BICALUTAMIDE
| BICALUTAMIDE (bi-ca-lu'ta-mide) Casodex Classifications: antineoplastic; antiandrogen; Therapeutic: antineoplastic; antiandrogen Prototype: Flutamide Pregnancy Category: X |
Availability
50 mg tablets
Action
Bicalutamide is a nonsteroidal antiandrogen. It inhibits the pharmacologic effects of androgen by binding to the androgen receptors in the target tissue.
Therapeutic Effect
Prostatic carcinoma is androgen sensitive; it responds to removal of the source of androgen or treatment that counteracts the effects of androgen.
Uses
In combination with a luteinizing hormone-releasing hormone (LHRH) analog for advanced prostate cancer.
Contraindications
Hypersensitivity to bicalutamide, pregnancy (category X), hepatic failure; lactation.
Cautious Use
Moderate to severe hepatic impairment. Safety and efficacy in children are not established.
Route & Dosage
| Advanced Prostate Cancer Adult: PO 50 mg once/d |
Administration
Oral- Give drug at the same time each day.
- Start treatment with bicalutamide at the same time as treatment with a luteinizing hormone-releasing hormone (LHRH) analog.
- Store at 15°–30° C (59°–86° F).
Adverse Effects (≥1%)
CNS: Dizziness, paresthesia, insomnia, anxiety, decreased libido, confusion, neuropathy, somnolence, nervousness, headache. CV: Hot flashes, hypertension, chest pain, CHF. GI: Constipation, nausea, diarrhea, vomiting, increased liver function tests, abdominal pain, anorexia, dyspepsia, dry mouth, melena. Urogenital: Nocturia, hematuria, UTI, impotence, gynecomastia, incontinence, frequency, dysuria, urinary retention, urgency. Metabolic: Peripheral edema, hyperglycemia, weight loss, weight gain, gout. Musculoskeletal: Myasthenia, arthritis, myalgia, leg cramps, pathologic fractures. Skin: Rash, sweating, dry skin, pruritus, alopecia. Body as a Whole: Flu syndrome, bone pain, infection, anemia.Interactions
Drug: May increase effects of oral anticoagulants.Pharmacokinetics
Absorption: Readily from GI tract. Metabolism: In liver. Elimination: In urine and feces. Half-Life: 5.8 d.Nursing Implications
Assessment & Drug Effects
- Monitor for S&S of disease progression.
- Lab tests: Periodic PSA levels, CBC, liver functions, renal functions; with concurrent Coumadin therapy, closely monitor PT and INR.
Patient & Family Education
- Report jaundice or any other troubling adverse effects immediately.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug