Bicalutamide

Other Names: Casodex®

About This Drug

Bicalutamide is used to treat cancer. This drug is given orally (by mouth). 

Possible Side Effects

  • Hot flashes or sudden skin flushing may happen. You may also feel warm or red. 
  • Pain (general, back pain, pain in your abdomen)
  • Weakness 
  • Infections
  • Trouble breathing
  • Constipation (not being able to move bowels)
  • Loose bowel movements (diarrhea)
  • Nausea
  • Blood in your urine
  • Frequent urination at night
  • Swelling of your legs, ankles, and/or feet
  • Decrease in red blood cells (you may feel more tired)

Note: Each of the side effects above was reported in 10% or greater of patients treated with bicalutamide. Not all possible side effects are included above. 

Warnings and Precautions

  • Changes in your liver function, which can very rarely cause liver failure and/or be life-threatening. 
  • Swelling of your breasts and/or breast pain.
  • Blood sugar levels may change if this drug is taken together with a drug called a luteinizing hormone-releasing hormone  (LHRH) agonist. If you have diabetes, changes may need to be made to your diabetes medication.
  • Sensitivity to sunlight/light. You may get a skin rash/reaction while being out in the sun, sun lamps and tanning beds. 
  • Increased risk of bleeding if this drug taken together with warfarin. Symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds, or any other unusual bleeding. 

Important Information

  • This drug may impair your ability to drive or use machinery. Use caution and tell your nurse or doctor if you feel very sleepy. 

How to Take Your Medication

  • Swallow the medicine whole with or without food. Take this medicine at the same time each day. 
  • Missed dose: If you vomit or miss a dose, take your next dose at the regular time.  Do not take 2 doses at the same time.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • Ask your doctor or nurse about medicines that are available to help stop or lessen constipation.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you’re diabetic, keep good control of your blood sugar level. Tell your nurse or your doctor if your glucose levels are higher or lower than normal.
  • Use sunscreen with SPF 30 or higher when you are outdoors even for a short time. Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.

Food and Drug Interactions

  • There are no known interactions of bicalutamide with food.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are known drug interactions with bicalutamide. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.
  • There are known interactions of bicalutamide with blood thinning medicine such as warfarin. Ask your doctor what precautions you should take.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Wheezing or trouble breathing
  • Feeling dizzy or lightheaded
  • Fatigue that interferes with your daily activities
  • No bowel movement in 3 days or when you feel uncomfortable
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Weight gain of 5 pounds in one week (fluid retention) Abnormal blood sugar
  • Easy bleeding or bruising
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools (bright red, or black/tarry)
  • Coughing up blood
  • Unusual thirst, passing urine often, headache, sweating, shakiness, irritability
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Frequent urination at night
  • Blood in urine
  • Sensitivity to sunlight/light
  • If you think you may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Bicalutamide is not indicated for use in women. Men with female partners of child-bearing potential should use effective methods of birth control during your cancer treatment and for at least 130 days after your cancer treatment. Let your doctor know right away if you think you may have impregnated your partner.
  • Breastfeeding warning: It is not known if this drug passes into breast milk. Bicalutamide is not indicated for use in women.
  • Fertility Warning: In men, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm banking.

Revised November 2017

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services.  The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication.  The dose, method of administration and contraindications for any administered medication should be confirmed before use.  UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.