Bicalutamide

Other Names: Casodex®

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About This Drug

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

Possible Side Effects

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

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 cause liver failure and 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 an LHRH agonist. If you have diabetes, changes may need to be made to your diabetes medication.
  • 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.
  • This drug can cause sensitivity to sunlight/light. You may get a skin rash/reaction while being out in the sun, sun lamps and tanning beds.

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 and contact your doctor. Do not take 2 doses at the same time and do not double up on the next dose.
  • 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.
  • Disposal of unused medicine: Do not flush any expired and/or unused medicine down the toilet or drain unless you are specifically instructed to do so on the medication label. Some facilities have take-back programs and/or other options. If you do not have a take-back program in your area, then please 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.
  • Ask your doctor or nurse about medicines that are available to help stop or lessen constipation.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • 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 that is available to help stop or lessen these symptoms.
  • If you throw up or have diarrhea, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • If you have diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea and/or constipation.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • 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.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • 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 over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) 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 supplements 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 100.4° F (38° C) or higher
  • Chills
  • Wheezing or trouble breathing
  • Feeling dizzy or lightheaded
  • Tiredness or weakness that interferes with your daily activities
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Pain in your abdomen that does not go away 
  • No bowel movement in 3 days or when you feel uncomfortable
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • Weight gain of 5 pounds in one week (fluid retention)
  • Swelling of your legs, ankles and/or feet
  • Swelling of your breasts and/or breast pain
  • 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
  • Abnormal blood sugar
  • 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 your urine
  • Pain that does not go away or is not relieved by prescribed medicine
  • New rash and/or itching
  • Rash that is not relieved by prescribed medicines
  • 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 June 2019

This patient information was developed by Via Oncology, LLC © 2019. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.