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BICALUTAMIDE

Medical Diagnosis and Drugs, Medications
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

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