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Bicalutamide

    DEA Class; Rx

    Common Brand Names; Casodex

    • Antineoplastics, Antiandrogen; 
    • CYP3A4 Inhibitor, Moderate

    Oral nonsteroidal antiandrogen
    Used for the treatment of metastatic prostatic carcinoma
    Can cause hepatotoxicity; monitor liver function tests

    Indicated for the treatment of prostate cancer.
    For prevention of stuttering priapism (i.e., recurrent priapism).

    Hypersensitivity

    Female patients (esp pregnant-may harm fetus)

    • Hot flashes (53%)
    • General pain (35%)
    • Back pain (25%)
    • Asthenia (22%)
    • Constipation (22%)
    • Pelvic pain (21%)
    • Infection (18%)
    • Nausea (15%)
    • Dyspnea (13%)
    • Edema (13%)
    • Peripheral edema (13%)
    • Diarrhea (12%)
    • Hematuria (12%)
    • Nocturia (12%)
    • Abdominal pain (11%)
    • Anemia (11%)
    • Gynecomastia (9%)
    • Rash (9%)
    • UTI (9%)
    • Chest pain (8%)
    • Hypertension (8%)
    • Vomiting (8%)
    • Flu like symptoms (7%)
    • Headache (7%)
    • LFTs elevation (7%)
    • Weight loss (7%)
    • Anorexia (6%)
    • Breast pain (6%)
    • Anxiety (5%)
    • Arthritis (5%)

    Hepatic impairment

    Severe liver injury resulting in hospitalization or death reported

    Spermatogenesi inhibition reported

    Gynecomastia and breast pain reported during therapy when used as single agent

    May reduce glucose tolerance in males when used in combination with LHRH; monitor blood glucose

    Monitor prostate specific antigen (PSA) progression if PSA increases

    Antiandrogen therapy may cause morphological changes in spermatozoa; based on findings in animal reproduction studies and its mechanism of action, advise male patients with female partners of reproductive potential to use effective contraception during treatment and for 130 days after administering final dose administered

    Based on animal studies, therapy can lead to inhibition of spermatogenesis and may impair fertility in males of reproductive potential; long-term effects on male fertility not studied

    Contraindicated for use in pregnant women because it can cause fetal harm; not indicated for use in females; there are no human data on use in pregnant women

    Not indicated for use in pregnant women

    Adults

    50 mg/day PO.

    Elderly

    50 mg/day PO.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Bicalutamide

    tablet

    • 50mg