Enzalutamide has revolutionized the treatment of advanced prostate cancer, offering significant improvements in patient outcomes. However, like all potent medications, it can be associated with a range of side effects. Understanding these potential effects and knowing how they can be managed is crucial for patients and their healthcare providers to ensure the best possible treatment experience.

The side effect profile of enzalutamide is varied, with some common reactions being generally manageable and others requiring closer medical attention. Common side effects reported in clinical trials and patient experiences include fatigue, hot flashes, diarrhea, decreased appetite, muscle and joint pain, and hypertension. While these can impact a patient's quality of life, they are often addressed through supportive care, lifestyle adjustments, and, in some cases, other medications. For instance, managing fatigue might involve balancing rest and activity, while dietary changes can help with gastrointestinal issues.

More significant, though less common, side effects of enzalutamide include the risk of seizures. This is thought to be related to the drug's interaction with the central nervous system. Patients with a history of seizures or brain injury are at a higher risk and require careful monitoring. Posterior Reversible Encephalopathy Syndrome (PRES) is another rare but serious neurological condition that can occur. Prompt medical attention is critical if symptoms such as headache, confusion, blurred vision, or seizures develop.

Cardiac events, such as ischemic heart disease, have also been reported, emphasizing the importance of monitoring cardiovascular health throughout treatment. Furthermore, bone fractures and falls have been noted, potentially due to the drug's impact on bone health and general well-being. Healthcare providers typically manage these risks by monitoring patients closely, optimizing management of existing cardiovascular risk factors, and advising on fall prevention strategies.

Effective management of enzalutamide's side effects often involves open communication between the patient and their medical team. By reporting any new or worsening symptoms promptly, patients can receive timely interventions, which may include dose adjustments or specific treatments for the side effects. The ongoing research and clinical experience with enzalutamide continue to refine our understanding and management strategies, aiming to maximize treatment benefits while minimizing adverse effects.