bicalutamide (Oral route)

Pronunciation

bye-ka-LOO-ta-mide

Commonly used brand name(s)

In the U.S.

  • Casodex

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antiandrogen

Uses For bicalutamide

Bicalutamide is used together with another medicine to treat stage D metastatic prostate cancer (cancer that has spread) in men. Bicalutamide belongs to the group of medicines called antiandrogens. It works by blocking the effects of testosterone (a male hormone), which helps stop the growth and spread of cancer cells. Bicalutamide will always be given together with a luteinizing hormone-releasing hormone (LHRH) analog (e.g., goserelin or leuprolide).

Slideshow: Flashback: FDA Drug Approvals 2013

bicalutamide is available only with your doctor's prescription.

Before Using bicalutamide

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For bicalutamide, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to bicalutamide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of bicalutamide in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of bicalutamide in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters X Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking bicalutamide, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using bicalutamide with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acenocoumarol
  • Amiodarone
  • Dicumarol
  • Domperidone
  • Fentanyl
  • Phenprocoumon
  • Piperaquine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of bicalutamide. Make sure you tell your doctor if you have any other medical problems, especially:

  • Diabetes or
  • Liver disease (including hepatitis)—Use with caution. May make these conditions worse.

Proper Use of bicalutamide

Take bicalutamide only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

bicalutamide usually comes with a patient information leaflet. Read it carefully and make sure you understand it before taking bicalutamide. If you have any questions, ask your doctor.

It is best to take bicalutamide at the same time each day. If you have been directed to take the medicine once a day, you may take it either in the morning or in the evening.

bicalutamide should be started at the same time as treatment with a luteinizing hormone-releasing hormone (LHRH) analog (such as goserelin, leuprolide, Lupron®, or Zoladex®). Do not stop taking these medicines without checking with your doctor first.

You may take bicalutamide with food or on an empty stomach.

Dosing

The dose of bicalutamide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of bicalutamide. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine 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 the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For prostate cancer:
      • Adults—50 milligrams (mg) once a day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of bicalutamide, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using bicalutamide

It is very important that your doctor check your progress at regular visits to make sure that bicalutamide is working properly. Blood tests may be needed to check for unwanted effects.

Women who are pregnant or may become pregnant should not use bicalutamide tablets. Bicalutamide may cause harm in unborn babies.

Liver problems may occur while you are taking bicalutamide. Stop using bicalutamide and check with your doctor right away if you are having more than one of these symptoms: clay-colored stools; dark urine; fever; headache; loss of appetite; nausea and vomiting; pain or tenderness in the upper right side of the stomach; unusual tiredness or weakness; or yellow eyes or skin.

bicalutamide may cause swelling of the breasts (gynecomastia) and breast pain in some patients. If you have questions about this, talk to your doctor.

Using bicalutamide with an LHRH analog may affect blood sugar levels. If you notice a change in the results of your blood sugar tests or if you have any questions, check with your doctor.

bicalutamide may affect the results of the prostate specific antigen (PSA) test, which may be used to detect prostate cancer. Make sure you tell all of your doctors that you are using bicalutamide.

If you plan to have children, talk with your doctor before using bicalutamide. bicalutamide may cause some men to become infertile (unable to have children), at least temporarily.

bicalutamide may make you sleepy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

bicalutamide Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • blood in the urine
  • blurred vision
  • body aches or pain
  • congestion
  • cough or hoarseness
  • cough producing mucus
  • difficult or labored breathing
  • dizziness
  • dryness or soreness of the throat
  • fever or chills
  • headache
  • lower back or side pain
  • nervousness
  • painful or difficult urination
  • pounding in the ears
  • rapid weight gain
  • runny nose
  • shortness of breath
  • slow or fast heartbeat
  • sweating
  • tender, swollen glands in the neck
  • tightness in the chest
  • tingling of the hands or feet
  • trouble with swallowing
  • unusual weight gain or loss
  • voice changes
  • wheezing
Less common
  • Abnormal growth filled with fluid or semisolid material
  • ankle, knee, or great toe joint pain
  • arm, back, or jaw pain
  • bleeding from the rectum or bloody stools
  • blindness
  • bloody nose
  • burning while urinating
  • burning, tingling, numbness, or pain in the hands, arms, feet, or legs
  • change in bowel habits
  • chest pain or discomfort
  • chest tightness or heaviness
  • chills
  • confusion
  • decrease in frequency of urination
  • decrease in urine volume
  • decreased vision
  • difficulty in passing urine (dribbling)
  • difficulty with swallowing or eating
  • dilated neck veins
  • dry mouth
  • fainting
  • fast or irregular heartbeat
  • fever
  • irregular breathing
  • joint stiffness or swelling
  • lightheadedness
  • loss of appetite
  • lump or swelling in the abdomen
  • nausea
  • no blood pressure or pulse
  • noisy breathing
  • pain in the neck
  • pain or discomfort in the arms, jaw, back, or neck
  • painful blisters on trunk of the body
  • persistent non-healing sore
  • rapid, shallow breathing
  • reddish patch or irritated area
  • sensation of pins and needles
  • shiny bump
  • stabbing pain
  • stomach discomfort
  • stopping of heart
  • sunken eyes
  • swelling of the face, fingers, feet, or lower legs
  • thirst
  • tumor
  • unconsciousness
  • unexplained weight loss
  • unusual tiredness or weakness
  • vomiting
  • weight gain
  • white, yellow or waxy scar-like area
  • wrinkled skin
  • yellow skin or eyes
Incidence not known
  • Hives or welts
  • itching
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • redness of the skin
  • skin rash

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Acid or sour stomach
  • belching
  • breast pain
  • constipation
  • decreased interest in sexual intercourse
  • diarrhea
  • difficulty with moving
  • dry skin
  • hair loss or thinning of the hair
  • heartburn
  • inability to have or keep an erection
  • indigestion
  • lack or loss of strength
  • leg cramps
  • loss in sexual ability, desire, drive, or performance
  • loss of strength or energy
  • muscle aching or cramping
  • muscle pain or weakness
  • nervousness
  • pain in the pelvis
  • pain or tenderness around the eyes and cheekbones
  • passing of gas
  • sleepiness or unusual drowsiness
  • stomach pain, fullness, or discomfort
  • stuffy or runny nose
  • swelling of the breasts or breast soreness in both females and males

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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