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Flutamide Disease Interactions

There are 2 disease interactions with flutamide.

Major

Flutamide (applies to flutamide) hepatic dysfunction

Major Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

There have been postmarketing reports of hospitalization and rarely death due to liver failure in patients taking flutamide. Signs of hepatic injury included elevated serum transaminase levels, jaundice, hepatic encephalopathy and death related to acute hepatic failure. The hepatic injury was reversible after discontinuation of therapy in some patients. Approximately half of the reported cases occurred within the initial 3 months of treatment. Serum transaminase levels should be measured prior to starting treatment with flutamide. Flutamide is not recommended in patients whose ALT values exceed twice the upper limit of normal. Serum transaminase levels should then be measured monthly for the first 4 months of therapy, and periodically thereafter. Liver function tests also should be obtained at the first signs and symptoms suggestive of liver dysfunction, e.g., nausea, vomiting, abdominal pain, fatigue, anorexia, "flu-like" symptoms, hyperbilirubinuria, jaundice or right upper quadrant tenderness. If at any time, a patient has jaundice, or their ALT rises above 2 times the upper limit of normal, flutamide should be immediately discontinued with close follow-up of liver function tests. Flutamide should be administered with extreme caution in patients with or predisposed to compromised hepatic function, and it is contraindicated in patients with severe hepatic impairment.

References

  1. Gomez J-L, Dupont A, Cusan L, et al. (1992) "Incidence of liver toxicity associated with the use of flutamide in prostate cancer patients." Am J Med, 92, p. 465-70
  2. Hart W, Stricker BH (1989) "Flutamide and hepatitis ." Ann Intern Med, 110, p. 943-4
  3. Wysowski DK, Freiman JP, Tourtelot JB, Horton ML (1993) "Fatal and nonfatal hepatotoxicity associated with flutamide." Ann Intern Med, 118, p. 860-4
  4. Dankoff JS (1992) "Near fatal liver dysfunction secondary to administration of flutamide for prostate cancer." J Urol, 148, p. 1914
  5. Moller S, Iversen P, Franzmann MB, Mller S (1990) "Flutamide-induced liver failure." J Hepatol, 10, p. 346-9
  6. (2002) "Product Information. Eulexin (flutamide)." Schering Corporation
  7. Wallace C, Lalor EA, Chik CL (1993) "Hepatotoxicity complicating flutamide treatment of hirsutism." Ann Intern Med, 119, p. 1150
  8. Wysowski DK, Fourcroy JL (1993) "Hepatotoxicity complicating flutamide treatment of hirsutism - reply." Ann Intern Med, 119, p. 1150
  9. Labrie F (1994) "Acute cholestatic hepatitis secondary to flutamide therapy - reply." Am J Med, 96, p. 392-3
  10. Dourakis SP, Alexopoulou AA, Hadziyannis SJ (1994) "Fulminant hepatitis after flutamide treatment." J Hepatol, 20, p. 350-3
  11. Moghetti P, Castello R, Negri C, Tosi F, Magnani CM, Fontanarosa MC, Armanini D, Muggeo M (1995) "Flutamide in the treatment of hirsutism: long-term clinical effects, endocrine changes, and androgen receptor behavior." Fertil Steril, 64, p. 511-7
  12. Wysowski DK, Fourcroy JL (1996) "Flutamide hepatotoxicity." J Urol, 155, p. 209-12
  13. Crownover RL, Holland J, Chen A, Krieg R, Young BK, Roach M, Fu KK (1996) "Flutamide-induced liver toxicity including fatal hepatic necrosis." Int J Radiat Oncol Biol Phys, 34, p. 911-5
  14. Rosenthal SA, Linstadt DE, Leibenhaut MH, Andras EJ, Brooks CP, Stickney DR, Chang GC, Wolkov HB, Gilbert RM (1996) "Flutamide-associated liver toxicity during treatment with total androgen suppression and radiation therapy for prostate cancer." Radiology, 199, p. 451-5
  15. Cicognani C, Malavolti M, Morsellilabate AM, Sama C, Barbara L (1996) "Flutamide-induced toxic hepatitis: potential utility of ursodeoxycholic acid administration in toxic hepatitis." Dig Dis Sci, 41, p. 2219-21
View all 15 references
Moderate

Flutamide (applies to flutamide) hemolysis

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hemolytic Anemia

Toxicity consistent with aniline exposure such as methemoglobinemia, hemolytic anemia, and cholestatic jaundice has been reported during flutamide therapy. Therapy with flutamide should be administered cautiously in patients with glucose-6-phosphate deficiency, hemoglobin M disease, and patients who smoke. Clinical monitoring of methemoglobin levels in susceptible individuals is recommended,

References

  1. Schott AM, Vial T, Gozzo I, Chareyre S, Delmas PD (1991) "Flutamide-induced methemoglobinemia." DICP, 25, p. 600-1
  2. (2002) "Product Information. Eulexin (flutamide)." Schering Corporation
  3. Kouides PA, Abboud CN, Fairbanks VF (1996) "Flutamide-induced cyanosis refractory to methylene blue therapy." Br J Haematol, 94, p. 73-5

Flutamide drug interactions

There are 299 drug interactions with flutamide.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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