abiraterone vs enzalutamide
Side-by-side comparison of abiraterone and enzalutamide Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Zytiga
Xtandi
Abiraterone (Zytiga) is a medicine used with prednisone to treat prostate cancer that has spread. It works by lowering the amount of androgen your body makes.
Xtandi contains enzalutamide. It is used to treat prostate cancer that is resistant to certain treatments.
Abiraterone is used to treat prostate cancer that has spread to other parts of the body. It is for cancers that are castration-resistant, meaning they no longer respond to hormone therapy alone. It is also used for high-risk castration-sensitive prostate cancer. You will take this medicine with prednisone.
Xtandi is used to treat prostate cancer in men. It is for prostate cancer that keeps growing even when treated with hormone therapy or after surgery. Xtandi can treat prostate cancer that has spread or has not spread.
Abiraterone blocks an enzyme called CYP17, which your body needs to make androgens. Androgens can help prostate cancer grow. By blocking this enzyme, abiraterone lowers androgen levels and slows cancer growth.
Xtandi blocks the effect of hormones called androgens, like testosterone. Androgens can help prostate cancer cells grow. By blocking androgens, Xtandi can slow or stop the growth of prostate cancer.
- • Feeling tired
- • Joint pain
- • High blood pressure
- • Feeling sick to your stomach
- • Swelling
- • Muscle or joint pain
- • Feeling tired
- • Hot flashes
- • Constipation
- • Less hungry
- Death 1,390
- Feeling tired 1,022
- Hot flash 678
- Weakness 562
- Worsening of disease 561
- Feeling tired 10,159
- Death 7,667
- Cancer getting worse 5,409
- PSA level increased 4,295
- Weakness 4,120
Abiraterone can cause problems with mineralocorticoid excess, like high blood pressure, low potassium, and fluid retention. If you have heart problems, your doctor will monitor you closely. This medicine can also cause liver problems, which can be severe. Your doctor will check your liver function regularly. Do not take abiraterone with radium Ra 223 dichloride. Abiraterone can harm an unborn baby, so men should use effective birth control if their partner can get pregnant.
Xtandi can cause seizures. If you have a seizure while taking Xtandi, stop taking it permanently. Xtandi can also cause a condition called posterior reversible encephalopathy syndrome (PRES). If you experience PRES, stop taking Xtandi. Xtandi can harm an unborn baby, so men with partners who can get pregnant should use effective birth control during treatment and for 3 months after the last dose.
Abiraterone can cause harm to an unborn baby. Men who are taking abiraterone should use effective birth control during treatment and for 3 weeks after the last dose if their partner is able to get pregnant. It is not known if abiraterone passes into breast milk.
Xtandi is not for use in women. It can cause harm to an unborn baby if taken by a pregnant woman. Men who are taking Xtandi and have partners who can get pregnant should use effective birth control during treatment and for 3 months after the last dose.
How to Read This abiraterone vs enzalutamide Comparison
abiraterone is classified in the CYP17 Inhibitor drug class, while enzalutamide sits within the Androgen Receptor Inhibitor class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, abiraterone has 4,213 submissions while enzalutamide has 31,650. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between abiraterone and enzalutamide — always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.