Casodex Side Effects
Generic name: bicalutamide
Note: This document contains side effect information about bicalutamide. Some of the dosage forms listed on this page may not apply to the brand name Casodex.
Some side effects of Casodex may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to bicalutamide: oral tablet
Along with its needed effects, bicalutamide (the active ingredient contained in Casodex) 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 while taking bicalutamide:More common
- Bloating or swelling of the face, arms, hands, lower legs, or feet
- blood in the urine
- blurred vision
- body aches or pain
- cough or hoarseness
- cough producing mucus
- difficult or labored breathing
- dryness or soreness of the throat
- fever or chills
- lower back or side pain
- painful or difficult urination
- pounding in the ears
- rapid weight gain
- runny nose
- shortness of breath
- slow or fast heartbeat
- 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
- 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
- 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
- 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
- fast or irregular heartbeat
- irregular breathing
- joint stiffness or swelling
- loss of appetite
- lump or swelling in the abdomen
- 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
- unexplained weight loss
- unusual tiredness or weakness
- weight gain
- white, yellow or waxy scar-like area
- wrinkled skin
- yellow skin or eyes
- Hives or welts
- 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 of bicalutamide 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
- breast pain
- decreased interest in sexual intercourse
- difficulty with moving
- dry skin
- hair loss or thinning of the hair
- inability to have or keep an erection
- 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
- 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
For Healthcare Professionals
Applies to bicalutamide: oral tablet
Unless otherwise noted, all data below refer to patients treated concurrently with bicalutamide (the active ingredient contained in Casodex) and a luteinizing hormone-releasing hormone (LHRH) analogue (goserelin acetate or leuprolide acetate).
Cardiovascular system side effects include the most frequently encountered side effect, hot flashes, which has been reported in approximately 49% of treated patients. Hypertension has also been reported.
General side effects are also very common and have included generalized pain (27%), back pain (15%), asthenia (15%), pelvic pain (13%), and infection (10%). Abdominal and chest pain, headache, and flu syndrome have also been reported.
Gastrointestinal effects are common and have included constipation (17%), nausea (11%), and diarrhea (10%). Flatulence and vomiting have also been reported.
Hepatic side effects including severe liver injury leading to hospitalization and death have been reported rarely. Hepatitis or marked increases in liver enzymes leading to drug discontinuation have been reported in approximately 1% of bicalutamide (the active ingredient contained in Casodex) patients. One case of fulminant hepatic failure associated with bicalutamide use has also been reported.
Increased values in liver enzyme tests include increased AST, ALT, or both. This effect has occurred in approximately 6% of treated patients.
Genitourinary side effects are somewhat common and include nocturia, hematuria, urinary tract infection, impotence, and urinary incontinence.
Metabolic effects are somewhat common and include peripheral edema, hyperglycemia, and weight loss.
Hematologic side effects include anemia (7%) and decreased white blood cell counts.
Renal side effects including new or worsened renal insufficiency (as measured by elevated BUN and creatinine) have been reported.
Musculoskeletal complaints include bone pain. This may be due to underlying disease.
Nervous system side effects including dizziness, paresthesia, and insomnia have been reported.
Respiratory system side effects including dyspnea have been reported. Uncommon cases of interstitial lung disease, including interstitial pneumonitis and pulmonary fibrosis have been reported with the use of bicalutamide (the active ingredient contained in Casodex) One case of pneumonitis has also been reported.
Dermatologic side effects including rash and sweating have been reported.
Bicalutamide has not been approved for use as monotherapy.
In one phase II clinical trial with bicalutamide (the active ingredient contained in Casodex) used as a single agent, breast tenderness, breast swelling, and hot flashes were reported in 63.4%, 52.5%, and 23.6% of treated patients, respectively.
Another phase II clinical trial with bicalutamide used as a single agent reported breast pain, and gynecomastia in 76% and 60% of treated patients, respectively. This study also showed generalized pain in 30% of treated patients, hot flashes in 28%, pelvic pain in 26%, and libido decrease and impotence, both at 25%.
Endocrine system side effects including gynecomastia (38%) and breast pain (39%) have been reported with the use of bicalutamide as a single agent. Several cases of decreases in prostate specific antigen (PSA) after withdrawal of bicalutamide therapy (referred to as antiandrogen withdrawal syndrome) have been reported.
Hypersensitivity side effects including angioneurotic edema and urticaria have been reported.
More Casodex resources
- Casodex Prescribing Information (FDA)
- Casodex Consumer Overview
- Casodex Monograph (AHFS DI)
- Casodex Advanced Consumer (Micromedex) - Includes Dosage Information
- Casodex MedFacts Consumer Leaflet (Wolters Kluwer)
- Bicalutamide Professional Patient Advice (Wolters Kluwer)
- Bicalutamide Prescribing Information (FDA)
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