrated p 0.016 ✓
11.9 EB05 7.0 · IC025 +2.4
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Likely indication confounding
shares a disease stem with the indications wording
serious n=11no trial arm names this drug
Hydroureter1312.9
7.4–22.4ROR 12.9 · calibrated p 0.020 ✓
11.0 EB05 6.2 · IC025 +2.2
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 5.1 (2.4–10.9)
Not in label — unassessedserious n=13no trial arm names this drug
Metastases to bone54812.4
11.4–13.5ROR 12.5 · calibrated p 0.014 ✓
12.0 EB05 11.2 · IC025 +3.4
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 6.5 (5.7–7.3)
Not in label — unassessedserious PRR 11.3no trial arm names this drug
Oncologic complication3111.8
8.2–16.8ROR 11.8 · calibrated p 0.022 ✓
10.9 EB05 7.8 · IC025 +2.7
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Reporting / coding artifactserious n=31 · 100% consumerno trial arm names this drug
Bladder obstruction1611.8
7.2–19.4ROR 11.8 · calibrated p 0.025 ✓
10.2 EB05 6.2 · IC025 +2.3
3/3 methods agree
vs other Androgen Receptor Inhibitors: only this drug
Not in label — unassessedserious n=16no trial arm names this drug
Oesophageal ulcer haemorrhage1611.6
7.1–19.2ROR 11.7 · calibrated p 0.026 ✓
10.1 EB05 6.1 · IC025 +2.3
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 5.9 (2.9–11.9)
Not in label — unassessedserious n=16no trial arm names this drug
Testicular atrophy2611.0
7.5–16.3ROR 11.0 · calibrated p 0.028 ✓
10.0 EB05 6.9 · IC025 +2.5
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 8.4 (4.6–15.5)
Not in label — unassessedserious n=18 · 100% consumerno trial arm names this drug
Underdose2,08410.5
10.1–11.0ROR 10.9 · calibrated p 0.024 ✓
10.2 EB05 9.9 · IC025 +3.3
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 122.1 (99.3–150.1)
Reporting / coding artifactserious PRR 18.9 · 78% consumerno trial arm names this drug
Metastases to spine9410.3
8.4–12.7ROR 10.3 · calibrated p 0.030 ✓
9.9 EB05 8.2 · IC025 +2.9
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 8.0 (5.8–10.9)
Not in label — unassessedserious n=94no trial arm names this drug
Nipple pain519.2
7.0–12.1ROR 9.2 · calibrated p 0.047 ✓
8.6 EB05 6.7 · IC025 +2.6
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 15.6 (9.1–26.7)
Not in label — unassessedserious n=24 · 88% consumerno trial arm names this drug
Radiation injury269.0
6.1–13.2ROR 9.0 · calibrated p 0.055
8.0 EB05 5.6 · IC025 +2.3
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 8.9 (4.8–16.7)
Not in label — unassessedserious n=24 · 73% consumerno trial arm names this drug
Spinal cord compression948.8
7.2–10.8ROR 8.8 · calibrated p 0.051
8.4 EB05 7.0 · IC025 +2.7
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 11.5 (8.1–16.4)
Labeled adverse reaction
exact term
serious n=93no trial arm names this drug

Trial evidence (ClinicalTrials.gov)

No completed trial with posted adverse-event results was found on ClinicalTrials.gov for Enzalutamide (searched ENZALUTAMIDE).

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Fatigue (tiredness)10,2674.8
4.7–4.9ROR 5.6 · calibrated p 0.178
4.7 EB05 4.7 · IC025 +2.2
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 42.6 (40.3–45.0)
Labeled adverse reaction
exact term
serious PRR 3.7 · 80% consumerno trial arm names this drug
Death7,6983.2
3.2–3.3ROR 3.6 · calibrated p 0.469
3.2 EB05 3.1 · IC025 +1.6
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 42.7 (40.0–45.5)
Outcome field, not a reactionserious PRR 3.0no trial arm names this drug
Malignant neoplasm progression5,46820.3
19.8–20.8ROR 22.3 · calibrated p 0.001 ✓
19.3 EB05 18.8 · IC025 +4.2
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 40.0 (37.1–43.1)
Reporting / coding artifactserious PRR 18.3no trial arm names this drug
Prostatic specific antigen increased4,344164.4
158.8–170.3ROR 177.6 · calibrated p 1e-9 ✓
112.5 EB05 109.7 · IC025 +6.7
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 23.9 (22.4–25.6)
Lab value / disease markerserious PRR 103.3 · 70% consumerno trial arm names this drug
Asthenia (weakness)4,1714.0
3.9–4.1ROR 4.2 · calibrated p 0.335
4.0 EB05 3.9 · IC025 +1.9
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 28.4 (26.4–30.6)
Labeled adverse reaction
exact term
serious PRR 3.1 · 77% consumerno trial arm names this drug
Drug ineffective (drug did not work)4,0521.1
1.1–1.1ROR 1.1 · calibrated p 0.381
1.1 EB05 1.1 · IC025 +0.1
vs other Androgen Receptor Inhibitors: PRR 36.6 (33.7–39.9)
Reporting / coding artifactserious PRR 1.2 · 76% consumerno trial arm names this drug
Hot flush (hot flashes)3,88219.4
18.8–20.1ROR 20.8 · calibrated p 0.002 ✓
18.5 EB05 18.0 · IC025 +4.2
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 27.0 (25.0–29.1)
Labeled adverse reaction
exact term
serious PRR 17.1 · 87% consumerno trial arm names this drug
Decreased appetite (loss of appetite)3,4085.3
5.2–5.5ROR 5.6 · calibrated p 0.178
5.3 EB05 5.1 · IC025 +2.3
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 36.7 (33.4–40.2)
Labeled adverse reaction
exact term
serious PRR 4.6 · 76% consumerno trial arm names this drug
Nausea3,2591.5
1.4–1.5ROR 1.5 · calibrated p 0.650
1.5 EB05 1.4 · IC025 +0.5
vs other Androgen Receptor Inhibitors: PRR 31.9 (29.2–34.8)
Labeled adverse reaction
exact term
serious PRR 1.4 · 76% consumerno trial arm names this drug
Dizziness3,1432.3
2.2–2.4ROR 2.3 · calibrated p 0.882
2.3 EB05 2.2 · IC025 +1.1
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 29.7 (27.3–32.5)
Labeled adverse reaction
exact term
serious PRR 1.9 · 80% consumerno trial arm names this drug
Diarrhoea (diarrhea)2,7981.6
1.5–1.6ROR 1.6 · calibrated p 0.701
1.6 EB05 1.5 · IC025 +0.6
vs other Androgen Receptor Inhibitors: PRR 29.2 (26.7–32.1)
Labeled adverse reaction
exact term
serious PRR 1.2 · 80% consumerno trial arm names this drug
Back pain2,2983.6
3.4–3.7ROR 3.7 · calibrated p 0.443
3.5 EB05 3.4 · IC025 +1.8
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 31.6 (28.5–35.2)
Labeled adverse reaction
exact term
serious PRR 3.0 · 79% consumerno trial arm names this drug
Arthralgia (joint pain)2,1521.9
1.8–1.9ROR 1.9 · calibrated p 0.889
1.9 EB05 1.8 · IC025 +0.8
vs other Androgen Receptor Inhibitors: PRR 31.4 (28.1–34.9)
Labeled adverse reaction
exact term
serious PRR 1.6 · 81% consumerno trial arm names this drug
Underdose2,08410.5
10.1–11.0ROR 10.9 · calibrated p 0.024 ✓
10.2 EB05 9.9 · IC025 +3.3
3/3 methods agree
vs other Androgen Receptor Inhibitors: PRR 122.1 (99.3–150.1)
Reporting / coding artifactserious PRR 18.9 · 78% consumerno trial arm names this drug
Fall1,8342.0
1.9–2.1ROR 2.0 · calibrated p 0.953
2.0 EB05 1.9 · IC025 +0.9
vs other Androgen Receptor Inhibitors: PRR 23.9 (21.5–26.5)
Labeled adverse reaction
exact term
serious PRR 1.9no trial arm names this drug

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Enzalutamide?

In FDA FAERS, the most frequently co-reported reaction terms for Enzalutamide are fatigue, prostatic specific antigen increased, asthenia, hot flush, decreased appetite, nausea. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Enzalutamide have an FDA boxed warning?

No. The FDA label retrieved for Enzalutamide has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Enzalutamide causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.