Bicalutamide (Casodex® )

Warning: Bicalutamide is a drug intended only for use in men.  Women should not take this medication.  A woman who is pregnant or wishing to become pregnant should be aware that Bicalutamide has been shown to cause abnormalities in the developing fetus.  If you have or have had liver disease, you should tell your doctor before beginning to take Bicalutamide.

Indications: Bicalutamide, also known by its brand name Casodex, comes in tablet form to be taken by mouth. It is part of a class of drugs called nonsteriodal antiandrogens.  This drug is used to treat metastic prostate cancer – that is, cancer that began in the prostate gland and then spread to other parts of the body.  Androgen is a male hormone that stimulates and supports parts of the body associated with male anatomy, such as the prostate.  Androgens affect all cells in the body and, under normal circumstances, help support a healthy prostate.  However, in a prostate affected by cancer, androgen can increase the growth and spread of cancer cells. Bicalutamide, being an antiandrogen drug, prevents the body’s cells from receiving androgen hormones. This means that the cancer cells will be held back from developing and spreading further. You should be aware that Bicalutamide is a treatment for metastic prostate cancer and not a cure.  Bicalutamide is taken in combination with leuteinizing hormone-releasing hormone (LHRH) drugs such as goserelin or leuprolide.  At this time, there is no generic version of Bicalutamide available; it is available only by prescription and your drug regimen must be managed by a physician.

Dosage: Bicalutamide is dispensed in 50 mg tablets that are taken orally once a day.  You may take it in the morning or in the evening, with or without food.  You should begin taking Bicalutamide on the same day you begin administering injections of leuteinizing hormone-releasing hormone (LHRH).  Everyone taking Bicalutamide should be careful to take the drug at the same time each day.  Do not take more or less of the medication than has been prescribed.  Be sure to continue taking Bicalutamide until your prescribing physician directs you to stop.  Even if you are feeling better, do not stop taking Bicalutamide until your doctor has told you to. 

Overdose: Bicalutamide overdose is not known to be fatal, but can be serious. As a precaution, if you believe you have taken a higher dose of the medication, contact your physician or a drug and poison control center near you immediately. 

Missing dose: IUtis is important to take the medication as recommended. Do not take less or more of the dose recommended by your doctor. If you miss a dose of Bicalutamide in a time not too closed to next one, it is important to take it as soon as possible. If you recall the missing in the next day, or when it is time to take the next dose, do not double the dose; it can cause serious health problems. The wise option is to contact your physician or wait to continue the normal dosage. 

Interactions:   Bicalutamide should not be taken at the same time you are taking warfarin (Coumadin).  If warfarin has been prescribed to you, your doctor may need to adjust the dose before you can start taking Bicalutamide.  Be sure to tell your doctor about any prescription or non-prescription (over-the-counter) drugs, herbal remedies, and nutritional supplements – including vitamins – that you are currently taking. 

Here is a list of other drugs that can alter the curative effects of Bicalutamide or increase the risk of developing side effects:

Contraindications:  As mentioned above, this medication should not be taken by women; it is a drug meant to be taken by men.  Also, if you have ever shown hypersensitivity to Bicalutamide or any of the drug’s components, you should not use the drug.  Your doctor may prescribe you a different medication.

Side effects:  Bicalutamide also attacks healthy cells that multiply rapidly; in most patients, this can cause these common adverse effects:

Although rare, Bicalutamide can cause serious side effects which require immediate medical attention; contact your doctor immediately if you experience any of these symptoms:   

• dizziness   
• chest pain
• shortness of breath
• bloody urine
• painful or swollen breasts
• fainting (temporary loss of consciousness) 
• shortness of breath or difficulty breathing 
• Painful or Difficulty swallowing 
• yellowing of the skin or eyes  (jaundice)
• unusual bruising or bleeding 
• pain in the upper right part of the stomach
• Swelling of your arms, feet, ankles, or lower legs.