Casodex (Bicalutamide)

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Casodex (Bicalutamide) Medication Information

Uses

Casodex is an androgen receptor inhibitor indicated for use in combination therapy with a luteinizing hormone-releasing hormone (LHRH) analog for the treatment of Stage D2 metastatic carcinoma of the prostate

Dosage

The oral tablets are available in 50 mg strength.

Side Effects

The most common side effects of Casodex include:

  • Hot flashes
  • Pain
  • Asthenia
  • Constipation
  • Infection
  • Nausea
  • Peripheral edema
  • Dyspnea
  • Diarrhea
  • Hematuria
  • Nocturia
  • Anemia 

Speak with your doctor or pharmacist for a full list of side effects that applies to you.

Precautions

Severe hepatic injury and fatal hepatic failure have been observed. Monitor serum transaminase levels prior to starting treatment with Casodex, at regular intervals for the first four months of treatment and periodically thereafter, and for symptoms or signs suggestive of hepatic dysfunction. Use Casodex with caution in patients with hepatic impairment. 

Hemorrhage with Concomitant Use of Coumarin Anticoagulant. Closely monitor the Prothrombin Time (PT) and International Normalized Ratio (INR), and adjust the anticoagulant dose as needed.

Gynecomastia and breast pain have been reported during treatment with Casodex 150 mg when used as a single agent. 

Casodex is used in combination with an LHRH agonist. LHRH agonists have been shown to cause a reduction in glucose tolerance in males. Consideration should be given to monitoring blood glucose in patients receiving Casodex in combination with LHRH agonists. 

Monitoring Prostate Specific Antigen (PSA) is recommended. Evaluate for clinical progression if PSA increases.

Interactions

Some of the common drug interactions with Casodex:

  • Dofetilide
  • Nimodipine
  • Tacrolimus
  • Warfarin 

Speak with your doctor or pharmacist for more information. 

Storage

Store at controlled room temperature (68-77ºF). 

Pharmacist Tips

  • Casodex and the LHRH analog should be started at the same time and you should not interrupt or stop taking these medications without consulting your healthcare provider.
  • It is recommended that Casodex be taken at the same time each day.
  • Somnolence has been reported. Patients who experience this symptom should observe caution when driving or operating machines

Bicalutamide FAQs

Can I take this with food?

Can be taken with or without food

 

Can I take this if I am pregnant?

Casodex is contraindicated for use in pregnant women because it can cause fetal harm. Casodex is not indicated for use in females.

 

Can I take this while breastfeeding?

Casodex is not indicated for use in pregnant women

 

What if I miss a dose?

If a dose of Casodex is missed, take the next dose at the scheduled time. Do not take the missed dose and do not double the next dose.

 

Does this need to be taken with other medications?

Treatment with Casodex should be started at the same time as treatment with an LHRH analog.

 

Can photosensitivity occur with Casodex?

Photosensitivity has been reported during treatment with Casodex and you should avoid direct exposure to excessive sunlight or UV-light exposure. Consideration should be given to the use of sunscreen.

Related Drugs

Reference:

Casodex {package insert}. Wilmington, DE: AstraZeneca; 2008.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020498s019s021lbl.pdf

PharmD Medical Writer

Author: Dr. Larisa Roybal, PharmD

Dr. Roybal is a board-certified pharmacotherapy specialist who has practiced in both ambulatory and acute care settings. Her pharmacy interests include oncology and general inpatient pharmacy.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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