Casodex (Bicalutamide) is a nonsteroidal antiandrogen that blocks the effect of the male hormone testosterone in the body. Nonsteroidal antiandrogen is used in combination with another treatment that reduce the amount of testosterone produced in the body is one way of treating this type of cancer.
Medications and Prescriptions
Generic name: Bicalutamide
Product Brand Name: Casodex ®
1. Description: Nonsteroidal antiandrogens help in treating cancer of the prostate gland that is present only in males; therefore, females do not get prostate cancer. Nonsteroidal antiandrogens hinder the effect of the male hormone testosterone in the body. Together with another treatment, nonsteroidal antiandrogen that decreases the amount of testosterone produced in the body is one way of treating this type of cancer.
Bicalutamide is available with doctor's prescription only in the following dosage form(s):
Oral Bicalutamide Tablets (U.S. and Canada)Flutamide Capsules (U.S.) Tablets (Canada) Nilutamide Tablets (U.S. and Canada)
2. Before Using This Medicine: the risks of taking the medicine must be weighed before deciding to use a medicine against the good it will do. You and your doctor should make this decision. The following should be considered for the nonsteroidal antiandrogens,:
Allergies—inform your doctor if you ever have had any unusual or allergic reaction to any of the nonsteroidal antiandrogens. Also consult your doctor if you are allergic to any other substances like foods, preservatives, or dyes.
3. Fertility: for prostate cancer when used together, Nonsteroidal antiandrogens and other treatments lead to low sperm counts or otherwise decrease a man's ability to father a child. These effects may be permanent in some cases. Men who wish to have children should talk about this with their doctors before opening treatment.
Pregnancy— typically given to men, Nonsteroidal antiandrogens can sometimes be needed for woman. In such case, avoid pregnancy during treatment as these drugs can block the effect of the male hormone, testosterone and may interfere with the normal development of a male fetus.
Breast-feeding—Nonsteroidal antiandrogens are usually given to men, and it is not known whether any of these medicines passes into breast milk. However, nonsteroidal antiandrogens can cause serious side effects. Therefore, if a woman needs one of these medicines, she should not breast-feed during treatment.
Children—Studies have been done only in adults with the nonsteroidal antiandrogens, and no specific information comparing the use of these medicines in children is available with use in other age groups. Some times nonsteroidal antiandrogen could hinder with the development of boys. On the other hand, cancer of the prostate gland happens usually in middle-aged or older men, therefore it is very unlikely that a child would need these drugs.
Older adults— Being tested in elderly people, Nonsteroidal antiandrogens have not been reported to cause different side effects or problems than in younger adults.
4. Race A chronic side effect of nilutamide that that occur in Asian patients than in Caucasian patients is its effect towards the lungs. Other drugs—even though some medicines should not be used at all in combination, in other cases two different medicines can be combined even if an interaction occurs. In such cases, your doctor can change the dose, or other precautions may be required. It is important especially for your health care professional to know if you are taking any of the following medicines when taking a nonsteroidal antiandrogen,:
Anticoagulants like warfarin (e.g., Coumadin)—Bicalutamide,
5. Other medical problems: use of nonsteroidal antiandrogens cause some other medical problems. Tell your doctor if you have any other medical problems, particularly: some kind of blood deficiencies or disorders or Tobacco smoking, increased risk of anemia, other blood disorders, and jaundice Liver disease. The risk for Lung disease or other breathing problems are also reported. The effect of nilutamide can worsen your condition and your doctor may want to suggest a different antiandrogen.
6. Proper Use of This Medicine: use this medicine accurately as suggested by your doctor. Avoid taking more or less of it, and do not take it more often than your doctor ordered. The correct amount of medicine you require has been carefully checked out. Taking excess amount may amplify the risk of side effects and taking low amount will not improve your condition.
It is recommended to take the drug same time each day. You may take it either in the morning or in the evening if you have been directed to take the medicine once a day.
You may take Bicalutamide and nilutamide with food or on an empty stomach. Often used together with another medicine, a nonsteroidal antiandrogen is given by injection. Use it as directed. Carefully follow the instructions of your doctor about when to use these medicines.
Unpleasant side effects such as hot flashes and decreased sexual ability may take place during treatment for prostate cancer. Also, difficult or painful urination, bloody urine, and urinary tract infections are other symptoms that often occur in men with prostate cancer, including, may occur or continue to occur for a while, until your condition starts to improve. It is very important that you continue to take the medicine, even if it causes side effects or if you start to feel better. Never stop taking this medicine without first checking with your doctor. When you vomit after taking a dose of this medicine shortly, talk with your doctor. You will be suggested to take the dose again or to wait until the next scheduled dose.
7. Dosing: The doses of these medicines will vary from patients to patients. Pursue your doctor’s orders or the directions on the label. The following information includes only the average doses of these medicines. If your dosage is different, do not modify it unless your doctor tells you to do so. The number of capsules or tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on which of these medicines you are taking.
For bicalutamide For the oral dosage form (tablets):
Adults—50 milligrams (mg) (one tablet) once a day.
Children—It is unlikely that bicalutamide would be needed to treat cancer of the prostate in a child. If a child needs this medicine, the dose would have to be determined by the doctor. For flutamide For oral dosage forms (capsules or tablets):
Adults—250 milligrams (mg) (two 125-mg capsules or one 250-mg tablet) every eight hours.
Children—It is unlikely that flutamide would be needed to treat cancer of the prostate in a child. If a child needs this medicine, the dose would have to be determined by the doctor. For nilutamide
For the oral dosage form (tablets):
Adults—300 milligrams (mg) (six 50-mg tablets) once a day for the first thirty days, then 150 mg (three 50-mg tablets) once a day.
Children—It is unlikely that nilutamide would be needed to treat cancer of the prostate in a child. If a child needs this medicine, the dose would have to be determined by the doctor.
Missed dose— Take it as soon as possible if you miss a dose of this medicine. For bicalutamide or nilutamide: skip the missed dose and go back to your regular dosing schedule if you do not remember your missed dose until the next day,. Do not double doses. For flutamide: skip the missed dose and go back to your regular dosing schedule if it is almost time for your next dose. Avoid taking double doses.
8. Storage: store out of the reach of children and away from heat and direct light and not in the bathroom, near the kitchen sink, or in other damp places as heat or moisture may cause the medicine to break down. Avoid keeping outdated medicine or medicine no longer desirable. Make sure if any discarded medicine is out of the reach of children.
9. Precautions: It is very imperative that your doctor ensure your progress at regular visits while using this medicine to make sure that this medicine is working properly and to verify for unwanted effects. During treatment, Nonsteroidal antiandrogens rarely cause liver problems. The most significant symptoms of this side effect are pain or tenderness in the upper right side of the abdomen (stomach) and yellow eyes or skin. Inform your doctor immediately if either of these occurs. Also, consult your doctor if itching occurs or your urine appears unusually dark as soon as possible. Other likely symptoms include: loss of appetite, flu-like” symptoms (headache, muscle or joint pain), nausea or vomiting, and “or tiredness even if you are not having any liver problems.
These signs do not need medical attention usually. However, if two or more of them occur at the same time, and they stays for more than a few days, check with your doctor even if you do not have any of the other symptoms mentioned earlier. For patients taking nilutamide: consult your doctor if shortness of breath or difficult breathing occurs right away or gets worse during treatment. While driving be very careful, particularly when you drive into or out of tunnels. Nilutamide can temporarily change the way your eyes react to light. You may not be capable to see as well as usual for up to several minutes after going from bright light to darkness or from dark to lighted areas. Also, nilutamide can lead to damage to your eyes or make your eyes more sensitive to light than they are normally. Wearing eyeglasses with tinted lenses or sunglasses may help lessen these effects.
Alcoholic beverages should be avoided while taking nilutamide may cause unwanted effects in some people. Other effects are flushing of the face; feeling dizzy, lightheaded, or faint; and general feeling of illness. Do not drink any more alcoholic beverages if you notice any of these effects, while being treated with this drug.
10. Side Effects of This Medicine: A medicine may cause some unwanted effects along with its good effects. Even though not all of these side effects may take place, they may need medical attention if they do occur. Inform your doctor if any of the following side effects occur immediately. Less common effects are: shortness of breath, Chest pain; or difficult or troubled breathing. Rare ones are: pain or tenderness in the upper right side of the abdomen (stomach) and yellow eyes or skin.Also, consult your doctor if any of the following side effects occur as soon as possible.
More common side effects are: fever; cough or hoarseness, sneezing; runny nose; sore throat; tightness in chest or wheezing etc. Bloody or black, tarry stools; itching; chills (flutamide only); pain, lower back or side pain (flutamide only); numbness, mental depression; tingling, or muscle weakness in hands, arms, feet, or legs; swelling of face, fingers, feet, or lower legs; skin rash; unusual tiredness or weakness etc are less common ones. Rare effects include: dark urine; bluish-colored lips, fingernails, or palms of hands (flutamide only); feeling of severe pressure in head (flutamide only); dizziness (severe) or fainting (flutamide only); pinpoint red spots on skin and unusual bleeding or bruising.
Other effects may occur that usually do not require medical attention. These side effects may leave during treatment as your body adjusts to the medicine. However, consult your doctor if any of the following side effects continue or are troublesome. Some other more common side effects are: decrease in or loss of appetite; constipation; diarrhea; headache; dizziness; impotence or decrease in sexual desire; swelling of breasts with pain or tenderness; nausea; trouble in sleeping etc. tiredness (occurring together); bloated feeling, gas, or indigestion; nervousness; vomiting change in color vision (nilutamide only); drowsiness; dryness of mouth; confusion and“flu-like” symptoms, such as headache, muscle or joint pain are less common.
Even though not all of the side effects listed here have been accounted for all of these medicines, at least one of them has been reported. Still, as all nonsteroidal antiandrogens are very alike, it is possible that any of the above side effects may happen with any of these medicines. Hot flashes (flushing, sudden sweating, and feeling of warmth are additional side effects that occur during treatment with this medicine. Also, flutamide may make your urine to have amber or a yellow-green color. These effects are risk-free and do not call for medical attention. Other side effects not listed above may also occur in some patients. If you observe any other effects, talk to your doctor.
Be cautious before begining to take this medicine as it is vital that you should consult your doctor. Avoid taking at your own initiative, without medical advice.
Casodex notes:
The nonsteroidal antiandrogen Casodex, is available in brand name of Bicalutamideand is used to cure cancer of the prostate gland. They obstruct the effect of the male hormone testosterone in the body and if given along with another treatment that decreases the amount of testosterone production and is used as the best option for treating this type of cancer. Nonsteroidal antiandrogens, and other treatments for prostate cancer are decrease the sperm counts and decrease the man's ability to father a child. The effects may be permanent in some cases.
Before beginning with the nonsteroidal antiandrogen, consult your doctor if you are taking other medicines to evade any adverse interaction. Avoid using like warfarin (e.g., Coumadin)—Bicalutamide, nilutamide or flutamide as it may increase the effects of the anticoagulant. You should talk to your doctor for any allergies or reactions you ever had to any nonsteroidal antiandrogens prior to using this medication. Allergies to substances such as foods, preservatives or dyes should also be told.
Some common side effects are: cough or hoarseness; fever; runny nose; sneezing; or wheezing tightness in chest sore throat; are some of the side effects of Casodex medication. Whereas, some relatively rare side effects are: itching; bloody or black, tarry stools; chills (flutamide only); mental depression; lower back or side pain (flutamide only); numbness, tingling, pain, unusual tiredness or weakness or muscle weakness in hands, arms, feet, or legs; skin rash; swelling of face, fingers, feet, or lower legs etc.
Taking exact dose of the medicine that your doctor has worked out for you is important. You should continue taking the medicine even if some side effects emerge or even if they start to feel better. You should store Casodex away from heat, direct sunlight and moisture, away from the reach of the children.
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