Medical Oncologist
Enzalutamide (Xtandi)
Taking Enzalutamide: — Food, Timing and What to Do If You Miss a Dose
Enzalutamide is a once-daily capsule that works best when taken at the same time every day. Getting the routine right from the start — and knowing what to do when something goes wrong — is what this page covers.
Medically reviewed by Dr. C. Raghavendra Reddy, Medical Oncologist, MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Last reviewed August 2026
- Once a day, same time — Consistency matters more than which time you pick — choose a time you can keep to every day.
- Food is your choice — Enzalutamide can be taken with or without food, so fit it around your routine.
- Never double up — If you miss a dose and only notice the next day, skip it — two doses is not the right response.
- Drug interactions matter — Enzalutamide changes the way many other medicines work. Tell every treating doctor what you take.
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Take enzalutamide once a day, at the same time each day, with or without food. Swallow the capsules whole with water. If you miss a dose on the same day, take it as soon as you remember. If you only notice the next day, skip the missed dose — never double up.
What is the right way to take enzalutamide each day?
Take your capsules at the same time every day. The specific time matters less than the consistency — morning, afternoon, or evening all work, as long as you pick a time you can stick to.
You do not need to eat before or after taking enzalutamide. It is absorbed reliably whether your stomach is empty or full, so take it at whatever point in the day fits your routine.
Swallow the capsules whole with a full glass of water. Do not crush, open, or chew them.
Store your capsules away from heat, direct sunlight, and moisture. A bathroom cabinet is not ideal because steam can affect the medicine.
What do you need to remember every time you take your dose?
- Take at the same time each daySet a daily alarm if that helps you build the habit.
- Swallow capsules whole with waterDo not crush, break, or chew them.
- Food is optionalTake with or without a meal — whichever fits your day.
- Tell your team about everything you takeThis includes prescribed medicines, over-the-counter tablets, vitamins, and herbal supplements.
- Do not stop without speaking to your oncologistStopping suddenly can affect your treatment. Always call before you decide to pause or stop.
- Keep a week's supply aheadContact your pharmacy early so you never run out between appointments.
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What should you do if you miss a dose of enzalutamide?
Check what day it is
If it is still the same calendar day as your missed dose, take it as soon as you remember.
If it is already the next day
Skip the missed dose entirely. Take your next dose at your usual time and continue as normal.
Never take two doses
Do not double up to make up for the missed one. Taking two doses is not safe and does not help.
Make a note and tell your team
Write down when you missed it and mention it at your next appointment. Your team needs to know about any gaps in your treatment.
When should you call your team, and when is it fine to wait?
| Situation | What to do |
|---|---|
| Missed dose, still the same day | Take it as soon as you remember; continue as normal |
| Missed dose, only noticed the next day | Skip it; take your next dose at your usual time |
| Vomited shortly after taking your capsules | Call your team today — they will tell you whether to re-dose |
| Vomited well after taking your capsules | Likely absorbed; mention it at your next appointment |
| Want to shift your usual time | Call first before adjusting; do not change it on your own |
| Running low on capsules | Contact your pharmacy now — do not wait until you run out |
Did you know?
Enzalutamide is a strong inducer of liver enzymes that process many common medicines — including some used for seizures, heart conditions, and diabetes.
NCCN guidance recommends reviewing every medicine and supplement you take before starting enzalutamide, and again whenever anything new is added.
Source: NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer
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Common questions
Frequently asked questions
Can I take enzalutamide with or without food?
Yes — enzalutamide can be taken with or without food. It is absorbed reliably either way, so take it at the point in the day that fits your routine best. If you find that taking it with a small meal reduces any nausea you notice, that is fine. The important thing is consistency in your timing, not whether your stomach is empty or full.
What should I do if I vomit after taking my dose?
Call your oncology team the same day. How long after taking the capsules you vomited will affect whether they ask you to take another dose or wait until the next day. Do not make that decision on your own — your team needs to advise. If you cannot reach your team and feel unwell, go to your nearest CION centre or the emergency department.
Can I take enzalutamide at night instead of in the morning?
Yes. The timing is your choice, and your oncologist may already have suggested a time that suits your schedule. What matters is that you take it at the same time every day. Some people prefer morning because it fits their daily routine; others prefer evening. If you want to change the time you are currently taking it, speak to your team first — they will tell you how to shift the timing safely.
Does enzalutamide interact with other medicines?
Yes, and this is one of the most important practical issues with enzalutamide. It changes the way many other medicines are processed by the body, which can make them less effective or cause unexpected effects. This includes some medicines for seizures, blood thinners, heart conditions, diabetes, and certain supplements. Tell every doctor you see — not just your oncologist — that you are taking enzalutamide. Before starting any new medicine or supplement, always check with your oncology team first.
What happens if I stop taking enzalutamide suddenly?
Do not stop without speaking to your oncologist first. Enzalutamide is a continuous treatment, and gaps or stopping can affect how well it works. If you are having side effects that feel unmanageable, or if cost or access is a concern, call your team rather than stopping on your own. There are often ways to address the problem without interrupting treatment, and your team needs to know what is happening.