Casodex

A nonsteroidal antiandrogen, Casodex (Bicalutamide) helps in blocking the effect of the male hormone testosterone in the body. This nonsteroidal antiandrogen in combination with another treatment helps in decreasing the amount of testosterone formed in the body in treating cancer of prostate gland in men.

Medications and Prescriptions

Generic name: Bicalutamide

Product Brand Name: Casodex ®

1. Description:

These Nonsteroidal antiandrogens are used for treating prostate gland’s cancer in males; and not in females. It works by blocking the effect of the male hormone testosterone in men’s body. When administered in combination with another treatment, it helps in reducing the amount of testosterone created in the body, thereby treating this cancer.

Available only with your doctor's prescription, these drugs comes in 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 following things are to be considered before using nonsteroidal antiandrogens.

Allergies— inform your doctor if you suffer from unusual or allergic reactions from nonsteroidal antiandrogens. Inform if you are allergic to any other substances like foods, preservatives or dyes.

3. Fertility

Nonsteroidal antiandrogens may lead to low sperm counts or may pave way to destroy a man's ability to father a child. It may cause permanent effects in some cases. Men who wish to father a child should inform their doctor before beginning the treatment.

Pregnancy —usually prescribed for men, if Nonsteroidal antiandrogens are needed by woman should be avoided during pregnancy. Since this drug can the effect of testosterone – the male hormone, it may affect 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 — As per the studies with the nonsteroidal antiandrogens, no specific information regarding the use of these drugs in children are so far reported. Howver, it is believed that a nonsteroidal antiandrogen can possibly hinder the development of boys. But, prostate gland cancer occurs usually in middle-aged or older men, so a child would not require these drugs.

Older adults—Nonsteroidal antiandrogens has not been reported to cause different side effects or problems in older and younger adults.

4. Race

Nilutamide comes with a serious side effect as it affects the lungs that occur more in Asian patients than in Caucasian patients. Even though certain medicines should never be used in combination, two different medicines can be used together even if an interaction occurs. Your doctor may change the dose, or advise some in cases of drug interactions. It is essential to inform your doctor if you are using these following medicines with nonsteroidal antiandrogen that includes:

Anticoagulants like warfarin (e.g. Coumadin), Bicalutamide, flutamide, or nilutamide that augments the effects of the anticoagulant. Blood test will be recommended by your doctor so as to change the dose of anticoagulant if necessary. Using Phenytoin like Dilantin or Theophylline like Theo-Dur; Theolai, Nilutamide may also boost the blood levels of these medicines in the body, thereby causing serious side effects. Inform your doctor if you smoke tobacco as it can increase the risk for a rare side effect of flutamide.

5. Other medical problems

Tell your doctor if you have other medical problems including blood deficiencies or disorders or Tobacco smoking, blood disorders, Increased risk of anemia, and jaundice Liver disease. Lung disease or other breathing problems will be worsened.

6. Proper Use of This Medicine

Use this drug exactly as prescribed by your doctor. Never take more or less, and not more often than your doctor has directed. The correct amount of medicine you require has been worked out carefully. Taking excess amount can augment the chance of side effects and taking too small in quantity will be effective to your condition. It is advised to take it same time each day. When directed to take the medicine once daily, taking it either in the morning or in the evening is recommended.

Take Bicalutamide and nilutamide with food or on an empty stomach. A nonsteroidal antiandrogen can be taken in combination with another medicine in the form of injection. Using the two medicines as directed is very important. When using these medicines, follow your doctor's instructions carefully.

Hot flashes, decreased sexual ability and other unwanted effects can occur during treatment for prostate cancer. Other symptoms occurring in men with prostate cancer are bloody urine, difficult or painful urination, and urinary tract infections. It may continue to occur for sometime until your condition begins to improve. It is important to continue to use the medicine, even if it causes adverse effects or if you begin to feel better. Never stop taking this medicine without consulting with your doctor.

In case you vomit with the initial dose of this medicine, talk with your doctor. You will be prescribed to use the dose again or to wait till the next scheduled dose.

7. Dosing

Different patients have different doses of medicine. Following your doctor's orders or the directions on the label is important. The following information includes only the average doses of these medicines. Do not change if your dose is different, unless your doctor tells you to do so.

The number of capsules or tablets taken depends on the strength of the medicine. it will also depend on factors like the number of doses you take each day, the length of time you take the medicine and the time allowed between doses.

For bicalutamide For the oral dosage form (tablets):

For prostate cancer:

Adults—50 milligrams (mg) (one tablet) once a day.

Children—bicalutamide would not be needed to treat cancer of the prostate in a child. In case it is needed, dose will be determined by the doctor. For flutamide For oral dosage forms (capsules or tablets):

For prostate cancer:

Adults—250 milligrams (mg) (two 125-mg capsules or one 250-mg tablet) every eight hours.

Children—flutamide would not be needed to treat cancer of the prostate in a child. If a it is needed, the dose would have to be determined by the doctor. For nilutamide

For the oral dosage form (tablets):

For prostate cancer:

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—in case of missing a dose, take it as soon as possible.

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. Never 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. Never double doses.

8. Storage

Store this medicine at places that are out of the reach of children. Store from heat and direct light. Never store in the bathroom, near the kitchen sink, or in other damp places as heat or moisture can cause the medicine to break down. Never keep outdated medicine or medicine no longer needed. Check if the discarded medicine is out of the reach of children.

9. Precautions While Using This Medicine

Check with your doctor on your progress with regular visits to make him known that the medicine is working properly and inform about the unwanted effects.

Nonsteroidal antiandrogens cause liver problems rarely during treatment. The most significant signs of side effects include pain or tenderness in the upper right side of the abdomen (stomach) and yellowing of eyes or skin. Inform your doctor immediately if either of these occurs. Also, tell with your doctor immediately if itching occurs or your urine appears strangely dark. Other possible symptoms are nausea, loss of appetite or vomiting, and “flu-like” symptoms (headache, muscle or joint pain, or tiredness. It can occur even if you are not suffering from any liver problems.These symptoms do not need medical attention usually. However, if two or more of them occur at the same time, and they last for more than a few days, check with your doctor even if you do not have any of the other symptoms mentioned earlier.

Check with your doctor right away for patients taking nilutamide if shortness of breath or difficult breathing occurs or gets worse during treatment. Be very cautious while driving, particularly when you drive into or out of tunnels. Nilutamide can change the way your eyes react to light temporarily. You may not be capable of seeing as usual for up to several minutes after going from bright light to darkness or from dark to lighted areas. Moreover, nilutamide can cause your eyes to be more sensitive to light than they are usually. You can reduce these effects by wearing eyeglasses with tinted lenses or sunglasses may help.

unwanted effects in some people may be caused by drinking alcoholic beverages while taking nilutamide may cause. Other side effects are lightheaded, feeling dizzy, or faint; flushing of the face; or a general feeling of illness. In case you notice any of these effects, avoid drinking any more alcoholic beverages while you are being treated with this medicine.

10. Side Effects of This Medicine:

In addition to these effects, some unwanted effects of this medicine are also reported. Although not all, if some of them occur they may need medical attention. Inform your doctor immediately if any of the following side effects occur: Less common Chest pain; shortness of breath or difficult or troubled breathing

Rare side effects are pain or tenderness in the upper right side of the abdomen (stomach) ; yellow eyes or skin. Also, inform your doctor immediately if any of the following side effects occur. Some more common side effects are cough or hoarseness; fever; runny nose; sneezing; sore throat; tightness in chest or wheezing. Less common side effects include: bloody or black, tarry stools; chills (flutamide only); numbness, tingling, itching; lower back or side pain (flutamide only); pain, or muscle weakness in hands, arms, feet, or legs; mental depression; skin rash; unusual tiredness or weakness swelling of face, fingers, feet, or lower legs; etc. Rare side effects are: dark urine; bluish-colored lips, fingernails, or palms of hands (flutamide only); dizziness (severe) or fainting (flutamide only); pinpoint red spots on skin; feeling of severe pressure in head (flutamide only); unusual bleeding or bruising etc. Some not so serious side effects may occur that vanish away during treatment as your body adjusts to the medicine. However, inform your doctor if any of the following side effects continue or are bothersome:

Some 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. Other less common side effects are gas, bloated feeling, or indigestion; confusion ; change in color vision (nilutamide only); drowsiness; “flu-like” symptoms, such as headache, dryness of mouth; muscle or joint pain, or tiredness (occurring together); vomiting nervousness; etc.

Not all of the side effects listed here have been reported for all of these medicines, at least one of them have been reported. However, since all nonsteroidal antiandrogens are very similar, it is possible that any of such side effects may occur with any of these medicines.

Moreover to the effects listed here, hot flashes (flushing, sudden sweating, and feeling of warmth) often occur with these medicines. Also, flutamide lead to an ambering of your urine or a yellow-green color. These effects are not dangerous and do not need medical attention. Other side effects not listed here may also occur in some patients. If you notice any other effects, inform with your doctor.

Before starting to take this medicine, it is vital that you should consult your doctor! Do not use it on your own initiative, without medical advice.

Casodex notes:

Sold with the brand name Bicalutamide, Casodex is a nonsteroidal antiandrogen which is used for treating cancer of the prostate gland. Nonsteroidal antiandrogens work by blocking the effect of the male hormone testosterone in the body and if given along with another treatment that decreases the amount of testosterone production provide another way of treating this type of cancer.

Nonsteroidal antiandrogens, and other treatments for prostate cancer are known to cause low sperm counts or otherwise lessens a man's ability to father a child. In some cases, these effects may be enduring.

Before begining on nonsteroidal antiandrogen, you should tell your doctor if you are taking any of the following medicines to avoid any unfavorable interactions. Anticoagulants including warfarin (e.g., Coumadin)—Bicalutamide, nilutamide or flutamide, may amplify the effects of the anticoagulant.

Inform your doctor about allergies or reactions you ever had to any nonsteroidal antiandrogens before using Casodex as any allergy to substances such as foods, preservatives or dyes should also be informed.

Some of the common side effects of Casodex medication are Cough or hoarseness; fever; runny nose;sneezing; wheezing or tightness in chest sore throat etc. Chills (flutamide only); Bloody or black, tarry stools; itching; mental depression; numbness, lower back or side pain (flutamide only); pain, tingling, or muscle weakness in hands, arms, feet, or legs; skin rash; unusual tiredness or weakness swelling of face, fingers, feet, or lower legs; etc are rare side effects.

It is vital to take correct dose of the medicine that your doctor has worked out for you. Patients should persist to take the medicine even if some side effects crop up or even if they start to feel better. Casodex should be kept away from heat, direct sunlight and moisture, away from the reach of the children.