Casodex Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Casodex Tablet (bicalutamide) is a prescription non-steroidal antiandrogen used to treat metastatic, stage D2, prostate cancer. It is given together with an LHRH analogue drug or after surgical castration, and works by blocking the effects of male hormones that can make prostate cancer grow. It is taken once daily as a long-term treatment and must not be used by women or children.

What is Casodex Tablet

Casodex is a prescription tablet used to treat advanced (metastatic, stage D2) prostate cancer. It contains the active ingredient bicalutamide and belongs to a group of medicines called anti-androgens, which work by blocking the effects of male hormones that can make prostate cancer grow.

Casodex Tablet uses

• Treatment of metastatic (Stage D2) prostate cancer, given together with an LHRH analogue drug or after surgical removal of the testicles (surgical castration)

Benefits of Casodex Tablet

• Helps slow down or stop the growth and spread of prostate cancer when used with an LHRH analogue or surgical castration
• Has been shown in studies to work about as well as another anti-androgen called flutamide for treating metastatic prostate cancer
• Treats certain metastatic prostate cancers
• Blocks androgen receptors
• Reduces androgen stimulation of prostate cancer cells
• Helps slow cancer growth when combined with LHRH therapy
• Provides an oral hormonal treatment option

How Casodex Tablet works

Androgens are male hormones that can cause prostate tumors to grow. Casodex blocks the action of these hormones on prostate cancer cells, helping to stop the tumor from growing. It is used together with other treatments that lower hormone levels in the body.

Casodex Tablet dosage

Take the tablet with or without food. Swallow the tablet whole with a drink of water; do not crush, split, or chew it. Try to take your dose at the same time each day, either in the morning or evening. Treatment with Casodex should be started at the same time as treatment with an LHRH analogue drug, or after surgical castration. This medicine is meant to be used as a long-term treatment; keep taking it for as long as your doctor recommends, and do not stop without talking to your doctor first. This medicine is not to be used in children, as safety and effectiveness have not been established in children. It must not be taken by women, including those who are pregnant or breastfeeding.

Available forms and strengths

• Film-coated tablets (50 mg), available in blister strips of 15 or 30 tablets

Side effects of Casodex Tablet

Common

• Hot flashes/hot flushes
• Feeling weak (asthenia)
• Constipation
• Diarrhea
• Infection
• Nausea
• Peripheral edema (swollen ankles, feet, legs, or arms)
• Feeling short of breath
• Blood in the urine
• Frequently needing to urinate at night
• Anemia (low red blood cell count)
• General, back, pelvic, belly, bone, or chest pain
• Loss of appetite
• Reduced sex drive
• Depression
• Sleepiness
• Indigestion
• Flatulence
• Hair loss or regrowth
• Rash
• Itching
• Dry skin
• Impotence (erectile dysfunction)
• Tender or enlarged breast tissue (gynecomastia)
• Weight gain
• Dizziness

Serious

• Liver problems, including liver inflammation (hepatitis) or liver failure, which can be fatal
• Serious allergic reactions, including severe itching with raised lumps, or swelling of the face, lips, tongue, and throat that may cause difficulty swallowing
• Raised blood sugar levels, which may lead to diabetes or make existing diabetes harder to control
• Interstitial lung disease (lung inflammation), which can cause serious or worsening breathlessness, cough, or fever, and has been fatal in some cases
• Heart failure (reduced heart function)
• Heart attack (myocardial infarction)
• Yellowing of the skin and eyes (jaundice), which may be a sign of liver damage
• Increased skin sensitivity to sunlight

Warnings and precautions

• Casodex at a higher 150 mg daily dose should not be used, as it has been linked to increased risk of death in certain patients.
• Casodex may rarely cause liver failure, and some cases have been fatal.
• Casodex may rarely cause a lung condition called interstitial lung disease, and some cases have been fatal.
• This medicine should only be prescribed by a doctor experienced in treating prostate cancer.
• If you are taking blood thinners such as warfarin, tell your doctor, as Casodex can increase the effect of these medicines and raise the risk of bleeding.
• You and/or your partner should use effective birth control while taking Casodex and for at least 130 days after stopping, as it can affect fertility and may harm a developing baby.
• Avoid excessive sun or UV light exposure while taking this medicine, as it may increase skin sensitivity to sunlight.
• If you have heart or blood vessel conditions, including irregular heartbeat or a condition called long QT syndrome, tell your doctor, as combination treatment may increase the risk of heart rhythm problems.
• Casodex must not be taken by women, including those who are pregnant, as it can harm a developing baby. It must also not be taken by women who are breastfeeding.
• No dose adjustment is needed for people with kidney problems.
• Tell your doctor if you have liver disease before starting this medicine. Casodex is broken down by the liver, and it should be used with caution in people with moderate to severe liver problems, as the drug may build up in the body. Your doctor will check your liver function with blood tests before and regularly during treatment.
• There is no known direct interaction between Casodex and alcohol, but drinking alcohol could worsen side effects like nausea or diarrhea, and heavy drinking may increase the risk of liver problems while taking this medicine.
• Casodex may make you feel sleepy. Do not drive or use machines until you know how the medicine affects you.

Storage

• Keep your tablets in the container they came in
• Do not take your tablets after the expiry date on the container; dispose of them in an appropriate way
• Keep your tablets in a safe place where children cannot see or reach them, as they could cause harm
• Keep your tablets at room temperature (15 to 30°C)

When to see a doctor

• Get medical help right away if you notice blood in your urine or abdominal pain.
• Stop taking the drug and call your doctor if you notice yellowing of your skin or eyes (jaundice), which may be a sign of liver damage.
• Call your doctor right away if you have signs of heart failure or a heart attack.
• Get medical help immediately if you have serious breathlessness or sudden worsening of breathlessness, possibly with cough or fever, as this could be a sign of lung inflammation.
• Seek urgent medical attention for severe itching with raised lumps on the skin, or swelling of the face, lips, tongue, or throat, which may cause difficulty swallowing, as this could be a serious allergic reaction.
• If you suspect an overdose, contact a healthcare practitioner, hospital emergency department, or your local poison control center right away, even if you have no symptoms.

Alternatives

• Enzalutamide
• Apalutamide
• Darolutamide