Bicalutamide Brand Name– Casodex
What is Bicalutamide
Bicalutamide is an oral nonsteroidal antiandrogen structurally related to flutamide (Eulexin(R)).
Bicalutamide is used as an antihormonal agent in the treatment of metastatic prostatic carcinoma.
Unlike flutamide, bicalutamide has a long plasma half-life that allows once-daily dosing compared with three times daily for flutamide.
In addition, bicalutamide is more selective for the peripheral androgen receptor and has less activity at the central androgen receptor on the hypothalamic-pituitary axis.
Bicalutamide is most effective when combined with LHRH agonists such as leuprolide acetate. The FDA approved bicalutamide on October 4, 1995, for the treatment of advanced prostatic carcinoma.
While a 150 mg dosage form was once under investigation as monotherapy or in combination with other drugs for select stages of prostate cancer, this dosage is not FDA-approved and select clinical trials have found significant trends in terms of increased mortality/decreased survival in the bicalutamide-treated group at the 150 mg-dosage versus patients undergoing castration or other treatments.
Indications
- prostate cancer
- stuttering priapism
For the treatment of stage D-2 metastatic prostate cancer in combination with a luteinizing hormone-releasing hormone (LHRH) analog
Side Effects
- abdominal pain
- alopecia
- anemia
- angina
- angioedema
- anorexia
- anxiety
- arthralgia
- asthenia
- back pain
- bone fractures
- bone pain
- cardiac arrest
- cataracts
- chest pain (unspecified)
- chills
- confusion
- constipation
- cough
- dehydration
- depression
- diabetes mellitus
- diaphoresis
- diarrhea
- dizziness
- drowsiness
- dyspepsia
- dysphagia
- dyspnea
- dysuria
- edema
- elevated hepatic enzymes
- epistaxis
- fever
- flatulence
- GI bleeding
- gout
- gynecomastia
- headache
- heart failure
- hematuria
- hepatic failure
- hepatitis
- hot flashes
- hyperbilirubinemia
- hypercholesterolemia
- hyperglycemia
- hypertension
- hypertonia
- impotence (erectile dysfunction)
- increased urinary frequency
- infection
- insomnia
- libido decrease
- melena
- muscle cramps
- myalgia
- myasthenia
- myocardial infarction
- nausea
- neutropenia
- new primary malignancy
- nocturia
- paresthesias
- peripheral edema
- pharyngitis
- photosensitivity
- pneumonitis
- pruritus
- pulmonary fibrosis
- rash
- rhinitis
- sinusitis
- syncope
- urinary incontinence
- urinary retention
- urinary urgency
- urticaria
- vomiting
- weight gain
- weight loss
- xerosis
- xerostomia
Monitoring Parameters
- LFTs
- prostate-specific antigen (PSA)
Contraindications
- breast-feeding
- children
- contraception requirements
- diabetes mellitus
- females
- hepatic disease
- hepatitis
- infertility
- jaundice
- male-mediated teratogenicity
- pregnancy
- reproductive risk
Interactions
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Oxycodone
- Amiodarone
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Oxycodone
- Barbiturates
- Benzhydrocodone; Acetaminophen
- Bosentan
- Carbamazepine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Clarithromycin
- Delavirdine
- Dexamethasone
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Eliglustat
- Erythromycin
- Erythromycin; Sulfisoxazole
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fosphenytoin
- grapefruit juice
- Ibuprofen; Oxycodone
- Imatinib
- Itraconazole
- Ketoconazole
- Lomitapide
- Mifepristone
- Nefazodone
- Nevirapine
- Nisoldipine
- Oxycodone
- Phenytoin
- Protease inhibitors
- Rifamycins
- St. John’s Wort, Hypericum perforatum
- Sufentanil
- Ubrogepant
- Vinorelbine
- Voriconazole
- Warfarin
