Bicalutamide
Indications
Bicalutamide is an anti-androgen medicine used to treat prostate cancer in men. It is used together with a hormone treatment that lowers testosterone (an LHRH analogue or surgical removal of the testicles) for advanced prostate cancer, and in some cases on its own for locally advanced prostate cancer.
How It Works
Many prostate cancers need male hormones (androgens) such as testosterone to grow. Bicalutamide attaches to androgen receptors on the cancer cells and blocks testosterone from acting on them. This slows or stops the growth of the cancer. When started together with LHRH treatment, it also prevents a short-term "flare" of the cancer that can occur when that treatment begins.
Dosage and Administration
This is a cancer medicine, so take it exactly as prescribed by your specialist; the dose depends on whether it is used alone or with other hormone treatment. It is taken by mouth once a day, at about the same time each day, with or without food. Swallow the tablet whole with water. Do not stop taking it without speaking to your doctor.
Interactions
- Warfarin and other coumarin anticoagulants: stronger blood-thinning effect; INR should be checked closely.
- Medicines broken down by CYP3A4, such as Ciclosporin, some calcium channel blockers (for example Nifedipine) and certain statins: levels may rise.
- Terfenadine, Astemizole and Cisapride: should not be used together.
- Medicines that prolong the QT interval on the heart tracing (such as some antiarrhythmics, Methadone, Moxifloxacin, antipsychotics): increased risk of heart rhythm problems.
Contraindications
Not for use in women or children. Do not use if you are allergic to bicalutamide or any ingredient, or together with Terfenadine, Astemizole or Cisapride.
Side Effects
- Breast tenderness and breast enlargement (gynaecomastia).
- Hot flushes.
- Tiredness, weakness, dizziness.
- Nausea, constipation, diarrhoea, stomach pain.
- Reduced sex drive and erection problems.
- Anaemia, rash, itching, weight gain, swelling of hands or feet.
- Changes in liver tests; rarely, serious liver injury.
Get urgent medical help for yellow skin or eyes, dark urine or severe stomach pain (possible liver problems), new or worsening shortness of breath or cough with fever (rare lung inflammation), chest pain, fainting or a very irregular heartbeat, or a severe allergic reaction.
Pregnancy and Lactation
Bicalutamide is not used in women and must not be taken by women who are pregnant or breastfeeding, as it may harm a male baby's development. Men should use effective contraception with a partner who could become pregnant during treatment and for some time afterwards, as advised by the doctor.
Precautions and Warnings
Your doctor will check liver function regularly, especially in the first months, and may check blood counts and heart tracing (ECG). Tell your doctor about liver disease, heart problems or a family history of heart rhythm problems, and diabetes (hormone treatment can affect blood sugar). It may reduce fertility. It can cause sleepiness; take care when driving.
Overdose
There is limited experience of overdose. Seek medical help; treatment is supportive.
Therapeutic Class
Non-steroidal anti-androgen (hormonal anticancer agent).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Women who are or may become pregnant should avoid handling broken tablets.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Bicalutamide