Casodex is an anti-androgen. It works in the body by preventing the actions of androgens (male hormones).

Casodex is used to treat prostate cancer that has spread to other parts of the body (metastatic).

Casodex is given in combination with another medicine called a luteinizing (LOO-tee-in-ize-ing) hormone-releasing hormone, or LHRH. LHRH helps prevent the testicles from producing testosterone.

Warnings

Casodex is used to treat prostate cancer. This medicine should never be taken by a woman or a child.

Bicalutamide can harm an unborn baby if you father a child while using this medicine. Use effective birth control to prevent pregnancy while using Casodex and for at least 130 days (about 19 weeks) after your last dose.

Casodex can harm your liver. Call your doctor at once if you have nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

Before taking this medicine

You should not use Casodex if you are allergic to bicalutamide.

Use effective birth control if your sex partner is able to get pregnant. Bicalutamide can harm an unborn baby if you father a child while using this medicine. Keep using birth control for at least 130 days (about 19 weeks) after your last dose.

Casodex is not for use by women or children.

This medicine can cause birth defects if a woman takes it during pregnancy.

To make sure Casodex is safe for you, tell your doctor if you have:

• liver disease; or
• diabetes.

How should I take Casodex?

Take Casodex exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Casodex is usually taken once per day in the morning or evening.

Take the medicine at the same time each day, with or without food.

LHRH is given as an injection or a tiny implant injected through a needle under the skin around your navel. LHRH injections are given at intervals such as once every 4 weeks. Follow your doctor’s instructions.

You should not stop using Casodex unless your doctor tells you to.

You will need frequent medical tests.

Store at room temperature away from moisture and heat.

Dosing information

Usual Adult Dose for Prostate Cancer:

In combination with an LHRH analog: 50 mg orally once a day (morning or evening)

Comments:
-Therapy with this drug should be started at the same time as therapy with an LHRH analog.
-If a dose is missed, take the next dose at the scheduled time. Do not take the missed dose and do not double the next dose.

Use: For use in combination therapy with a luteinizing hormone-releasing hormone (LHRH) analog for the treatment of Stage D2 metastatic carcinoma of the prostate

What happens if I miss a dose?

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

Call your doctor for instructions if you miss an appointment for your LHRH injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What to avoid

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Casodex could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Casodex side effects

Get emergency medical help if you have signs of an allergic reaction to Casodex: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• breast pain or swelling;
• sudden chest pain, wheezing, dry cough, feeling short of breath;
• low red blood cells (anemia)–pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet;
• liver problems–nausea, upper stomach pain, feeling tired, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes), fever, chills;
• high blood sugar–increased thirst, increased urination, dry mouth, fruity breath odor; or
• (if you also take warfarin) unusual bruising or bleeding.

Common Casodex side effects may include:

• anemia;
• blood in your urine;
• fever, chills, flu-like symptoms;
• trouble breathing;
• hot flashes;
• pain in your back, pelvis, or stomach;
• swelling in your arms, ankles, legs, or feet;
• increased night-time urination;
• weakness, dizziness; or
• nausea, diarrhea, constipation.

Bicalutamide is a prescription medicine belonging to a class of medicines called non-steroidal androgen receptor inhibitors.

Bicalutamide is used to treat prostate cancer that has spread to other parts of the body (metastatic).

Bicalutamide is given in combination with another medicine called a luteinizing (LOO-tee-in-ize-ing) hormone-releasing hormone, or LHRH. LHRH helps prevent the testicles from producing testosterone.

It is not known if bicalutamide tablets are safe and effective in children.

Warnings

Bicalutamide can harm an unborn baby if you father a child while using this medicine. Use effective birth control to prevent pregnancy while using bicalutamide and for at least 130 days (about 19 weeks) after your last dose.

Before taking this medicine

You should not use this medicine if you are allergic to bicalutamide.

Use effective birth control if your sex partner is able to get pregnant. Bicalutamide can harm an unborn baby if you father a child while using this medicine. Keep using birth control for at least 130 days (about 19 weeks) after your last dose.

Bicalutamide is not for use by women or children.

This medicine can cause birth defects if a woman takes it during pregnancy.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• liver disease; or
• diabetes.

How should I take bicalutamide?

Take bicalutamide exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Bicalutamide is usually taken once per day in the morning or evening.

Take the medicine at the same time each day, with or without food.

LHRH is given as an injection or a tiny implant injected through a needle under the skin around your navel. LHRH injections are given at intervals such as once every 4 weeks. Follow your doctor’s instructions.

You should not stop using bicalutamide unless your doctor tells you to.

You will need frequent medical tests.

Store at room temperature away from moisture and heat.

Dosing information

Usual Adult Dose for Prostate Cancer:

In combination with an LHRH analog: 50 mg orally once a day (morning or evening)

Comments:
-Therapy with this drug should be started at the same time as therapy with an LHRH analog.
-If a dose is missed, take the next dose at the scheduled time. Do not take the missed dose and do not double the next dose.

Use: For use in combination therapy with a luteinizing hormone-releasing hormone (LHRH) analog for the treatment of Stage D2 metastatic carcinoma of the prostate

What happens if I miss a dose?

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

Call your doctor for instructions if you miss an appointment for your LHRH injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking bicalutamide?

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Bicalutamide could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Bicalutamide side effects

Get emergency medical help if you have signs of an allergic reaction to bicalutamide: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• breast pain or swelling;
• sudden chest pain, wheezing, dry cough, feeling short of breath;
• low red blood cells (anemia) – pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet;
• liver problems – nausea, upper stomach pain, feeling tired, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes), fever, chills;
• high blood sugar – increased thirst, increased urination, dry mouth, fruity breath odor; or
• (if you also take warfarin) unusual bruising or bleeding.

Common bicalutamide side effects may include:

• anemia;
• blood in your urine;
• fever, chills, flu-like symptoms;
• trouble breathing;
• hot flashes;
• pain in your back, pelvis, or stomach;
• swelling in your arms, ankles, legs, or feet;
• increased night-time urination;
• weakness, dizziness; or
• nausea, diarrhea, constipation.

What is flutamide?

Flutamide is a nonsteroidal antiandrogen (testosterone blocker) medicine.

Flutamide capsules are used to treat prostate cancer.

Flutamide is given in combination with another medicine called a luteinizing (LOO-tee-in-ize-ing) hormone-releasing hormone, or LHRH. LHRH helps prevent the testicles from producing testosterone.

Warnings

Flutamide can cause serious liver problems. Call your doctor at once if you have upper stomach pain, itching, tiredness, loss of appetite, dark urine, clay-colored stools, or yellowing of your skin or eyes.

Before taking this medicine

You should not use flutamide if you are allergic to it, or if you have severe liver problems.

Flutamide should never be taken by a woman or a child.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• liver disease;
• a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency;
• hemoglobin M disease;
• if you smoke; or
• if you also take a blood thinner (warfarin, Coumadin, Jantoven).

Although flutamide is not for use by women, this medicine can cause birth defects if a woman is exposed to it during pregnancy.

How should I take flutamide?

Take flutamide capsules exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Flutamide is usually taken every 8 hours.

Follow your doctor’s dosing instructions very carefully.

Drink plenty of liquids. Your doctor may recommend a special diet to help prevent diarrhea.

You will need frequent medical tests.

It is recommended you get blood tests: before starting treatment with flutamide, every month for the first 4 months of treatment, and periodically after the first 4 months.

Call your doctor if you have severe or ongoing diarrhea. Your doctor may recommend an anti-diarrhea medicine.

You should not stop using flutamide suddenly. Stopping suddenly may make your condition worse.

Store at room temperature away from moisture, heat, and light.

Dosing information

Usual Adult Dose for Prostate Cancer:

250 mg orally every 8 hours

Comments:
-This drug may be taken with or without food.
-Stage B2-C Prostatic Carcinoma: Treatment with this drug and the goserelin acetate implant starting 8 weeks prior to initiating radiation therapy and continue during radiation therapy.
-Stage D2 Metastatic Carcinoma: This drug should be initiated with the LHRH-agonist and continued until progression.

Use: Locally confined Stage B2-C and Stage D2 metastatic carcinoma of the prostate

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Call your doctor for instructions if you miss an appointment for your LHRH injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking flutamide?

To help prevent diarrhea, avoid dairy products such as milk, cheese, and yogurt. Do not use laxatives while taking flutamide.

Flutamide side effects

Get emergency medical help if you have signs of an allergic reaction to flutamide: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Flutamide can cause serious liver problems. Call your doctor at once if you have:

• nausea, upper stomach pain, loss of appetite;
• itching, tiredness, flu-like symptoms;
• dark urine, clay-colored stools; or
• jaundice (yellowing of the skin or eyes).

Common flutamide side effects may include:

• breast swelling or tenderness;
• hot flashes;
• vomiting, nausea, diarrhea; or
• impotence, loss of interest in sex.

What is Nilandron?

Nilandron is used to treat prostate cancer that has spread to other parts of the body.

Nilandron is for use in men who have undergone surgical castration.

Nilandron may also be used for purposes not listed in this medication guide.

Nilandron side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Nilandron may cause serious side effects. Call your doctor at once if you have:

• chest pain, wheezing, dry cough, fever;
• new or worsening shortness of breath;
• flu symptoms, pale skin, feeling tired; or
• liver problems–nausea, vomiting, loss of appetite, right-sided upper stomach pain, flu-like symptoms, dark urine, jaundice (yellowing of the skin or eyes).

Common side effects of Nilandron may include:

• hot flashes;
• dizziness;
• constipation;
• nausea or vomiting, loss of appetite;
• skin rash;
• decreased libido, impotence; or
• vision changes.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects .

Warnings

You should not use Nilandron if you have severe liver disease or severe breathing problems.

Nilandron can cause serious lung problems. Call your doctor right away if you have chest pain, wheezing, dry cough, fever, and new or worsening shortness of breath.

Before taking this medicine

You should not use Nilandron if you are allergic to it, or if you have:

• severe liver disease; or
• severe breathing problems.

Tell your doctor if you have ever had:

• liver disease; or
• asthma or another lung disease.

Nilandron is not for use in women, and the effects of Nilandron during pregnancy or in breastfeeding women are unknown.

How should I take Nilandron?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Treatment with Nilandron should be started on the day of or on the day after surgical castration.

You may take Nilandron with or without food.

Do not stop taking this medication without first talking to your doctor.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking Nilandron?

Nilandron may cause a delay in your ability to see in the dark after you have been in a lighted area. Be careful when driving at night, when entering a tunnel, and in similar situations. Wearing tinted glasses may help lessen this effect.

Drinking alcohol with Nilandron may cause dizziness, flushing (warmth, redness, or tingly feeling), or other unpleasant symptoms.

What is nilutamide?

Nilutamide is used to treat prostate cancer that has spread to other parts of the body.

Nilutamide is for use in men who have undergone surgical castration.

Nilutamide may also be used for purposes not listed in this medication guide.

Nilutamide side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Nilutamide may cause serious side effects. Call your doctor at once if you have:

• chest pain, wheezing, dry cough, fever;
• new or worsening shortness of breath;
• flu symptoms, pale skin, feeling tired; or
• liver problems–nausea, vomiting, loss of appetite, right-sided upper stomach pain, flu-like symptoms, dark urine, jaundice (yellowing of the skin or eyes).

Common side effects of nilutamide may include:

• hot flashes;
• dizziness;
• constipation;
• nausea or vomiting, loss of appetite;
• skin rash;
• decreased libido, impotence; or
• vision changes.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings

You should not use nilutamide if you have severe liver disease or severe breathing problems.

Nilutamide can cause serious lung problems. Call your doctor right away if you have chest pain, wheezing, dry cough, fever, and new or worsening shortness of breath.

Before taking this medicine

You should not use nilutamide if you are allergic to it, or if you have:

• severe liver disease; or
• severe breathing problems.

Tell your doctor if you have ever had:

• liver disease; or
• asthma or another lung disease.

Nilutamide is not for use in women, and the effects of nilutamide during pregnancy or in breastfeeding women are unknown.

How should I take nilutamide?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Treatment with nilutamide should be started on the day of or on the day after surgical castration.

You may take nilutamide with or without food.

Do not stop taking this medication without first talking to your doctor.

Store at room temperature away from moisture and heat.

Nilutamide dosing information

Usual Adult Dose for Prostate Cancer:

-Initial dose: 300 mg orally once a day for first 30 days

-Maintenance dose: 150 mg orally once a day after first 30 days

-Comments: For maximum benefit, treatment should begin on the same day or the day after surgical castration.

Use: Treatment of metastatic prostate cancer (Stage D2) in combination with surgical castration.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking nilutamide?

Nilutamide may cause a delay in your ability to see in the dark after you have been in a lighted area. Be careful when driving at night, when entering a tunnel, and in similar situations. Wearing tinted glasses may help lessen this effect.

Drinking alcohol with nilutamide may cause dizziness, flushing (warmth, redness, or tingly feeling), or other unpleasant symptoms.

What is Nubeqa?

Nubeqa is a prescription androgen receptor inhibitor used to treat prostate cancer.

Nubeqa is used to treat prostate cancer that has not spread to other parts of your body and no longer responds to a medical or surgical treatment that lowers testosterone (non-metastatic castration-resistant prostate cancer or nmCRPC).

Nubeqa is also used to treat prostate cancer that has spread to other parts of the body and responds to medical or surgical treatment that lowers testosterone (metastatic castration-sensitive prostate cancer or mCSPC). It can be used alone or in combination with docetaxel. 

It is not known if Nubeqa is safe and effective in children or in females.

Warnings

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

To make sure Nubeqa is safe for you, tell your doctor if you have ever had:

• liver or kidney disease.

Darolutamide may harm an unborn baby or cause a miscarriage. Nubeqa is not for use by women. Use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 1 week after your last dose. Tell your doctor right away if a pregnancy occurs while you are using Nubeqa.

It may be harder for you to get a woman pregnant while you are using Nubeqa. You should still use birth control to prevent pregnancy because the medicine can harm an unborn baby.

Nubeqa is not for use by women or by anyone younger than 18 years old.

How should I take Nubeqa?

Take Nubeqa exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Take with food.

Swallow the tablet whole and do not crush, chew, or break it.

If you have not had castration surgery (to lower the amount of testosterone in your body), your doctor may also prescribe a gonadotropin-releasing hormone (GnRH) medicine such as Eligard, Lupron, Trelstar, Zoladex, or Vantas. Keep using your GnRH as directed.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Dosing information

Usual Adult Dose for Prostate Cancer:

• 600 mg (2 x 300 mg tablets) orally 2 times a day.
• Swallow tablets whole.
• Take with food.
  
  Comments:
  – Patients receiving this drug should also receive a gonadotropin-releasing hormone (GnRH) analog concurrently or should have had a bilateral orchiectomy.
  – For patients with mCSPC treated with Nubeqa in combination with docetaxel, administer the first cycle of docetaxel within 6 weeks after the start of Nubeqa treatment.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What to avoid

Follow your doctor’s instructions about any restrictions on food, beverages, or activity.

Nubeqa side effects

Get emergency medical help if you have signs of an allergic reaction to Nubeqa: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• severe ongoing nausea or diarrhea;
• painful or difficult urination;
• blood in your urine;
• severe headache, blurred vision, pounding in your neck or ears;
• slow heart rate, weak pulse, fainting, slow breathing (breathing may stop);
• signs of a blood clot in the lung – chest pain, sudden cough, wheezing, rapid breathing, coughing up blood; or
• signs of a lung infection – fever, chills, cough with mucus, chest pain, shortness of breath.

Your cancer treatments may be delayed if you have certain side effects.

Common Nubeqa side effects may include:

• feeling tired;
• pain in your arms, hands, legs, or feet;
• rash;
• low white blood cells; or
• abnormal liver function tests.

When used in combination with docetaxel in mCSPC, the most common side effects of Nubeqa are:

• constipation
• rash
• decreased appetite
• hemorrhage
• increased weight
• high blood pressure
• laboratory test abnormalities, such as anemia, high blood glucose levels, decreased lymphocyte count, decreased neutrophil count, increased AST, increased ALT, and low calcium levels.