I've been on Erleada since 2021 for bone-metastatic stage 4 prostate cancer, combined with androgen-deprivation therapy (ADT).

I've personally never heard of Erleada causing an initial testosterone (and perhaps, PSA) flare up. It is common for some types of ADT to trigger a flare: GnRH agonists like Lupron and Eligard do it, while ADT GnRH antagonists like Orgovyx and Firmagon do not.

My PSA was initially 67.9. Firmagon + Erleada reduced it to to 11.6 in under 3 weeks, and to undetectable in a couple more months (where it has remained for over 4 years). But every patient responds differently.