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Casodex (Oral)

Generic Name: bicalutamide (Oral route)

bye-ka-LOO-ta-mide

Medically reviewed on September 3, 2018

Commonly used brand name(s)

In the U.S.

  • Casodex

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antiandrogen

Uses For Casodex

Bicalutamide is used together with a luteinizing hormone releasing hormone (LHRH) analog (eg, goserelin or leuprolide) 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.

This medicine is available only with your doctor's prescription.

Before Using Casodex

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 this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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.

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 this medicine, 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 this medicine 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
  • Domperidone
  • Eliglustat
  • Phenprocoumon
  • Piperaquine
  • Warfarin

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 this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

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

Proper Use of Casodex

Take this medicine 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.

This medicine should come with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have questions.

It is best to take this medicine at the same time each day, in the morning or in the evening.

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

You may take this medicine with food or on an empty stomach.

Dosing

The dose of this medicine 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 this medicine. 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, in the morning or in the evening.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, 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 Casodex

It is very important that your doctor check your progress at regular visits to make sure that this medicine 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. Using this medicine while you are pregnant can harm your unborn baby. It may also cause birth defects if the father is using it when his sexual partner becomes pregnant. Male patients who have female partners should use effective birth control during treatment with this medicine and for 130 days after the last dose. If you think your female partner has become pregnant while using this medicine, tell your doctor right away.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Bicalutamide may cause serious bleeding when you use it together with a blood thinner medicine (eg, warfarin). Talk to your doctor if you have concerns.

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

Using this medicine with an LHRH analog may affect your 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.

This medicine may affect the results of the prostate specific antigen (PSA) test, which may be used to detect prostate cancer. Make sure any doctor or dentist who treats you knows that you are using this medicine.

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

This medicine may make you sleepy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

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.

Casodex 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
  • chills
  • congestion
  • cough
  • cough producing mucus
  • difficult or labored breathing
  • dizziness
  • dryness or soreness of the throat
  • fever
  • headache
  • hoarseness
  • lower back or side pain
  • nervousness
  • painful or difficult urination
  • pounding in the ears
  • rapid weight gain
  • runny nose
  • 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

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 feeling while urinating
  • burning, tingling, numbness, or pain in the hands, arms, feet, or legs
  • change in bowel habits
  • chest pain, discomfort, tightness or heaviness
  • 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
  • irregular breathing or heartbeat
  • joint stiffness or swelling
  • lightheadedness
  • loss of appetite
  • lump or swelling in the abdomen or stomach
  • nausea
  • no blood pressure or pulse
  • noisy breathing
  • pain or discomfort in the arms, jaw, back, or neck
  • painful blisters on the 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 the heart
  • sunken eyes
  • 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

  • Bleeding gums
  • coughing up blood
  • hives or welts, itching, skin rash
  • increased menstrual flow or vaginal bleeding
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • paralysis
  • prolonged bleeding from cuts
  • red or black, tarry stools
  • red or dark brown urine
  • redness of the skin

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

  • 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
  • leg cramps
  • loss in sexual ability, desire, drive, or performance
  • loss of strength or energy
  • muscle ache, cramp, pain, or weakness
  • pain in the pelvis
  • pain or tenderness around the eyes and cheekbones
  • passing of gas
  • sleepiness or unusual drowsiness
  • stomach pain or fullness
  • 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)

Further information

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

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