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Generic Name: Bicalutamide
Brand name: Casodex
Generic Ingredient: Nilutamide Nilandron

Type of Drug: Antiandrogen.
Prescribed For: Prostate cancer.

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General Information

Antiandrogens are prescribed together with another hormone product for prostate cancer. Casodex Bicalutamide competes with testosterone and other natural androgens (male hormones) by binding to the same places in body tissue where androgens normally bind. Prostate cancer is androgen sensitive and responds to treatments that counteract the effects of androgen or remove the sources of androgen.

Cautions and Warnings

Do not take Casodex if you are allergic or sensitive to it or any of its ingredients.
People taking Casodex may develop severe liver injury. People with liver disease may be at greater risk for serious side effects.
Almost 40% of men taking Casodex bicalutamide as single therapy for prostate cancer develop breast pain and enlargement. Casodex may also reduce sperm count.
Two of every 100 people taking nilutamide develop interstitial pneumonitis (symptoms include cough, chest pain, fever, and breathing difficulties). People with lung disease and Asians may be at greater risk. Report any breathing difficulty or worsening of pre-existing breathing difficulty to your doctor immediately.
Isolated cases of aplastic anemia (a potentially fatal blood disorder) have been reported in people taking nilutamide, but the relationship between the drug and the disease is not established.

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Possible Side Effects

Most common: hot dashes, hot flushes, general pain, headache, weakness, back pain, nausea, constipation, sleeplessness, breathing difficulties, and swollen breasts. Nilutamide, difficulty seeing in the dark and loss of testicle function.

Common: diarrhea and pelvic pain.
Less common: vomiting, abdominal pains, chest pain, flu-like symptoms, high blood pressure, swelling in the ankles or lower legs, high blood sugar, weight loss, dizziness,     tingling in the hands or feet, sweating, rash, nighttime urination, blood in the urine, urinary or other infection, loss of libido, impotence, breast pain, painful         urination, anemia, and bone pain.
Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.

Drug Interactions

•    Casodex Bicalutamide and nilutamide increase the effect of oral anticoagulant (blood-thinning) drugs such as warfarin. Dosage adjustment may be necessary.
•    Nilutamide may increase the risk of the potentially serious side effects of phenytoin, theophylline, or vitamin K antagonists.

Food Interactions

None known.

Usual Dose of generic Casodex Bicalutamide
Adult: Casodex 50 mg once a day, morning or night.

Nilutamide

Adult: Casodex 300 mg a day, reduced to Casodex 150 mg a day after 30 days.

Overdosage

Symptoms of Casodex overdose may include nausea, vomiting, tiredness, headache and dizziness. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.

Special Information

Report anything unusual to your doctor, especially pain or tenderness in the upper right abdomen, yellowing of skin or whites of eyes, severe itching, dark urine, persistent appetite loss, and unexplained flu-like symptoms. These may be signs of severe liver toxicity. Also report any breathing difficulties, cough, chest pain or fever.
Up to half of people taking Casodex can take from a few seconds to a few minutes to adapt to darkness. This can be a problem especially when driving at night or through tunnels. Wearing tinted glasses will minimize this effect. Up to 5% of people taking Casodex may experience intolerance to alcohol. Symptoms include flushing, tiredness, and lightheadedness. If you experience this reaction, you should avoid alcohol.
Casodex Bicalutamide should be taken at the same time each day for best results. If you forget a dose of Casodex, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Call your doctor if you forget to take more than 1 dose.

Pregnancy/Breast-feeding: Antiandrogens are not intended for use by women.

Seniors: Seniors may take Casodex without special precaution.

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The treatment of cancer is difficult because cancer cells are cells that have escaped from the controls that govern normal cell growth and differentiation of function. As a result, uncoordinated growth may develop rapidly, and cancer cells may migrate and invade other tissues. Any anti-cancer drug is therefore likely to damage normal cells, particularly actively growing cells such as those of the bone marrow, and the dose of a cytotoxic agent is often a compromise between that having the desired anti-cancer action and that causing toxicity.
The drugs used in the treatment of cancer can be divided into four main groups, which attack the cells at different points. The alkylating agents interfere with the replication and function of DNA, modify protein synthesis, and have correspondingly wide effects. The antimetabolites interfere with cell metabolism by combining with cell enzymes, or by forming abnormal proteins, or otherwise inhibiting normal development. The cytotoxic antibiotics have an action similar to that of the antimetabolites, but they also have radiomimetic properties, and combined radiotherapy may increase the risks of damage to normal cells. These antibiotics, with the exceptions of dactinomycin and bleomycin, also have undesirable cardiotoxic properties, and dosage requires careful control. Amsacrine is a synthetic cytotoxic agent with some of the properties of the antibiotic group. Some recently introduced drugs include docetaxel, gemcitabine, letrozole, paclitaxel, raltitrexed and topotecan.
The vinca alkaloids are a class apart, as they are plant substances, and act at the metaphase stage of cell division. They are used mainly in acute leukaemias and some lymphomas. Vincristine is almost free from any depressive effects on bone marrow function, vinblastine has some degree of myelosuppressive activity but is less neurotoxic. Vindesine occupies an intermediate position. Etoposide is a synthetic drug with some of the properties of the vinca alkaloids. Other and unclassified cytotoxic agents include the platinum complexes carboplatin and cisplatin, used mainly in ovarian cancer, and the enzyme crisantaspase used in acute lymphoblastic leukaemia. Some cancers are hormone dependent, and the symptoms may be controlled by suitable hormone antagonists. Breast cancer for example may respond to aminoglutethimide, anastrozole, formestane, letrozole and toremifene. Prostatic cancer can be treated with anti-androgens such as fosfesterol, bicalutamidc, cyproterone and flutamide. Certain hormone analogues such as buserelin, goserelin, leuprorelin and triptorelin are also used in cancer of the prostate. A distressing side-effect of high-dose cytotoxic chemotherapy was severe and intractable nausea and vomiting, which could be so intense that patients have been known to refuse further anti-cancer treatment. The problem has since been resolved by the introduction of potent antierneties of the ondansetron type.

Myleran
carmustine    BiCNU
chlorambucil    Leukeran
cyclophosphamide    Endoxana
estramustine    Estracyt
ifosfamide    Mitoxana
lomustine    CCNU
melphalan    Alkeran
mustine    Mustine
thiotepa    Thiotepa
treosulphan    Treosulfan
cladribine    Leustat
gemcitabine mercaptopurine methotrexate
thioguanine    Lanvis
cytarabine    Alexan, Cytosar
fludarabine    Fludara
fluorouracil    Fluoro-Uracil, Efudix
Gemzar Puri-Nethol
Maxtrex

raltitrexed    Tomudex
bleomycin    Bleomycin
dactinomycin    Cosmegen
daunorubicin    DaunoXome
doxorubicin    Doxorubicin
epirubicin    Pharmarubicin
idarubicin    Zavedos
mitomycin    Mitomycin C
mitozantrone    Novantrone
vinblastine    Velbe
vincristine    Oncovin
vindesine    Eldesine
vinorelbine    Navelbine
aldesleukin
amsacrine
bicalutamide
carboplatin
dacarbazine
Proleukin
Amsidine
Casodex
Paraplatin
DTIC
cisplatin    Cisplatin
docetaxel    Taxotere

etoposide
Vepesid
hydroxyurea
Hydrea
iritotecan
Campto
letrozole
Ferrara
octreotide
Sandostatin
paclitaxel
Taxol
pentostatin
Nipent
procarbazine
Natulan
razoxane
Razoxin
topotecan
Hycamptin
tretinoin
Vesanoid
aminoglutethimide
Orimeten
anastrozole
Armidex
buserelin
Suprefact
Cyprostat
Drogenil
flutamide
Lentaron
formestane
goserelin
Zoladex
tamoxifen
Torero
torasemide
Casodex
Emblon, Nottam, Notwadex, Tamofen
bicalutamide
cyproterone

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