Safety Precautions for Casodex (Bicalutamide )  

Serious side effects of Casodex:  

• Decreased appetite 

• Decreased libido 

• Depression (Arrhythmia) or Pounding Heartbeat (Palpitations) 

• Swelling of Ankles or Feet (Edema) 

• Dizziness 

• Indigestion 

• Flatulence 

• Hot flashes 

• Lung Irritation (allergic alveolitis) 

• Patchy skin/Pale skin tone 

• Common side effects of Casodex: 

• Nausea or vomiting  

• Shortness of breath 

• Fatigue 

• Urinary tract infection 

• Reducing bone strength resulting in frequent fractures 

• Diarrhea 

• Increased cholesterol (Hypercholesterolemia) and triglycerides 

• Anemia 

• Hypokalemia 

• Upper abdominal pain 

• Loss of appetite 

Note: Please refer a doctor immediately in case of any such side effects. Symptoms should not be ignored as it may lead to higher risks 

• The side effects of the medicine make it necessary for regular checkups and monitoring by medical advisor. 

• It is advised that the Casodex be administered 1 hour before meal or 2 hours after your meal. Casodex has adverse reactions to certain types of food resulting in serious side effects such as high blood pressure, muscle weakness, paralysis, and breathing difficulties. The medicine needs to be strictly administered on empty stomach on advisement from the doctor. 

• Alcohol consumption is strictly prohibited to patient undergoing administration of Casodex.

Direction for Use of Casodex (Casodex)  

• Use as prescribed by the physician 

• The recommended dose for CASODEX therapy in combination with an LHRH analog is one 50 mg tablet once daily (morning or evening), with or without food.  

• It is recommended that CASODEX be taken at the same time each day. Treatment with CASODEX should be started at the same time as treatment with an LHRH analog. 

• Medicine to be strictly administered on empty stomach 

• If a dose of CASODEX is missed, take the next dose at the scheduled time. Do not take the missed dose and do not double the next dose. 

Warning use of Casodex (Casodex) 

1. Cases of death or hospitalization due to severe liver injury (hepatic failure) have been reported post-marketing in association with the use of CASODEX. 

2. Hepatotoxicity in these reports generally occurred within the first three to four months of treatment. Hepatitis or marked increases in liver enzymes leading to drug discontinuation occurred in approximately 1% of CASODEX patients in controlled clinical trials. 

3. Not recommended for use in pediatric patients or females. 

4. Casodex can cause fetal harm, effective contraception methods must be used by patient under the administration for prevention of transfer of medication through bodily fluids.  

Do not donate sperm during administration of the medicine. Refer a doctor before donation.

Ques: What is the best time of day to take Casodex? 

Ans:  

• It is best to take this medicine at the same time each day, in the morning or in the evening. This medicine should be started at the same time as treatment with a luteinizing hormone-releasing hormone  

• It is advisable not to change and/or stop your dose without prior discussion/suggestion of your doctor. 

• Casodex should be taken on empty stomach. 

• Consume the whole tablet. Do not crush, chew or dissolve the medicine.  

• In case of grave side effects refer your doctor or visit the hospital emergency immediately. 

Ques: What are necessary precautions to be followed while administration of Casodex? 

Ans: Casodex may cause side effects and/or use impacts if administered with other medicines, vitamins, and herbal supplements. Before starting Casodex, your doctor should be completely aware of your medical history, previous ongoing treatments and prescriptions. Specific precautions that need to be taken: 

For Males  

• Who are with female partners who are pregnant or so plan should use effective birth control (contraception) during treatment. Transfer of medicine through bodily fluids can leave an irreparable damage to the fetus.  

• Avoid sperm donation during the treatment. Donation should only be made with prior consultation by the doctor. 

For Females  

• Having male counterparts consuming Casodex planning to be pregnant should use effective birth control (contraception) during the treatment period. 

• Who are breastfeeding should take necessary precautions. The medicine is highly toxic for the baby and has shown significant harmful effects in their development. 

Ques: Does Casodex lower PSA 

Ans: A subset of patients who stop Casodex treatment develop antiandrogen withdrawal syndrome, this is when after stopping Casodex the patient has a decrease in prostate-specific antigen (PSA) and they may benefit from a clinical improvement. 

• Hepatic impairment; 

• Any cardiovascular disease;  

• Lung or breathing problems;  

• Kidney problems; or  

• Blood pressure problems. 

Ques: How long do you stay on Casodex? 

Ans: If you are having bicalutamide to stop tumour flare, you take it for a few days before starting the luteinising hormone blocker, and stay on it for about 4 to 6 weeks. 

• Nausea or vomiting  

• Shortness of breath 

• Fatigue 

• Urinary tract infection 

• Reducing bone strength resulting in frequent fractures 

• Diarrhea 

• Increased cholesterol (Hypercholesterolemia) and triglycerides 

• Anemia 

• Hypokalemia 

• Upper abdominal pain 

• Loss of appetite 

Persistence in any of the symptoms may lead to fatal side effects. Refer your doctor immediately if you suffer any such symptoms for alternate medicine or additional medication to curb them. 

Ques: Is Casodex a steroid? 

Ans: The cost for Casodex oral tablet 50 mg is around $3,451 for a supply of 30 tablets, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.   

Specific studies to prove its efficiency/cure in any other type of cancer is yet not available. 

Ques: Can I take Casodex without referring a doctor? 

Ans: No. Self-medication is strictly prohibited. Casodex is known to have serious side effects. Prior consultation by a cancer specialist is strongly recommended. Also patients with pre-existing medical conditions need to disclose their medical history top their doctors before starting treatment with Casodex.   

Ques: Can I consume alcohol while under treatment with Casodex? 

Ans: Consumption of alcohol during administration of Casodex should be avoided. Though no studies support any reaction of the medicine with alcohol, doctor’s instructions should be sought before consumption.  

Ques: Can I take Casodex on empty stomach? 

Ans: Yes. Casodex is advised to be taken empty stomach to curb the side effects of the medicine when taken with food. Adverse effects such as a high blood pressure, muscle weakness, paralysis, and breathing difficulties are common symptoms noticed if medicine is taken along with food. Interval of 1 hour before meal and 2 hours after meal is advised for administration of the medicine.   

Ques: Is it common to have a low blood cell count during treatment with Casodex? 

Ans: Yes. Low blood cell count is a symptom. However, it is advisable to bring it to the notice of your physician. Persistent low blood cell count may lead to serious side effects. 

Ques: Is it important to get a regular blood cell count done up during treatment from Casodex? 

Ans: Yes. Usage of Casodex often leads to low blood cell count. To continue taking the medicine during the treatment period, it is advisable to get a regular blood cell count done up. 

Ques: Why is prednisolone advised while under regular administration of Casodex? 

Ans: Administration of Casodex leads to side effects such as high blood pressure, fluid retention (having too much water in your body), or having reduced levels of potassium in your blood. The risk of the side effects can be fatal. In order to counteract the side-effects of Casodex, your doctor advises prednisolone. 

Ques: Is it common to have swelling in feet or around ankles while administration of Casodex? 

Ans: Swelling of feet and ankles is a serious side-effect to the medicine. Immediate referral of a doctor is advised to curb additional effects. Self-medication to overcome symptoms is strictly prohibited.  

Ques: Is Casodex safe to be used for treating cancer in pediatric patients or females? 

Ans: Casodex is a hormonal treatment drug administered to males only undergoing treatment of prostate cancer. No definite study supports the use of Casodex in pediatric patients or females for any other type of cancer.  

Ques: Does the consumption of Casodex have any sexual effects? 

Ans: Yes. Reduced sex drive (libido) is a common medicinal side effect noticed due to the presence of the compound Casodex.