Erleada (apalutamide) is a prescription drug used to treat certain types of prostate cancer. The drug comes as a tablet. It’s usually taken once per day.

Erleada belongs to a group of drugs called anti-androgens. It’s prescribed for adult males to treat:

“Castration-sensitive” means that the prostate cancer grows and spreads in response to male sex hormones called androgens. Testosterone is an androgen. These cancer cells may die when there’s a lack of androgens.

With castration-resistant prostate cancer, the survival, growth, and spread of the cancer do not depend on androgens.

Erleada comes as a tablet that you swallow. Its active ingredient is apalutamide. (An active ingredient is what makes a drug work.)

This article describes the dosage of Erleada, as well as its strengths and how to take it. To learn more about Erleada, see this in-depth article.

Note: In this article, we use the term “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

This section describes the usual dosage of Erleada. Keep reading to learn more about Erleada’s dosage.

What’s Erleada’s form?

Erleada comes as a tablet that you swallow.

Erleada strengths: 60 mg and 240 mg

Erleada comes in two strengths: 60 milligrams (mg) and 240 mg.

The 240-mg tablet is slightly larger than the 60-mg tablet. If you have difficulty swallowing tablets, your doctor may prescribe the 60-mg tablet. For more information on taking this drug, see the “How is Erleada taken?” section.

What’s the usual dosage of Erleada?

The information that follows describes the dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Dosage for prostate cancer

The usual dosage of Erleada is 240 mg once per day. You’ll either take one 240-mg tablet or four 60-mg tablets, depending on which strength your doctor prescribes.

If your doctor prescribes Erleada, they’ll want to lower your androgen (male sex hormone) levels. If you haven’t already had surgery to remove both testicles, your doctor will prescribe a medication to lower the production of hormones in your testicles. This is known as chemical castration.

Is Erleada used long term?

Yes, Erleada may be given long term if it’s working well. Erleada should slow or stop prostate cancer from growing.

If your cancer is not growing in size or spreading, and you don’t have serious side effects from Erleada, your doctor may prescribe this medication long term.

If you have questions about the long-term use of Erleada, talk with your doctor.

Dosage adjustments

Dosage adjustments may be necessary if you have a severe side effect from Erleada. If you experience a side effect that requires treatment, your doctor will likely tell you to stop taking Erleada.

Once you recover and are no longer experiencing the side effect, your doctor may suggest that you start taking Erleada again but at a lower dose (typically 120 mg or 180 mg).

Here are answers to some commonly asked questions about Erleada.

What is Erleada’s cost? Are coupons available?

The price you’ll pay for Erleada can vary. Your cost may depend on your treatment plan and insurance coverage. You can refer to this Erleada cost article for details.

To save money on your Erleada treatment, explore the manufacturer’s savings options:

How long do you have to take Erleada?

You’ll typically take Erleada long term, as long as it’s working to slow or stop your cancer growth and you don’t have serious side effects. In studies, some people took Erleada for several years.

If you develop side effects that are serious or severe, your doctor will likely lower your dose or have you stop Erleada. And if your cancer grows or spreads, your doctor will likely have you stop Erleada completely.

Exactly how long you’ll take Erleada depends on your situation and your treatment plan.

Is Erleada’s dosage similar to the dosages of Xtandi or Zytiga?

The forms and how often you take each medication are similar. Erleada, Xtandi (enzalutamide), and Zytiga (abiraterone acetate) are all taken once per day. They’re all available as tablets. Xtandi also comes as a capsule.

The dose in milligrams for each drug differs. However, Erleada, Xtandi, and Zytiga contain different active ingredients. An active ingredient is what makes a drug work.

It’s not meaningful to compare dosages between drugs with different active ingredients. Each drug is recommended at a dose that has proven to be effective in studies.

To learn more about how these drugs compare, see “Erleada vs. Xtandi” and “Erleada vs. Zytiga” in this article. Your doctor can also provide details about these drugs.

How long does it take for Erleada to start working?

Erleada starts to work after your first dose. You probably won’t notice whether the drug is working or not, but your doctor will continue to monitor the size and spread of your cancer. If the cancer isn’t growing and spreading, then Erleada is likely working.

You’ll take your prescribed dose of Erleada once per day, preferably at the same time each day. You can take Erleada with or without food.

Do not crush or split the tablet. Swallow it whole if you can. But if swallowing tablets isn’t easy for you, see the next section.

If you have difficulty swallowing tablets

If you have difficulty swallowing tablets, tell your doctor. They may prescribe the 60-mg tablets, which are slightly smaller than the 240-mg tablets.

In addition, you can make a liquid mixture with the drug, which will be easier to swallow than the tablet form. But it’s important to follow the instructions the manufacturer provides for taking Erleada this way.

If your doctor prescribes the 240-mg tablet:

  1. Place the 240-mg tablet in a cup. Do not crush or split the tablet.
  2. Add 2 teaspoons of plain water to completely cover the tablet. The water should not be carbonated. Wait 2 minutes for the tablet to break up, and then stir the mixture.
  3. Add 2 tablespoons of either orange juice, applesauce, or water. Stir the mixture again.
  4. Swallow the mixture right away.
  5. To be sure you’ve taken the whole dose, swirl a little more water in the cup and drink it.

If your doctor prescribes the 60-mg tablet:

  1. Place the 60-mg tablets in a cup. (This will be two to four tablets, depending on your dosage.) Do not crush or split the tablets.
  2. Add 4 teaspoons of plain water to completely cover the tablets. The water should not be carbonated. Wait 2 minutes for the tablets to break up, and then stir the mixture.
  3. Follow the instructions in steps 3 through 5 for the 240-mg tablet.

It’s important to take any liquid mixture you make with Erleada right away. Do not store the liquid mixture. (For information on the expiration, storage, and disposal of Erleada, see this article.)

The manufacturer also provides step-by-step instructions you can refer to. (These instructions also describe how to administer Erleada via feeding tube, if needed.)

If you have any questions about how to take Erleada, talk with your doctor. And for more tips on how to swallow tablets, see this article.

Accessible drug containers and labels

Some pharmacies provide medication labels that:

  • have large print or use braille
  • feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

If you miss a dose of Erleada, take the dose as soon as you remember. But if it’s almost time for your next scheduled dose, skip the missed dose entirely. Take your next dose at the regularly scheduled time.

Do not double your dose if you’ve missed a dose. If you’re unsure when to take Erleada after missing a dose, talk with your doctor or pharmacist.

To help make sure you don’t miss a dose, try using a medication reminder. You could also download a reminder app on your phone.

Do not take more Erleada than your doctor prescribes, as this can cause harmful effects.

What to do in case you take too much Erleada

Call your doctor right away if you think you’ve taken too much Erleada. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

The previous sections describe the usual dosages provided by the drug’s manufacturer. If your doctor recommends Erleada for you, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Erleada without your doctor’s recommendation. Only take Erleada exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

To learn more about Erleada, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.