Xtandi, enzalutamide
Named-patient access overview. Xtandi is coordinated by Reserve Meds for international patients via physician-led cross-border sourcing.
This page is informational, not medical advice.
About Xtandi
Xtandi (enzalutamide) is an oral, next-generation androgen receptor inhibitor co-developed by Astellas and Pfizer for the treatment of prostate cancer. The US Food and Drug Administration first approved enzalutamide in 2012 for metastatic castration-resistant prostate cancer (mCRPC) in patients previously treated with docetaxel. Successive label expansions added chemotherapy-naive mCRPC (2014), non-metastatic castration-resistant prostate cancer (2018, nmCRPC), and metastatic castration-sensitive prostate cancer (2019, mCSPC). Xtandi is taken once daily as oral capsules or tablets, typically at a 160 mg total daily dose, in combination with ongoing androgen deprivation therapy.
Mechanistically, enzalutamide competitively inhibits the binding of androgens to the androgen receptor, blocks nuclear translocation of the activated receptor, and impairs DNA binding and transcription of androgen-receptor-dependent genes. It is one of several oral hormone-therapy agents that, alongside abiraterone, apalutamide, and darolutamide, have re-shaped the treatment of advanced prostate cancer over the past decade.
For international patients, Xtandi is registered in many high-income markets, but supply, reimbursement, and out-of-pocket pricing vary substantially across the markets Reserve Meds serves. Some patients seek US-sourced Xtandi via named-patient or personal-import pathways when local supply is unavailable, when their treating oncologist has specifically prescribed the US brand, or when continuity with a US treatment plan is the priority. Reserve Meds coordinates that sourcing from DSCSA-compliant US specialty channels.
How Reserve Meds coordinates Xtandi
- Patient or treating oncologist submits a named-patient request through our intake.
- The clinical team reviews appropriateness of Xtandi for the patient's prostate cancer stage and prior therapies.
- The treating oncologist issues a prescription and a written clinical justification.
- Country-specific named-patient or personal-import documentation is prepared.
- Xtandi is sourced from a DSCSA-compliant US specialty wholesaler with full serial-number traceability.
- The shipment is coordinated to the patient's physician, pharmacy, or home address, depending on the country pathway.
A single concierge coordinator stays with the case from intake through delivery. The coordinator owns documentation, timeline, customs clearance, and confirmation of receipt.
Access by country
Reserve Meds publishes a detailed country deep-dive for Xtandi in every market we coordinate. Each page below covers the destination-country regulatory pathway, real costs in local currency and USD, indicative timelines, physician-credential requirements, and cold-chain handling. Tap any country to read the full deep-dive.
What patients typically ask about Xtandi
Which prostate cancer patients is Xtandi approved for? The US label covers metastatic castration-resistant prostate cancer (mCRPC), non-metastatic castration-resistant prostate cancer (nmCRPC), and metastatic castration-sensitive prostate cancer (mCSPC). Use is typically alongside ongoing androgen deprivation therapy. The treating oncologist will discuss which stage applies to the patient and how Xtandi fits the treatment plan.
How does Xtandi compare with other oral hormone-therapy options? Enzalutamide is one of several androgen-receptor-pathway inhibitors used in advanced prostate cancer, alongside abiraterone, apalutamide, and darolutamide. They differ in mechanism details, drug-interaction profile, side-effect emphasis, and dosing logistics. The treating oncologist selects among them based on disease stage, prior therapy, comorbidities, and patient preference.
Is Xtandi registered in my country? In several Reserve Meds markets enzalutamide is registered and locally available. Pricing, reimbursement, and continuity of supply vary. The country deep-dives linked above describe the local registration status, the documentation route for importing US-branded Xtandi when needed, and indicative timelines.
How is Xtandi shipped? Xtandi is an oral capsule or tablet at ambient temperature; cold-chain handling is not required. Standard international logistics with documentation review apply.
What does a course cost? Patients pay for the medicine plus Reserve Meds coordination, regulatory documentation, and shipping. Costs vary by destination because of duties, VAT, and country-specific documentation. The per-country deep-dives publish indicative ranges; firm quotes are issued after intake.
Clinical and safety notes
Xtandi clinical considerations include risk of seizures (a labelled warning), posterior reversible encephalopathy syndrome (rare), hypertension, falls and fractures, ischemic heart disease, and hypersensitivity reactions. Common adverse reactions include fatigue, back pain, hot flushes, constipation, and arthralgia. Enzalutamide is a strong CYP3A4 inducer and interacts with several commonly prescribed medicines, so the treating oncologist and pharmacist will review the patient's full medication list before initiation.
Reserve Meds does not replace the prescribing relationship. We coordinate access to a US-licensed medicine for a patient already under physician care. Patients who experience seizure activity, neurological symptoms, chest pain, or any concerning side effect should contact their treating oncologist or seek emergency care promptly. Reserve Meds is not an emergency service.
How Xtandi fits a prostate cancer treatment plan
Treatment for advanced prostate cancer has moved decisively toward earlier and combined use of androgen-receptor-pathway inhibitors. In castration-sensitive disease (mCSPC), oncologists frequently pair androgen deprivation therapy with one of the oral hormone-therapy agents, sometimes adding docetaxel chemotherapy for higher-volume disease (triplet therapy). In castration-resistant disease (mCRPC), these agents anchor multiple lines of therapy and may be sequenced before or after taxane chemotherapy depending on prior treatment, disease burden, and biomarker findings. Non-metastatic castration-resistant prostate cancer (nmCRPC) is a distinct setting in which Xtandi, apalutamide, and darolutamide have all shown delay of metastasis and overall-survival benefit.
For an individual patient, the treating oncologist weighs prior therapy, PSA dynamics, imaging, performance status, comorbidities (notably cardiovascular disease, fall risk, and seizure history for enzalutamide specifically), drug-interaction risk, and patient preference. The conversation often includes the side-effect profile that matters most to that patient's quality of life. Fatigue is the most commonly reported issue across the class, but fall and fracture risk, cognitive concerns, and cardiovascular events also factor into the choice. Bone-protective therapy is a related conversation when patients have bone metastases. Reserve Meds does not influence those clinical decisions; we coordinate access to the agent the treating oncologist has chosen.
Continuity matters in oncology. A patient who has been started on Xtandi by a US-trained oncologist, who has tolerated initiation, whose PSA is responding, and who is travelling, relocating, or living outside the US often prefers to stay on the same agent rather than switch mid-response to a different brand or generic formulation. Reserve Meds exists to make that continuity practical, with the regulatory and logistical scaffolding that the patient and the treating oncologist would otherwise have to assemble themselves.
What is included in a Reserve Meds Xtandi case
A Reserve Meds case for Xtandi covers the full chain from intake to delivery. The named concierge coordinator confirms that the prescription, clinical justification, and patient identity documentation are complete before any procurement step begins. The regulatory team prepares country-specific named-patient or personal-import paperwork tailored to the destination, including translations where required. The procurement team places the order with a DSCSA-compliant US specialty wholesaler and confirms full serial-number traceability. The logistics team handles international shipping, customs documentation, and final-mile delivery, with proof-of-delivery returned to the case file. The coordinator remains the single point of contact for the patient and the treating oncologist throughout the case and across any subsequent refills.
Start a request for Xtandi
Submit a 60-second intake. Our clinical team will reach out as our first cohort opens with case-specific feasibility, timeline, and a formal quote.
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