Casodex-Bicalutamide

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

Uses For This Medication
  • Bicalutamide is used alone or in combination with other medications to treat early stage or advanced stage prostate cancer.
  • This medication may also be given for other conditions as determined by your doctor.
  How This Medication Works Bicalutamide works by blocking the effects of testosterone, which causes some prostate cancer cells to grow. When testosterone is blocked, the prostate cancer cells, which need testosterone to grow, will not be able to grow. Benefits of This Medication When bicalutamide is used in combination with other medications (goserelin or leuprolide which are known as LHRH analogs), it may slow down the growth of prostate cancer and may lengthen how long a person lives. Bicalutamide can also help reduce tumor flares. This is a side effect unique to LHRH analogs in which at first tumor growth increases and makes the symptoms worse in patients with prostate cancer that is spread to the bones. Who Should Not Take This Medication You should not take this medication if you:
  • Are allergic to bicalutamide or any of its components
  • Are a woman
  Precautions to be Aware of Before Taking This Medication

Organ related precautions

This medication can cause changes in the ability of your liver to work normally, usually within the first 3-4 months of treatment. In some cases, these liver problems can be serious. In addition, this medication is broken down by enzymes (chemicals) in the liver and cleared from the body. In patients with severe liver disease, bicalutamide may not break down normally which can lead to high levels of this medication in the body and a greater chance of side effects. While you are on this medication, your doctor or healthcare provider will check your liver regularly, usually through blood tests, to make sure that your liver is working properly. If you have any liver problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects. In addition, contact your doctor or healthcare provider immediately if you experience nausea, vomiting, stomach pain, fatigue, loss of appetite, darkened urine, yellowing of the whites of the eyes, or flu-like symptoms. Miscellaneous precautions
  • Enlargement of the breasts and breast pain have been reported in men receiving bicalutamide for the treatment of prostate cancer.
  • Your doctor or healthcare provider will probably monitor your serum prostate specific antigen (PSA) regularly while you are on bicalutamide to measure your response to this medication. Depending on your PSA levels, your doctor or healthcare provider may keep you on this medication, or may take you off for a period of time (treatment-free period).
 

Patient specific precautions

  • It is not known if this medication is safe and effective in children.
  Pregnancy and Breastfeeding Precautions
  • This medication should not be used in women.
  • This medication may cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
  • Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future.
  Medication and Food Interactions Before using this medication, tell your doctor or healthcare provider of all prescription or over-the- counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with bicalutamide and the following medications:
  • Warfarin (Coumadin®)
  • Terfendadine†
  • Astemizole
  • Cisapride†
  • Cyclosporine
  • Calcium channel blockers (diltiazem, verapamil, nifedipine)
  • Cimetadine
  • Ketoconazole
† No longer available in the United States. NOTE: This list may not include all medications that can have interactions with bicalutamide.

Side Effects

  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • Side effects can occur when bicalutamide is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with bicalutamide in combination with either goserelin (Zoladex®) or leuprolide (Lupron®) which are known as LHRH analogs.
 

More common side effects

  • Hot flashes
  • Enlargement of breasts, breast pain (see Precautions To Be Aware Of Before Taking This Medication)
  • Back pain
 

Less common side effects

  • Constipation, nausea, diarrhea
  • Weakness, pelvic pain
  • Infection
  • Shortness of breath
  • Swelling
  • Anemia
 

Rare side effects

This is not a complete list of the rare side effects reported with bicalutamide. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Headache, dizziness, difficulty sleeping
  • Liver problems (see Precautions To Be Aware Of Before Taking This Medication)
  • Bone pain
  • Loss of libido, impotence
  How To Take This Medication
  • This medication is taken by mouth (orally) with or without food. Take this medication exactly as directed by your doctor or healthcare provider. If you do not understand these instructions, ask your doctor or healthcare provider to explain them to you.
  • Bicalutamide is often started several days earlier than the other medications that are given by an injection [either goserelin (Zoladex®) or leuprolide (Lupron®) which are known as LHRH analogs]in order to help reduce tumor flares caused by LHRH analogs. These drugs work together to block the action of testosterone. If you are using these two medications together, be sure that you understand exactly how they should be taken.
  • It is important that you only use this medication when it’s been prescribed for you. Sharing this medication with someone for whom it is not prescribed could cause harm.
  • If you accidentally take too many pills or someone else accidentally takes your medication, contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
  Proper Storage
  • Store this medication at room temperature and keep in its original container.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.