It works by blocking testosterone, a male sex hormone that is also known as an androgen, from binding to androgen receptors. Testosterone can stimulate the growth of prostate cancer cells. By blocking the action of testosterone in the body, Casodex helps slow or stop the cancer.
What Is Casodex Used For?
The Food and Drug Administration approved Casodex to treat metastatic prostate cancer. Casodex must be used in combination with an LHRH agonist (e.g., goserelin or leuprolide).
Brand Name(s): Casodex
Administration Route(s): Oral
Drug Availability: Prescription
Therapeutic Classification: Antiandrogen
Available Generically: Yes
Controlled Substance: N/A
Active Ingredient: Bicalutamide
Dosage Form(s): Tablet
How to Take Casodex
Take Casodex once a day, in the morning or evening, and around the same time each day. It can be taken with food or on an empty stomach.
Storage
Casodex should be stored at room temperature, between 68 F and 72 F.
What Are the Side Effects of Casodex?
This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.
People who take Casodex for metastatic prostate cancer may have side effects from the medication. Contact your healthcare provider if you have side effects that worsen or don’t go away.
Common Side Effects
Common side effects of Casodex can include:
Hot flashes Fatigue Body pain (typically in the back, abdomen, and pelvis) Infection Constipation Muscle weakness Shortness of breath Nausea Swelling in the hands, ankles, or feet Diarrhea Increased urination at night Blood in the urine Anemia (low red blood cells) Gynecomastia (enlarged breast tissue in men)
Severe Side Effects
Though not common, there are some severe side effects associated with taking Casodex.
Casodex can cause liver injury, which can present with symptoms including:
Abdominal pain Nausea Yellowing of the eyes (jaundice) Dark urine Elevated liver enzymes in blood testing
Other serious side effects can include elevated blood sugar and bleeding in people also taking warfarin, a blood thinner.
Call your healthcare team right away if you have any severe side effects. If the side effects are life-threatening or you’re having a medical emergency, call 911 or go to the nearest emergency room right away.
Dosage: How Much Casodex Should I Take?
Missed Dose
If you miss a dose of Casodex, take it at the next scheduled time. Do not take a double dose to make up for a missed dose.
If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (tablets): For prostate cancer: Adults—50 milligrams (mg) once a day, in the morning or in the evening. Children—Use and dose must be determined by your doctor.
Overdose: What Happens If I Take Too Much Casodex?
Studies have shown no severe effects associated with high daily doses of Casodex. However, it is important to contact your healthcare provider or call Poison Control at 800-222-1222 if you think you may have overdosed on Casodex.
Precautions
What Are Reasons I Shouldn’t Take Casodex?
There are a couple of situations in which you should not take Casodex.
If someone collapses or isn’t breathing after taking Casodex, call 911 immediately.
Women who are pregnant or may become pregnant should not use bicalutamide tablets. Using this medicine while you are pregnant can harm your unborn baby. It may also cause birth defects if the father is using it when his sexual partner becomes pregnant. Male patients who have female partners should use effective birth control during treatment with this medicine and for 130 days after the last dose. If you think your female partner has become pregnant while using this medicine, tell your doctor right away.
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.
Bicalutamide may cause serious bleeding when you use it together with a blood thinner medicine (eg, warfarin). Talk to your doctor if you have concerns.
This medicine may cause swelling of the breasts (gynecomastia) and breast pain in some patients. If you have questions about this, talk to your doctor.
Using this medicine with an LHRH analog may affect your blood sugar levels. If you notice a change in the results of your blood sugar tests or if you have any questions, check with your doctor.
This medicine may affect the results of the prostate specific antigen (PSA) test, which may be used to detect prostate cancer. Make sure any doctor or dentist who treats you knows that you are using this medicine.
If you plan to have children, talk with your doctor before using this medicine. This medicine may cause some men to become infertile (unable to have children), at least temporarily.
This medicine may make you sleepy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Casodex is not indicated for use in females. If you are pregnant, you should not take Casodex, as it can harm your unborn baby. You should also not use Casodex if you are allergic to the medication. Symptoms of an allergic reaction can include:
ItchingSwellingHivesTrouble breathing or swallowingSwelling of the face, lips, or tongue
What Other Medications Interact With Casodex?
Casodex should be used cautiously in people taking the blood thinner warfarin, as the combination can cause increased bleeding. Your provider may adjust your warfarin dose.
What Medications Are Similar?
Casodex is not the only drug in its class. Flutamide (Eulexin) and nilutamide (Nilandron) are other antiandrogen therapies that are also available.
There are also second-generation antiandrogen medications for prostate cancer.
These second-generation medications are more effective than first-generation therapies, such as Casodex, in blocking testosterone:
Enzalutamide (Xtandi)Apalutamide (Erleada)Darolutamide (Nubeqa)
How Can I Stay Healthy While Taking Casodex?
It is important to take Casodex as prescribed by your healthcare provider. Hopefully, any side effects you experience are mild and tolerable. However, if you have any concerns about any of the potential side effects of the medication, be sure to reach out to your healthcare team.
Hot flashesFatigueBody pain (typically in the back, abdomen, and pelvis)InfectionConstipationMuscle weaknessShortness of breathNauseaSwelling in the hands, ankles, or feetDiarrheaIncreased urination at nightBlood in the urine
