Casodex (bicalutamide) Side Effects, Warnings, and Drug Interactions

Casodex (bicalutamide) is an anti-androgen used to treat prostate cancer.

Androgens (for example, testosterone) are hormones produced and released by the adrenal glands. They are responsible for supporting (stimulating) tissues that primarily are thought of as male such as the 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. Casodex is thought to prevent the growth of prostate cancer by blocking the effects of androgens on the cancer cells. 

Common side effects of Casodex include:

• hot flashes,
• facial flushing,
• infections,
• water retention,
• anemia,
• diarrhea,
• constipation,
• overall pain,
• and pain in the back, hips, and stomach.

Serious side effects of Casodex include:

• increased blood glucose and
• worsening diabetes.

Drug interactions of Casodex include anticoagulants and CYP3A4 substrates. Casodex is not indicated for use in women so is unlikely to be used during pregnancy or while breastfeeding.

Common side effects of Casodex include:

• hot flashes,
• facial flushing,
• infections,
• water retention,
• anemia,
• diarrhea,
• constipation,
• overall pain,
• and pain in the back, hips, and stomach.

Serious side effects of Casodex include:

• increased blood glucose and
• worsening diabetes.

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,
• 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.

Bicalutamide is not used for treating women.

Drug interactions of Casodex include:

• anticoagulants and
• CYP3A4 substrates.