Bicalutamide

The recommended dose for bicalutamide is one 50 mg tablet taken once daily at approximately the same time each day.

Bicalutamide may be taken with or without food. This treatment should be started at the same time as treatment with an LHRH analogue (e.g., Goserelin), or after surgical removal of the testicles.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Bicalutamide at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may decrease your appetite; it may cause hot flashes; it may cause indigestion; occasionally, it may cause breast development in men; it could cause water retention and swelling; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun; it may cause your breasts to feel swollen and tender. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Bicalutamide is no longer being manufactured for sale in Canada. For brands that may still be available, search under bicalutamide. This article is being kept available for reference purposes only. If you are using Bicalutamide, speak with your doctor or pharmacist for information about your treatment options.

Do not take bicalutamide if you:

• are allergic to bicalutamide or any ingredients of the medication
• have early-stage (localized) prostate cancer and would otherwise undergo watchful waiting

Bicalutamide is not intended to be used by women or children.

There may be an interaction between bicalutamide and any of the following:

• amiodarone
• anti-psychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Pimozide, Quetiapine, Risperidone)
• Aripiprazole
• "azole" antifungals (e.g., ketoconazole, fluconazole)
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• Disopyramide
• dofetilide
• Dronedarone
• flecainide
• Hydrocodone
• Lomitapide
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Porfimer
• Propafenone
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, moxifloxacin)
• salbutamol
• salmeterol
• sotalol
• Verteporfin
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Bicalutamide. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Bicalutamide.

Abnormal heart rhythm: Bicalutamide can cause changes to the normal rhythm of the heart, called QT prolongation. QT prolongation is a serious life-threatening condition. If you are at risk for heart rhythm problems (e.g., have heart failure, Angina, low potassium or magnesium levels; have congenital long QT syndrome; or are taking medications that can prolong the QT interval, such as quinidine, procainamide, Amiodarone, Sotalol, Flecainide), discuss with your doctor how Bicalutamide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bicalutamide, and whether any special monitoring is needed.

Anemia: Bicalutamide may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired, or pale skin, contact your doctor as soon as possible.

Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.

Diabetes: Bicalutamide may cause an increase in blood sugar levels. People with diabetes may find it necessary to monitor their blood sugar more frequently while using Bicalutamide.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Bicalutamide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bicalutamide, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Bicalutamide may cause drowsiness. Do not drive, operate machinery, or perform other hazardous tasks until you have determined how Bicalutamide affects you.

Heart disease: The risk of heart attack or heart failure is increased for people taking bicalutamide. If you have risk factors for heart disease (Obesity, high blood cholesterol, smoking), discuss with your doctor how Bicalutamide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bicalutamide, and whether any special monitoring is needed.

Liver function: Bicalutamide is broken down by the liver. Liver disease or reduced liver function may cause Bicalutamide to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Bicalutamide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bicalutamide, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Bicalutamide.

Bicalutamide may also cause liver problems. Contact your doctor immediately if you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin.

Lung disease: Rarely, and particularly when higher doses are used, cases of interstitial lung disease have been reported with Bicalutamide. If you experience any symptoms of lung problems such as breathing difficulties, wheezing, cough, fever, or shortness of breath, contact your doctor immediately.

Osteoporosis: Long-term use of bicalutamide has been shown to cause reduced bone strength and may increase the risk of bone fractures. If you have osteoporosis or are at increased risk of developing osteoporosis, discuss with your doctor how Bicalutamide may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Bicalutamide, and whether any special monitoring is needed.

Sensitivity to sunlight: Bicalutamide may increase the sensitivity of the skin to sunlight, increasing the risk of sunburn. Avoid exposure to sunlight for long periods of time, particularly between the hours of 10 am and 2 pm, while you are taking Bicalutamide and for 7 days after completing treatment. Wear a broad-spectrum sunscreen and lip balm with an SPF of 50 or greater. If you notice any unusual skin rash or peeling, contact your doctor immediately.

Children: The safety and effectiveness of Bicalutamide have not been determined for children.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. This medication should be swallowed whole. It should not be split, crushed or chewed. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food.