bicalutamide, Casodex

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GENERIC NAME: bicalutamide


DRUG CLASS AND MECHANISM: Bicalutamide is an oral medication that is used for treating cancer of the prostate. It belongs to a class of drugs called anti-androgens which includes flutamide (Eulexin) and nilutamide (Nilandron). Androgens (an example of which is testosterone) are hormones that are produced and released by the adrenal glands. They are responsible for supporting (stimulating) tissues that primarily are thought of as male, for example, the male prostate gland. Male traits that also are influenced by androgens include facial and body hair, and small breasts. Anti-androgens prevent the action of androgens by blocking the receptors for androgens on the cells of tissues, for example, the cells of the prostate gland. In addition to normal prostate cells, androgens also have been shown to stimulate the growth of cancer cells within the prostate. Bicalutamide is thought to prevent the growth of prostate cancer by blocking the effects of androgens on the cancer cells. Bicalutamide was approved by the FDA in 1995.



PREPARATIONS: Tablet: 50 mg.

STORAGE: Bicalutamide should be stored at room temperature, 15 C to 30 C(59 F to 86 F).

PRESCRIBED FOR: Bicalutamide is used in combination with another medication, a luteinizing hormone-releasing hormone (LHRH) analog, to treat advanced prostate cancer.

DOSING: Bicalutamide should be taken as one 50 mg tablet in the morning or evening at the same time each day. It may be taken with or without food. Once bicalutamide therapy has begun, it should not be interrupted or stopped without consulting a physician.

DRUG INTERACTIONS: Bicalutamide may interact with warfarin (Coumadin). Therefore, the dose of warfarin may need to be adjusted, and the ability of blood to clot should be closely monitored.

Bicalutamide reduces the activity of liver enzymes that breakdown certain drugs, for example, midazolam (Versed). Such combinations should be avoided if possible.

PREGNANCY: Bicalutamide is not used for treating women.

NURSING MOTHERS: Bicalutamide is not used for treating women.

SIDE EFFECTS: When bicalutamide and an LHRH analog are given together, the most common side effect is hot flashes (50% of patients) and facial flushing. Alcohol may worsen this reaction, and so it should be cautiously consumed. Other common side effects of the combination are infections, water retention, anemia diarrhea, constipation and overall pain including pain in the back, hips, and stomach. LHRH analogs may increase blood glucose and worsen diabetes. Less common side effects are breast enlargement and breast pain, which may be due to the bicalutamide alone.

Reference: FDA Prescribing Information

Medically Reviewed by a Doctor on 11/16/2012

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