bicalutamide

Action

Antagonizes effects of androgen at cellular level by binding to androgen receptors on target tissues

Availability

Tablets: 50 mg

Indications and dosages

➣ Metastatic prostate cancer

Adults: 50 mg P.O. once daily

Contraindications

• Hypersensitivity to drug

• Women who are or may become pregnant

Precautions

Use cautiously in:

• previous hypersensitivity or serious adverse reaction to flutamide or nilutamide

• moderate to severe hepatic impairment

• children.

Administration

• Know that drug is given in combination with luteinizing hormone-releasing hormone (LHRH).

• Administer at same time each day.

Adverse reactions

CNS: headache, weakness, dizziness, depression, hypertonia, paresthesia, lethargy

CV: chest pain, peripheral edema, vasodilation, hypertension, thromboembolic disease

EENT: pharyngitis, bronchitis

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, anorexia, dry mouth

GU: urinary tract infection, impotence

Musculoskeletal: bone and back pain

Respiratory: dyspnea, cough

Skin: rash, alopecia

Other: food distaste, weight gain, edema, pain, hot flashes, flulike symptoms

Interactions

Drug-drug. Warfarin: increased bicalutamide effects

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, cholesterol, BUN, creatinine: increased levels

Hemoglobin, white blood cells: decreased values

Patient monitoring

• Monitor prostate-significant antigen levels, CBC, and liver and kidney function test results.

• If patient is receiving warfarin concurrently, evaluate prothrombin time and International Normalized Ratio.

Patient teaching

• Instruct patient to take drug at same time each day, along with prescribed LHRH analog.

• Tell patient that any drug-related hair loss should reverse once therapy ends.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.