Enzalutamide [Xtandi] & altered sense of Taste

[pjoshea13]

New study below [1].

We herein report two cases of enzalutamide-induced dysgeusia successfully treated by changing the timing of drug intake from morning intake to just before sleep.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/315...

Case Rep Oncol. 2019 Aug 6;12(2):589-594. doi: 10.1159/000502054. eCollection 2019 May-Aug.

Changing the Timing of Enzalutamide Intake from Morning to before Sleep at Night Overcame Enzalutamide-Induced Dysgeusia.

Kawahara T1, Miyoshi Y1, Yao M2, Uemura H1.

Author information

1

Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan.

2

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

Abstract

Dysgeusia is an adverse effect caused by enzalutamide said to affect 1-5% of patients. The reported management strategies include a temporary drug holiday, the prescription of herbal medicine, and changing the timing of enzalutamide intake from morning to before sleep at night. Case 1: A 72-year-old man developed castration-resistant prostate cancer (CRPC) and was administered enzalutamide. After six weeks of enzalutamide installation, he showed taste alternation, and consequently his dysgeusia increased to grade 2; we therefore changed the medicine intake time from morning to night just before sleep without dose reduction. Four weeks after changing the timing, his dysgeusia had improved. Case 2: A 63-year-old man had developed bone metastatic CRPC, so the combination of Ra-223 and enzalutamide (160 mg/body) was introduced. His serum PSA level had gradually decreased, but dysgeusia appeared, so we changed the timing of enzalutamide intake from morning to night just before sleep without dose reduction. One month after changing the timing, his dysgeusia had improved. We herein report two cases of enzalutamide-induced dysgeusia successfully treated by changing the timing of drug intake from morning intake to just before sleep.

KEYWORDS:

Dysgeusia; Enzalutamide; Taste alternation; Timing of intake; Xtandi

PMID: 31543773 PMCID: PMC6738168 DOI: 10.1159/000502054

[Alvin735]

Thanks for the post. I will be starting Xtandi next week and will take it right before bed.

[Kaliber]

From the beginning I can taste and smell my PCa , it’s in my nasalbuds and my mouth taste buds . When i take Xtandi daily , I can taste and smell the slightly kinda sticky sweet odor / flavor of Xtandi. Actually I kinda like it as a break over the acrid chemically cancer odors / flavors.

The cancer odor - taste is clearly mostly systemic and hitting my buds via my bloodstream .... on the other hand, while there is also a systemic component to Xtandi, I mostly notice it externally in my sweaty - sticky armpits , crotch and rectal areas. The cancer odor is especially prominent when I urinate or poop tho. ( tmi, too much information ? )

I’ve had exceptional buds since a young child and in another lifetime could probably have been a professional food critic ... maybe it’s also possible that others have some element of unusually sensitive buds as well and that could figure in .

[Blackpatch in reply to Kaliber]

Hello Kaliber

That’s a very interesting set of observations - I too have always had a very keen sense of smell, and in fact believe that I can smell the difference between haematite and goethite, the two most common naturally occurring iron oxides.

Anyway, since starting zyitga and pred plus goserelin, I have definitely had a strong sickly sweet smell in my nose almost constantly - the PSA is undetectable, so I figure it has to be one of the drugs.

Stuart

[Kaliber in reply to Blackpatch]

We have pebble tek interior hallway floor coverings and definitely fine granite gravel has a distinctive odor and not a particularly nice one too Yayahahaha.

It’s hard to say if the drugs actually have the “ flavor “ or if it’s due to such a radical change in body chemistry. My guess it’s actually the drugs. Others I know say they get a similar thing with prednisone too. Seems like most people, tho, don’t notice any of this. Interesting.

Hang in there brother