Targeted Therapy / Oncology — Prostate Cancer

Erleada (apalutamide)

Janssen Oncology (Johnson & Johnson) · Androgen Receptor Inhibitor

FDA Approved 2018 Oral tablet Specialty Medication
Erleada apalutamide 60mg tablets, Janssen Oncology, prostate cancer targeted therapy

What is Erleada? Erleada (apalutamide) is an androgen receptor inhibitor by Janssen approved for non-metastatic castration-resistant prostate cancer (nmCRPC) and metastatic castration-sensitive prostate cancer (mCSPC), used in combination with androgen deprivation therapy (ADT).

About Erleada

Brand NameErleada
Generic / INNapalutamide
Drug ClassAndrogen Receptor Inhibitor
ManufacturerJanssen Oncology (Johnson & Johnson)
AdministrationOral tablet
FDA Approval2018
📦 60 mg tablets; standard dose is 240 mg (4 × 60 mg) once daily. Available in bottles of 120 tablets.

FDA-Approved Uses for Erleada

Indications are based on FDA approval. Your healthcare provider determines appropriate use based on your specific diagnosis, stage, biomarker status, and overall clinical picture.

  • Non-metastatic castration-resistant prostate cancer (nmCRPC)
  • Metastatic castration-sensitive prostate cancer (mCSPC) — in combination with androgen deprivation therapy
Biomarker Note: No specific biomarker is required for the approved nmCRPC or mCSPC indications. PSA doubling time is used to define nmCRPC eligibility. AR splice variant testing (AR-V7) may inform treatment sequencing in later-line settings.

How Does Erleada Work?

Apalutamide binds directly to the ligand-binding domain of the androgen receptor (AR), blocking AR nuclear translocation, DNA binding, and AR-mediated transcription. It inhibits multiple steps in the AR signaling pathway more completely than first-generation antiandrogens (e.g., bicalutamide). Used with ADT (GnRH agonist/antagonist or surgical castration).

Dosage & Administration

240 mg (four 60 mg tablets) orally once daily, with or without food. Swallow whole. Dose reductions to 180 mg or 120 mg for toxicity (seizures, ischemia, fractures, grade 3+ adverse reactions).

⚠️ Important

Dosing is individualized by the prescribing clinician. Never adjust your dose without consulting your healthcare provider. This information is educational only and does not replace the official prescribing information.

Warnings, Precautions & Side Effects

General Warning

Seizures — use with caution in patients with seizure history or risk factors. Ischemic cardiovascular events. Falls and fractures (bone-protective agents recommended). Hypothyroidism — monitor thyroid function. Embryo-fetal toxicity. Strong CYP3A4/2C8 drug interactions.

⛔ Serious Warnings & Precautions
  • Seizures
  • Ischemic cardiovascular events
  • Falls and fractures
  • Hypothyroidism
  • Embryo-fetal toxicity

Common Side Effects

  • Fatigue
  • Arthralgia
  • Rash
  • Decreased appetite
  • Falls
  • Weight loss
  • Hypertension
  • Hot flush
  • Diarrhea

This is not a complete list. Always report new or worsening symptoms to your healthcare provider promptly.

Storage & Handling

Store at room temperature 20°C to 25°C (68°F to 77°F). Store below 30°C.

BiologicHealthPlus provides temperature-monitored cold-chain specialty delivery for medications requiring refrigeration. Never use a medication if its storage conditions have been compromised.

Insurance Coverage, Prior Authorization & Patient Assistance

🛡️ Commercial Insurance

Erleada is covered by most major commercial insurance plans when medically necessary and prior authorized. Coverage tier and cost-sharing vary by plan.

✅ Prior Authorization

Prior authorization is required by virtually all insurance plans for Erleada. BiologicHealthPlus handles the complete prior authorization process at no cost to patients or providers.

🏥 Medicare Coverage

Medicare Part D covers this oral specialty medication. Medicaid coverage varies by state.

🆓 Patient Assistance

Manufacturer patient assistance programs may be available for eligible uninsured or underinsured patients. Contact BiologicHealthPlus for a confidential eligibility review.

Prior Authorization Patient Assistance Insurance & Savings Medication Costs

Frequently Asked Questions — Erleada

Erleada (apalutamide) is an androgen receptor inhibitor by Janssen approved for nmCRPC and mCSPC. It blocks testosterone from stimulating prostate cancer cell growth and is used with androgen deprivation therapy.

Non-metastatic castration-resistant prostate cancer (nmCRPC) is prostate cancer that continues to progress (rising PSA) despite castrate levels of testosterone, but has not yet spread to other organs detectable by imaging.

Seizures have been reported with apalutamide. Patients with a history of seizures or risk factors should use Erleada with caution. Avoid driving or other hazardous activities if you experience a seizure.

240 mg once daily (four 60 mg tablets), with or without food.

Erleada is covered by most commercial insurance plans and Medicare Part D with prior authorization. BiologicHealthPlus handles the full PA process.

Related Medications

Xtandi (enzalutamide)  ·  Nubeqa (darolutamide)  ·  Abiraterone Acetate  ·  Orgovyx (relugolix — ADT)

Related Conditions

Non-metastatic castration-resistant prostate cancer (nmCRPC)  ·  Metastatic castration-sensitive prostate cancer (mCSPC)  ·  Prostate cancer

Comparisons

Abiraterone Acetate

Authoritative References

Medical Disclaimer: This page is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult your oncologist, hematologist, or licensed healthcare professional before making any treatment decisions. Last reviewed: August 2026 by the BiologicHealthPlus Clinical Team.