Bicalutamide
Indications
Bicalutamide is used for:
Prostate Cancer
Adult Dose
Oral
Palliative treatment of advanced prostate cancer
Adult: When used with gonadorelin analogue: Usual dose: 50 mg once daily. May be started with or at least 3 days before starting gonadorelin analogue therapy.
Monotherapy or adjuvant therapy to surgery or radiotherapy in locally advanced prostatic cancer
Adult: 150 mg once daily.
Child Dose
Renal Dose
Administration
May be taken with or without food.
Contra Indications
Hypersensitivity. Females, children. Pregnancy, lactation.
Precautions
Monitor liver function regularly in hepatically impaired patients on prolonged therapy. Monitoring serum levels of Prostate Specific Antigen (PSA) may be useful in evaluating the patient's clincial progress.
Lactation: Bicalutamide is not indicated for use in women.
Pregnancy-Lactation
Pregnancy
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; in animal reproduction studies, oral administration of bicalutamide to pregnant rats during organogenesis caused abnormal development of reproductive organs in male fetuses at exposures approximately 0.7 to 2 times the human exposure at recommended dose
Lactation
Not indicated for use in pregnant women; there is no information available on presence of bicalutamide in human milk, or on effects on breastfed infant or on milk production; bicalutamide has been detected in rat milk
Interactions
Enhances effect of coumarin anticoagulants.
Adverse Effects
Side effects of Bicalutamide :
>10%
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%)
1-10%
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%)
Mechanism of Action
Bicalutamide competes with androgen for the binding of androgen receptors, consequently blocking the action of androgens of adrenal and testicular origin, thus preventing the growth of normal and malignant prostatic tissue.