Erleada (apalutamide) 60 mg film coated tablets

Erleada (Apalutamide) is an oral prescription medication used for the treatment of prostate cancer. Each film-coated tablet contains 60 mg of apalutamide, which is a type of androgen receptor inhibitor. Erleada works by inhibiting the activity of male hormones (androgens), such as testosterone, that can promote the growth of cancer cells in the prostate gland. It is commonly used for patients with non-metastatic castration-resistant prostate cancer (nmCRPC) or metastatic castration-sensitive prostate cancer (mCSPC).

How Erleada Works

Erleada belongs to a class of medications known as androgen receptor (AR) inhibitors. Androgens like testosterone and dihydrotestosterone (DHT) fuel the growth of prostate cancer cells by binding to androgen receptors. Apalutamide blocks this binding process, preventing these hormones from stimulating the growth of cancer cells.

Mechanism of Action:

1. Blocking Androgen Receptors: Erleada binds to androgen receptors on the surface of prostate cancer cells, blocking the androgens (such as testosterone) from interacting with these receptors.
2. Inhibition of Cancer Cell Growth: By blocking androgen receptor signaling, the drug slows down or stops the growth of prostate cancer cells.
3. Prevention of Metastasis: In patients with non-metastatic prostate cancer, Erleada helps delay the spread of cancer to other parts of the body.

This mechanism helps to control prostate cancer progression, especially in patients who are resistant to surgical or chemical castration therapies.

Side Effects

Like all medications, Erleada can cause side effects. These side effects may vary in severity, ranging from mild to more serious conditions.

Common Side Effects:

• Fatigue: Patients may experience unusual tiredness and fatigue.
• Hypertension: Increased blood pressure may occur.
• Rash: Some patients develop skin rashes, which may range from mild to moderate.
• Arthralgia: Joint pain is commonly reported.
• Diarrhea: Gastrointestinal upset, particularly diarrhea, may occur.

Serious Side Effects:

• Fractures: The risk of bone fractures is elevated, particularly in older patients.
• Seizures: Although rare, some patients may experience seizures due to Erleada’s effect on the nervous system.
• Cardiovascular Issues: Increased risk of heart attack, stroke, or other cardiovascular events.
• Hypothyroidism: Reduced thyroid function may occur, leading to hormonal imbalances.

It is important for patients to inform their healthcare provider about any side effects that occur, especially if they become severe or persistent.

Indications

Erleada is specifically used to treat certain forms of prostate cancer.

Approved Indications:

1. Non-Metastatic Castration-Resistant Prostate Cancer (nmCRPC): In men whose prostate cancer has not yet spread to other parts of the body but continues to grow despite castration therapy.
2. Metastatic Castration-Sensitive Prostate Cancer (mCSPC): In men whose prostate cancer has spread to other parts of the body but still responds to hormone therapy.

Contraindications

While Erleada is an effective treatment for prostate cancer, it is not suitable for everyone. Certain conditions and situations may contraindicate its use.

Contraindications:

1. Hypersensitivity to Apalutamide: Patients who have experienced severe allergic reactions to apalutamide or any of its components should not use Erleada.
2. Pregnancy: Erleada is contraindicated in pregnant women due to the risk of harm to the fetus. Although it is a prostate cancer medication, it can still pose a risk if a woman comes into contact with it.
3. Severe Liver Impairment: Patients with severe liver disease may not be able to metabolize the drug effectively, leading to potential toxicity.
4. Cardiac Conditions: Patients with a history of cardiovascular issues, such as recent heart attack or stroke, should exercise caution when using Erleada, as it may increase the risk of cardiovascular events.

Price in Different Countries

The price of Erleada varies significantly depending on the country and healthcare system. Below is a table showing the estimated price of Erleada in different countries.

Country	Price (Per Month Supply)	Reference
United States	$12,000 – $13,000	GoodRx
Canada	CAD $9,000 – $10,000	DrugBank
United Kingdom	£8,500 – £9,500	NHS UK
Australia	AUD $12,000 – $13,500	PBS Australia
India	INR ₹8,00,000 – ₹9,50,000	MedIndia

Top 5 Global Brands

There are several key pharmaceutical companies that are leading providers in the oncology and prostate cancer treatment landscape, including Erleada.

1. Janssen Pharmaceuticals (Johnson & Johnson)

• Janssen is the manufacturer of Erleada and a leader in innovative cancer treatments.

2. AstraZeneca

• AstraZeneca produces drugs such as Zoladex for prostate cancer and is a major player in oncology.

3. Pfizer

• Pfizer manufactures a range of cancer treatments, including Xtandi, another androgen receptor inhibitor used in prostate cancer.

4. Sanofi

• Sanofi is known for Jevtana, a chemotherapy drug used to treat prostate cancer that has spread and become resistant to other therapies.

5. Astellas Pharma

• Astellas is involved in prostate cancer treatments, including co-developing Xtandi with Pfizer.