Understanding Nubeqa (Darolutamide): How This Prostate Cancer Treatment Works

When your oncologist prescribes Nubeqa (darolutamide) for prostate cancer, it’s natural to have questions. How does this medication actually work? Why this drug instead of others? What should I expect?

Understanding your treatment can make a real difference — not just in how you take your medication, but in how you feel about your care. This guide breaks down everything you need to know about Nubeqa in plain language, including a video that explains the science in a simple, visual way.

“Patients who understand how their medication works tend to be more engaged in their treatment and better at managing their care,” says Julia Kravtsova, PharmD, Head Patient Navigator at QuickRx Specialty Pharmacy. “Nubeqa works in a fascinating way, and once patients understand the ‘lock and key’ concept, the whole treatment makes more sense.”

Watch: Darolutamide Explained (Video Guide)

Before we dive into the details, watch this short video that explains how darolutamide (Nubeqa) works to fight prostate cancer. It covers the key concepts in an easy-to-understand visual format.

Video Summary: This guide covers the basics of darolutamide, how it uses a “lock and key” mechanism to stop cancer growth, proper dosing instructions, potential side effects, and important questions to discuss with your healthcare team.

What Is Nubeqa (Darolutamide)?

Nubeqa is the brand name for darolutamide, an oral medication that belongs to a class of drugs called androgen receptor inhibitors. It was approved by the FDA on July 30, 2019, specifically to treat certain types of advanced prostate cancer.

FDA-Approved Uses for Nubeqa:

• Non-metastatic castration-resistant prostate cancer (nmCRPC): Prostate cancer that is still responding to hormone-lowering treatment but is at high risk of spreading
• Metastatic castration-sensitive prostate cancer (mCSPC): Prostate cancer that has spread to other parts of the body but still responds to hormone therapy — can be used alone or with docetaxel chemotherapy

In both cases, Nubeqa is used alongside androgen deprivation therapy (ADT) — meaning you’ll also be receiving treatment to lower your testosterone levels (through medication or surgery).

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The Lock and Key: How Nubeqa Fights Prostate Cancer

Here’s the concept that makes Nubeqa’s mechanism of action easy to understand:

The Lock

Prostate cancer cells have special proteins on their surface called androgen receptors. Think of these as locks. When these locks are activated, they send signals telling the cancer cell to grow and multiply.

The Key

Testosterone (and other androgens) act as keys. When testosterone fits into the androgen receptor “lock,” it activates the receptor and triggers the cancer cell to grow. This is why prostate cancer is often called a “hormone-driven” cancer — it needs testosterone to fuel its growth.

The Block

This is where Nubeqa comes in. Darolutamide acts as a plug that fits into the androgen receptor lock before testosterone can get there. It blocks the lock so the testosterone key can’t enter.

The result? The growth signal is cut off. Without that signal, cancer cells slow down or stop multiplying — and may even die (a process called apoptosis).

Why This Matters for Your Treatment

You might wonder: “If I’m already on hormone therapy that lowers my testosterone, why do I need Nubeqa too?”

Great question. Even when testosterone levels are very low (from ADT), there’s often still enough hormone activity to stimulate cancer growth. Nubeqa provides an additional layer of protection by blocking the receptors directly — even if small amounts of testosterone are still present.

This is why Nubeqa combined with ADT has been shown to significantly extend the time before cancer progresses, compared to ADT alone.

Who Is Nubeqa For? Understanding nmCRPC and mCSPC

Prostate cancer treatment involves a lot of abbreviations. Let’s decode them:

Non-Metastatic Castration-Resistant Prostate Cancer (nmCRPC)

• Non-metastatic: The cancer has NOT spread to other parts of your body (confirmed by scans)
• Castration-resistant: The cancer is growing even though testosterone levels are very low (from ADT)
• High-risk: Your PSA levels suggest the cancer could spread soon

For nmCRPC, Nubeqa has shown impressive results. In the ARAMIS clinical trial, patients taking Nubeqa had a median metastasis-free survival of 40.4 months compared to just 18.4 months for those on placebo. That’s more than double the time before the cancer spread.

Metastatic Castration-Sensitive Prostate Cancer (mCSPC)

• Metastatic: The cancer HAS spread to other parts of your body (like bones or lymph nodes)
• Castration-sensitive: The cancer still responds to hormone-lowering therapy

For mCSPC, Nubeqa can be used alone or combined with docetaxel chemotherapy. Clinical trials have shown improved overall survival when Nubeqa is added to standard treatment.

How to Take Nubeqa Correctly

Taking Nubeqa correctly is crucial for it to work effectively. Here’s what you need to know:

Dosing

• Standard dose: 600mg twice daily
• What that looks like: Two 300mg tablets, taken together, twice a day
• Schedule: Approximately 12 hours apart (example: 8am and 8pm) to maintain steady levels

Critical: Take With Food

This isn’t optional — it’s essential. Taking Nubeqa with food increases absorption by 2 to 2.5 times. Without food, you’re not getting the full benefit of your medication. Take it with a meal or substantial snack.

Swallow Tablets Whole

Never crush, chew, or break Nubeqa tablets. Swallow them whole with water.

What If You Miss a Dose?

• Take it as soon as you remember
• Unless it’s almost time for your next scheduled dose
• If it’s nearly time for the next dose, skip the missed one
• Never double up to make up for a missed dose

“Setting phone alarms for your doses can be a game-changer,” suggests Julia Kravtsova, PharmD. “Consistency is key with Nubeqa, and most patients find twice-daily medication easier to remember than they expected.”

What to Expect During Treatment

How Long Will You Take Nubeqa?

Nubeqa is a long-term treatment. You’ll continue taking it until your cancer progresses or you experience side effects that your doctor considers unacceptable. Many patients take Nubeqa for months or even years.

Monitoring During Treatment

Your healthcare team will regularly monitor:

• PSA levels: To track how well the cancer is responding
• Liver function: Blood tests to check liver enzymes
• Cardiovascular health: Especially if you have heart risk factors
• Imaging scans: To check if the cancer has spread or changed

Common Side Effects

Most patients tolerate Nubeqa well, but you may experience:

• Fatigue and weakness (16% of patients)
• Urinary tract infections (12% of patients)
• Skin rash (4% of patients)
• Pain in arms and legs (6% of patients)

For a detailed guide on managing side effects, read our article: Nubeqa Side Effects: The Good, The Bad, and What to Actually Expect

Questions to Ask Your Doctor

Be an active participant in your care. Consider asking:

• Why is Nubeqa the right choice for my specific situation?
• What other medications or supplements should I avoid?
• What side effects should prompt me to call you?
• How will we know if the treatment is working?
• What happens if my cancer progresses?

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Frequently Asked Questions About Nubeqa Treatment

How long does it take for Nubeqa to start working?

Nubeqa begins working immediately at the cellular level, but you won’t “feel” it working. Your doctor will monitor your PSA levels and imaging scans to assess how well the treatment is controlling your cancer. Significant effects on PSA and disease progression are typically measured over weeks to months.

Is Nubeqa a chemotherapy drug?

No, Nubeqa is not chemotherapy. It’s an androgen receptor inhibitor — a type of hormone therapy that blocks testosterone from stimulating cancer growth. It works differently than chemotherapy drugs and generally has a different side effect profile. However, Nubeqa can be combined with docetaxel chemotherapy for mCSPC.

Can Nubeqa cure prostate cancer?

Nubeqa is not a cure for prostate cancer. It’s a treatment that can slow or stop cancer progression, potentially for months or years. Clinical trials have shown that Nubeqa significantly extends the time before cancer spreads (for nmCRPC) and improves overall survival (for mCSPC).

Why do I need to take Nubeqa with food?

Taking Nubeqa with food increases its absorption by 2 to 2.5 times. Without food, your body absorbs much less of the medication, which means you’re not getting the full therapeutic benefit. Always take your doses with a meal or substantial snack.

What’s the difference between Nubeqa and other prostate cancer drugs like Xtandi or Erleada?

Nubeqa (darolutamide), Xtandi (enzalutamide), and Erleada (apalutamide) are all androgen receptor inhibitors used for similar types of prostate cancer. Nubeqa has low blood-brain barrier penetration, which may result in fewer central nervous system side effects. Your oncologist will recommend the best option based on your specific situation, other health conditions, and potential drug interactions.

Can I travel while taking Nubeqa?

Yes, you can travel while taking Nubeqa. Keep your medication in its original container, bring enough for your trip plus extra in case of delays, and maintain your twice-daily schedule (adjust for time zones if needed). Store tablets at room temperature and avoid extreme heat.

What happens if I need surgery while on Nubeqa?

Inform your surgical team that you’re taking Nubeqa. Your oncologist will advise whether you need to temporarily stop the medication before surgery. Don’t make any changes to your medication without consulting your healthcare team.

Does Nubeqa interact with supplements or herbal products?

Yes, Nubeqa can interact with various supplements and herbal products. St. John’s Wort, for example, can decrease Nubeqa’s effectiveness. Always tell your healthcare team about everything you take — including vitamins, supplements, and herbal products.

How is Nubeqa different from hormone therapy (ADT)?

Androgen deprivation therapy (ADT) works by lowering testosterone levels in your body. Nubeqa works by blocking testosterone from attaching to cancer cells — even the small amounts that remain after ADT. They work together: ADT reduces testosterone, and Nubeqa blocks whatever testosterone is left from reaching cancer cells.

Is financial assistance available for Nubeqa?

Yes! QuickRx Specialty Pharmacy offers free copay assistance services. We help patients access manufacturer copay cards, patient assistance programs, and foundation grants depending on their insurance status. Call (917) 830-2525 or visit our Nubeqa copay assistance page to get started.

References

1. Nubeqa (darolutamide) Prescribing Information. U.S. Food and Drug Administration.
2. Fizazi K, et al. Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer. N Engl J Med. 2019.
3. National Cancer Institute. Prostate Cancer Treatment (PDQ) – Patient Version.
4. American Cancer Society. Treating Prostate Cancer.
5. Mayo Clinic. Darolutamide (Oral Route) – Description.
6. Prostate Cancer Foundation. Patient Resources.
7. MedlinePlus. Darolutamide.
8. UpToDate Clinical Drug Information Database (LexiDrug). Darolutamide Monograph. Accessed January 2026.

This information is not intended to replace professional medical advice. Always consult your oncologist or pharmacist for guidance about your specific prostate cancer treatment. For questions about Nubeqa copay assistance, contact QuickRx Specialty Pharmacy at (917) 830-2525.