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Casodex (BICALUTAMIDE) is an oral non-steroidal anti-androgen for prostate cancer. It is the world's leading anti-androgen and is available in all major European markets, the USA and Japan. Casodex was first launched in 1995 as a combination treatment (with surgical or medical castration) for advanced prostate cancer and subsequently launched as monotherapy for the treatment of earlier stages of the disease. Casodex has received approval as a monotherapy treatment in over 60 markets to date.

Common uses

Casodex is an anti-androgen. It works in the body by preventing the actions of androgens (male hormones).
Casodex is used together with another hormone to treat prostate cancer.
Casodex may also be used for purposes other than those listed in this medication guide.
Before using

Before taking Casodex, tell your doctor if you have liver disease or if you use a blood thinner such as warfarin (Coumadin). Casodex is given as part of a combination prostate cancer treatment with another medication that prevents the testicles from producing testosterone. You should not start taking this medication until you have received the other medication prescribed as part of your treatment.
Your doctor may occasionally change your Casodex dose to make sure you get the best results from this medication. Do not stop taking Casodex without your doctor's advice. If you stop your treatment suddenly, your condition may become worse.
To be sure Casodex is helping your condition and is not causing harmful effects, your prostate and liver function will need to be checked with blood tests on a regular basis. Do not miss any scheduled appointments.
Call your doctor at once if you have a serious side effect such as chest pain, shortness of breath, swelling, blood in your urine, or stomach pain with loss of appetite, dark urine, and yellowing of your skin or eyes.
Casodex should never be taken by a woman or a child. Although Casodex is not for use by women, this medication can cause birth defects if a woman is exposed to it during pregnancy.

Directions

Casodex is a pill, taken by mouth. It is taken once a day and is usually started at the same time LHRH therapy is started.
• It should be taken at the same time each day, with or without food.
• You should empty your bladder (urinate) before taking the medication.
• In some cases (e.g. spinal cord metastasis), Casodex will be started approximately 5-7 days before you receive the LHRH agonist. This is done to block the "flare" or surge of testosterone that occurs after LHRH agonist is given.
• The amount of Casodex you receive depends on many factors. Your doctor will determine your dose and schedule.

Cautions

• Do not stop taking Casodex unless your healthcare provider tells you to. Take the medication exactly as directed.
• Take at the same time each day.
• Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
• If you are experiencing hot flashes, wearing light clothing, staying in a cool environment, and putting cool cloths on your head may reduce symptoms. Consult you health care provider if these worsen, or become intolerable.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
• Get plenty of rest.
• Maintain good nutrition.
• If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.


Possible side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• chest pain;
• cough or trouble breathing;
• feeling short of breath, even with mild exertion;
• swelling in your hands or feet;
• blood in your urine; or
• nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
• hot flashes;
• breast pain or swelling;
• weakness;
• back pain, pelvic pain, joint or muscle pain;
• increased nighttime urination;
• stomach pain, nausea, vomiting, loss of appetite;
• diarrhea or constipation;
• weight changes;
• impotence, loss of interest in sex, or trouble having an orgasm;
• dizziness, headache; or
• sore throat, runny nose or other cold symptoms.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.


If you take too much

Seek emergency medical attention if you think you have used too much of this medicine.
An overdose of Casodex is not expected to produce life-threatening symptoms.

Additional information

Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are using Casodex.

Drug interactions

Before taking Casodex, tell your doctor if you are taking a blood thinner such as warfarin (Coumadin).
There may be other medicines that can interact with Casodex. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.