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Estramustine Side Effects

For the Consumer

Applies to estramustine: oral capsule

In addition to its needed effects, some unwanted effects may be caused by estramustine. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking estramustine:

  • Black, tarry stools
  • blood in urine or stools
  • cough or hoarseness
  • fever or chills
  • headaches (severe or sudden)
  • loss of coordination (sudden)
  • lower back or side pain
  • painful or difficult urination
  • pains in chest, groin, or leg (especially calf of leg)
  • pinpoint red spots on skin
  • shortness of breath (sudden, for no apparent reason)
  • slurred speech (sudden)
  • unusual bleeding or bruising
  • vision changes (sudden)
  • weakness or numbness in arm or leg

Severity: Moderate

If any of the following side effects occur while taking estramustine, check with your doctor or nurse as soon as possible:

More common:
  • Swelling of feet or lower legs
  • Skin rash or fever
  • unusual tiredness or weakness

Minor Side Effects

Some of the side effects that can occur with estramustine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Breast tenderness or enlargement
  • decreased interest in sex
  • diarrhea
  • nausea
Less common:
  • Trouble in sleeping
  • vomiting

For Healthcare Professionals

Applies to estramustine: oral capsule


Gynecomastia and impotence have been reported as estrogenic effects.[Ref]

Genitourinary side effects including breast tenderness (71%), mild breast enlargement (65%), and moderate breast enlargement (11%) have been reported. One case of hemolytic-uremic syndrome has also been reported.[Ref]


Hepatic side effects including LDH and/or SGOT abnormalities (33%), bilirubin and SGOT abnormalities (2%), and bilirubin, LDH, and SGOT abnormalities (2%) have been reported.[Ref]


Exacerbation of preexisting or incipient peripheral edema or congestive heart disease has been reported.[Ref]

Cardiovascular side effects including edema (20%), leg cramps (9%), myocardial infarction (3%), thrombophlebitis (3%), congestive heart failure (3%), cerebrovascular accident (2%), and pulmonary emboli (2%) have been reported.[Ref]


Gastrointestinal side effects including nausea (16%), diarrhea (13%), minor gastrointestinal upset (11%), anorexia (4%), and flatulence (2%) have been reported.[Ref]


Respiratory side effects including dyspnea (12%) have been reported.[Ref]


Hematologic side effects including leukopenia (4%) have been reported.[Ref]


Other side effects including lethargy (4%), insomnia (3%), and emotional lability (2%) have been reported.[Ref]


Dermatologic side effects including easy bruising (3%), pruritus (2%), and dry skin (2%) have been reported.[Ref]


Oncologic side effects including mutagenicity have been reported for both estradiol and nitrogen mustard. Animal studies on estrogens have reported an increase in the frequency of carcinomas of the breast and liver.[Ref]


1. Tassinari D, Sartori S, Panzini I, Ravaioli A, Iorio D "Hemolytic-uremic syndrome during therapy with estramustine phosphate for advanced prostatic cancer." Oncology 56 (1999): 112-3

2. "Product Information. Emcyt (estramustine)." Pharmacia and Upjohn, Kalamazoo, MI.

Not all side effects for estramustine may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.