Apalutamide Side Effects

Common Adverse Events

The American Urological Association notes that fatigue is a common side effect of apalutamide, occurring in 30.4% of patients compared to 21.1% in the placebo group 1, 2
Hypertension is a common adverse event associated with apalutamide, with an incidence of 24.8% compared to 19.8% in the placebo group 1, 3
Rash is a common side effect of apalutamide, occurring in 23.8% of patients compared to 5.5% in the placebo group 1, 3
Diarrhea is a common adverse event associated with apalutamide, with an incidence of 20.3% compared to 15.1% in the placebo group 1, 3
Nausea is a common side effect of apalutamide, occurring in 18.1% of patients compared to 15.8% in the placebo group 1, 3
Weight loss is a common adverse event associated with apalutamide, with an incidence of 16.1% compared to 6.3% in the placebo group 1, 3
Arthralgia is a common side effect of apalutamide, occurring in 15.9% of patients compared to 7.5% in the placebo group 1, 3
Falls are a common adverse event associated with apalutamide, with an incidence of 15.6% compared to 9.0% in the placebo group 1, 3

Dizziness is a known side effect of apalutamide, occurring in 9.3% of patients compared to 6.3% in the placebo group 1, 3
Mental-impairment disorders are a side effect of apalutamide, occurring in 5.1% of patients compared to 3.0% in the placebo group 1, 3
Seizure is a rare side effect of apalutamide, occurring in 0.2% of patients compared to 0% in the placebo group 1, 3

If a patient on apalutamide reports double vision, consider that this may be an uncommon or unreported side effect 3
The American Academy of Ophthalmology recommends evaluating patients with diplopia for other potential causes, as it has many neurological and ophthalmological etiologies 4
Consider whether dizziness, a known side effect of apalutamide, might be contributing to visual disturbances 3
Document the onset, pattern, and severity of diplopia in patients experiencing visual disturbances while on apalutamide 4
Perform a complete ophthalmological examination to rule out other causes of diplopia in patients on apalutamide 4
Consider temporary dose reduction or discontinuation of apalutamide if symptoms of diplopia are severe 3
Monitor for improvement after medication adjustment in patients with diplopia on apalutamide 3