Casodex (Bicalutamide)

Casodex (bicalutamide) is a drug that is prescribed by doctors to treat metastatic prostate cancer in advanced form, when cancer had extended to other parts of body.

This medicine usually goes together with some other medication against prostate cancer to decrease the amount of testosterone in the organism.

Some clinical studies showed that Casodex can work like another medicine flutamide (Eulexin) that is used to cure advanced prostate cancer. The studies were also made to compare the action of both medicines. So, 47,3% of patients that took Casodex, kept on living for 160 weeks after they took a medicine, when people that were alive after taking flutamide were 42.5%. These amounts of percent are pretty close, but still they show the superiority of one medicine comparing to the other. The progression of cancer had almost the same numbers for both medicines after 160 weeks.

IPR Pharmaceuticals Inc. is manufacturing Casodex for AstraZeneca Pharmaceuticals LP. Different manufacturers produce the generic version of this drug. The drug is available only in pills of Casodex of 50mg. tablets. It is also sold in generic form.



Uses

Prostate cancer
Prostate cancer
 
Casodex or bicalutamide is a medicine that doctors prescribe as a part of combined treatment for patients that have an advanced prostate cancer. This medicine is used with luteinizing hormone-releasing hormone agonist or LH-RH, occasionally it is named gonadotropin-releasing hormone or GnRH, which consists of:
  • Leuprolide acetate such as Lupron Depot, Eligard or Lupron
  • Acetate implant of Histrelin or Vantas
  • Trelstar or Triptorelin
  • Acetate implant of Goserelin or Zoladex

The most usual cancer that happens to men is the cancer of prostate. The process of cancer begins when abnormal cells start to increase in size in the prostate gland's tissues.

When the doctor makes diagnosis of your body, he will settle the stage of your cancer by knowing how far it had progressed. The stage of prostate cancer depends on the dimensions of tumor and on the spreading area of cancer. Actually, prostate cancer has 4 stages. The advance of cancer increases as the number goes up from one to four.

Chemotherapy
Chemotherapy
The latest stage and the most advanced is the fourth stage of prostate cancer. It happens when the cells of cancer extent through other organs of the organism. It reaches rectum, bones, bladder or lymph nodes. The fourth stage of cancer can not be treated by making a surgery, because the cells of cancer had spread very widely. At this case, the following options of treatment can be applied:
  • Chemo
  • Therapy using hormones
  • Radiation

Casodex is one of the hormone therapies to cure prostate cancer. We mentioned above that this medicine should be used together with some other options of hormone treatment.

Can older adults use it?


Usually older men use Casodex to treat prostate cancer. The dose of medicine does not depend on the age of a patient that is taking it.

Off-Label uses


Sometimes, doctors prescribe this medicine to cure some other conditions except the ones that we described in our article. An "off-label" use is how they call it. If a patient has an early stage of cancer of prostate and he is prescribed to take Casodex, than it is considered as an off-label treatment.

Can children use it?


18 year old people and older are approved to take Casodex because there were not many studies made in this group of age. Boys that had puberty earlier than the others normal boys were studied to take a low dose of Casodex. These studies didn't show any dangerous side effects, but they should do more researches concerning the effectiveness of medication.



Dosage

Casodex use with drugs
Casodex use with drugs
 
Doctors recommend for patients that have advanced prostate cancer to take Casodex one time a day, with a dosage of 50 mg. They usually prescribe it with GnRH, which is a ganadotropin-releasing hormone and a medicament that they usually name an agonist of luteinizing hormone-releasing hormone. It can be:
  • Trelstar or Triptorelin
  • Acetate of leuprolide which is also Lupron Depot, Eligard or Lupron
  • Vantas or histrelin acetate implant
  • Zoladex or Goserelin acetate implant

Some information that you need to know on how to take Casodex


The following points you should know in time you take Casodex:
  • They sell this medication in pills. Patients take it one time a day by mouth.
  • It doesn't matter when you take your dose of Casodex, in the evening or in the morning. The medicine is needed to be taken every day only at one time you will appoint. The level of medicine in your blood should be even.
  • There is no difference on how you take Casodex, during nourishing or after. We advise you to take it during nourishing, or it might irritate your stomach.
  • Patients are prescribed to take Casodex with another medicine for prostate cancer. You should start taking these two medicines at one day. Read the instruction on how to take the other medicine and try to follow them.
  • You should follow the instructions properly when taking the medicine. When you experienced the improvement of your condition, it is forbidden to stop the treatment.
  • If you hesitate about the dosage of Casodex, your nurse, doctor or pharmacist can advise you.


Warnings and Precautions

Liver problems
Liver problems
 
There are following conditions that you should discuss with your doctor before you start using Casodex:
  • Allergies to preservatives, foods or color including substances
  • Problems with liver like its failure, cirrhosis or hepatitis
  • Diabetes
  • Problems with your blood cells like anemia

If you have following conditions, you should tell about them to your doctor:
  • You are feeding a baby with your breast
  • You want to get regnant or you are pregnant

It is necessary that your doctor knows about all the drugs that you use at the moment. It doesn't matter if it is an over the counter or prescription medicine, nutritional supplement or vitamins.

Particular warnings and precautions


You should consider the following precautions and warnings before you take this drug:
LHRH
LHRH
 
  • Usually patients take this medicine to treat prostate cancer and it goes in combination with agonist medication of GnRH or ganadotropin-releasing hormone, which people call sometimes agonist of luteinizing hormone-releasing hormone or LHRH. You should pay attention at taking it, according how your doctor told you. Stopping the usage of one of these medications should be consulted only by your doctor.
  • There are some cases when Casodex made people sleepy. You should better stay away from driving a car or maintaining powerful machines. You should also stay away from doing something dangerous before you find out how the drug can affect you.
  • It was reported that some people that took Casodex had problems with their liver. Some time before the beginning of treatment, your doctor will take some blood tests and try to monitor the function of your liver. When you started to feel some pain or discomfort about your liver, the doctor should be notified immediately. It is very bad, if you don't have appetite, have pain, you are tired all the time, you have yellow eyes and skin and you experience nausea.
  • Doctors put Casodex as a medicine of Category X for pregnancy. Those women that want to get pregnant or who are already pregnant are forbidden to take this drug.
  • If you take Casodex together with agonist of GnRH, it is important to know that they can develop diabetes or make your blood sugar level more increased. The doctor should control you for not having diabetes. If you have this disease it is recommended to check the level of you blood glucose as often as possible.
  • There are cases when patient that were taking Casodex had an increasing of prostate cancer. It is very important to follow your condition closely when you take the medicine. It will include the monitoring of levels of PSA or prostate-specific antigen. You might be recommended to stop taking Casodex if your doctor sees that you have a progress in cancer considering the increasing of your PSA.
  • The drug can come into reaction with the list of other drugs.
  • During clinical trials it was noticed that the drug can go into the breast milk. You should discuss this treatment with your healthcare provider when you want to breastfeed or you are intended to do it.

Who should not take Casodex?


It is forbidden to take Casodex for those, who are:
  • Not a man
  • Have an allergy to this medicine, to bicalutamide or other components that are active and are taking part in making this drug. All these ingredients can be shifted to you by your medical care or pharmacist
  • You are going to have a baby or you are already pregnant


Side Effects

Low libido
Low libido
It is significant to know about some side effects of Casodex:
  • You can predict when side effects from taking Casodex will occur to you and for how long
  • From all the side effects that Casodex has there are people that don't feel them
  • You can reduce or prevent side effects from taking Casodex by lots of ways
  • Side effects of Casodex are reversible and you will not experience them after the treatment is over
  • Effectiveness of Casodex does not depend on the hardness or presence of Casodex side effects

More than 30% of patients experience the following side effects after taking Casodex:
  • You don't want to have sex and your libido is low
  • You get gynecomastia and your breasts swell
  • Pain in breasts
  • Afflux of blood
  • You are unable to get erection and sustain it

About from 10 to 29% of patients have the following less common side effects from taking Casodex:
  • Constiveness
  • Sickness
  • Diarrhea
  • The medicine can affect you when you are intended to make a baby. It will be useful to talk about this to your doctor
  • The level of blood could increase when you do tests concerning the function of your liver. They will become stable after you finish the treatment

We didn't put above all the side effects. Some of those that are not listed here could happen to less than 10% of people that are taking Casodex. You still need to consult your healthcare provider when you think that you have some unusual symptoms.


Mechanism of action

Bicalutamide formula
Bicalutamide formula
 
Casodex is an androgen receptor inhibitor without steroids. It is strong enough to stop androgens' actions. It links to the receptors of cytosol androgens in the aimed tissue. They found out, that prostatic carcinoma is very sensitive to androgen. It can only be cured by some substance that will object androgen's effect or remove its source.

In fact, it will be less effective to combine Casodex with LHRH or luteinizing hormone releasing hormone, because the inhibition of serum testosterone gets induced after the action of LHRH. During clinical testing, they noticed the rise of estradiol and serum testosterone when Casodex was used as single medicine against cancer of prostate.

Some patients that were using LHRH agonist and Casodex and those that stopped taking Casodex after they noticed that their prostate cancer had progressively increased, were observed to have clinical improvement and a decrease of their PSA or Prostate Specific Antigen.


Generic Casodex

Generic Casodex
Generic Casodex
 
IPR Pharmaceuticals, Inc. is making Casodex for AstraZeneca Pharmaceuticals LP. You can find them on a market in one singe form and strength. They are Bicalutamide 50mg tablets.

A generic form of Casodex is produced by the following different manufacturers:
  • Sun Pharmaceutical Global, Inc.
  • Mylan
  • Actavis, Inc.
  • Sandoz
  • Accord Healthcare, Inc.
  • Sun Pharmaceutical Global, Inc.
  • Zydus Pharmaceuticals
  • Teva Pharmaceuticals

These generic forms of medicine go through specific tests in order to be compared to the medications of trade name. After that, American FDA observes the results of tests and decides if this medicine is equal to the medications of trade name and they appoint an assessment to each of the drug.

If a generic medication has assessment or rating "AB", than it means that American Food and Drugs Administration think that this drug has the same quality as trade name drug. At the moment, all the generic versions of Casodex have a rating "AB". It means that they all have the same level of quality as Casodex.

Sometimes it is allowed when generic version of medication has inactive ingredients that differ from the trade name drug. They can be colors, fillers or some ingredients that could harm people that are too sensitive or have allergies.


Overdose

Casodex hasn't been fully studied in regard to consequences of overdose. Individual perception of exceeding dosage is suggested to correlate with a set of factors, including combination of drugs it is taken along with.

There are no registered Casodex overdose cases to date. When the drug had been tested, dosage of roughly 200 mg daily was perceived by testers without showing considerable symptoms of exceeded dose. Note that dosages over 200 mg haven't been tested. Consequences of taking such doses are still unknown.


Drug interactions

Casodex interactions with other drugs, in particular, calcium channel blockers, buspirone and others are potentially unfavorable. Such unfavorable interactions can cause side effects to occur, or render the medicine ineffective. When required to combine Casodex with those medicines, patients are advised to stay under doctor's monitoring.

The medicine's potentially unfavorable reactions can be revealed in combinations with other medicine as well, among which are:
  • Budesonide (Pulmicort, Rhinocort Aqua, Entocort)
  • Buspirone (BuSpar)
  • Calcium channel blockers:
    Calcium channel blockers
    Calcium channel blockers
     
    • Amlodipine (Norvasc)
    • Diltiazem (Cardizem CD, Cardizem LA, Cardizem, Cartia XT, Dilacor XR, Dilt-CD, Dilt-XR, Diltia XT, Taztia XT, Tiazac)
    • Felodipine (Plendil)
    • Isradipine (Dynacirc CR, Dynacirc)
    • Nisoldipine (Sular)
    • Nicardipine (Cardene SR, Cardene)
    • Nifedipine (Adalat CC, Afeditab CR, Nifedical XL, Nifediac CC, Procardia XL, Procardia)
    • Nimodipine (Nimotop)
    • Verapamil (Calan SR, Calan, Covera-HS, Isoptin SR, Verelan PM, Verelan)
  • Carbamazepine (Carbatrol, Epitol, Equetro, Tegretol)
  • Some antidepressants:
    Antidepressants
    Antidepressants
     
    • Citalopram (Celexa)
    • Escitalopram (Lexapro)
    • Mirtazapine (Remeron)
    • Nefazodone (Serzone)
    • Trazodone (Desyrel) or Trazodone ER (Oleptro)
    • Trimipramine (Surmontil)
    • Venlafaxine (Effexor XR, Effexor)
    • Vilazodone (Viibryd)
  • Some antipsychotic medications:
    Antipsychotic medications
    Antipsychotic medications
     
    • Aripiprazole (Abilify)
    • Haloperidol (Haldol)
    • Lurasidone (Latuda)
    • Molindone (Moban)
    • Pimozide (Orap)
    • Quetiapine (Seroquel)
  • Some benzodiazepines:
    Benzodiazepines
    Benzodiazepines
     
    • Alprazolam (Xanax)
    • Chlordiazepoxide (Librium, Limbitrol, Librax)
    • Clobazam (Onfi)
    • Clonazepam (Klonopin)
    • Clorazepate (Tranxene)
    • Diazepam (Valium)
    • Flurazepam (Dalmane)
    • Midazolam (Versed)
    • Triazolam (Halcion)
  • Clarithromycin (Biaxin)
  • Colchicine (Colcrys)
  • Cyclosporine (Gengraf, Neoral, Sandimmune)
  • Eplerenone (Inspra)
  • Ergot medications:
    Ergot medications
    Ergot medications
     
    • Bromocriptine (Parlodel)
    • Dihydroergotamine (Migranal)
    • Ergonovine
    • Ergotamine (Cafergot, Ergomar)
    • Methylergonovine (Methergine)
    • Pergolide (Permax)
  • Erythromycin
  • Everolimus (Afinitor, Zortress)
  • Fentanyl (Abstral, Actiq, Duragesic, Fentora, Lazanda, Onsolis, Subsys)
  • Pimecrolimus (Elidel)
  • Phosphodiesterase type 5 inhibitors (PDE5 inhibitors):
    PDE5 inhibitors
    PDE5 inhibitors
     
  • Ranolazine (Ranexa)
  • Salmeterol (Serevent)
  • Saxagliptin (Onglyza) and saxagliptin/metformin ER (Kombiglyze XR)
  • Certain statin medications:
  • Theophylline (Uniphyl, Theochron, TheoCap, Theo-24, Elixophyllin)
  • Tolvaptan (Samsca)
  • Warfarin (Coumadin, Jantoven)


Budesonide
This medicine combined with Casodex is reported to cause budesonide accumulation in your body, thus bringing up the risk of unintended effects. However, inhaled budesonide is less dangerous in combination with the medicine. Under circumstances such that you have to combine these drugs, consult with your doctor and stay under monitoring.

Buspirone
This medicine combined with Casodex is reported to cause buspirone accumulation in your body, thus bringing up the risk of unintended effects. Under circumstances such that you have to combine these drugs, consult with your doctor and observe his recommendation.

Calcium channel blockers
This medicine combined with Casodex is reported to cause calcium channel blockers accumulation in your body, thus bringing up the risk of unintended effects. Under circumstances such that you have to combine these drugs, consult with your doctor and observe his recommendation. Also, you may have to stay in hospital for monitoring.

Carbamazepine
When combined with this medicine, it is reported to cause Carbamazepine accumulation in your body, thus potentially bringing up the risk of unintended effects. Under circumstances such that you have to combine these drugs, consult with your doctor and observe his recommendation.

Certain antidepressants
When combined with this medicine, certain antidepressants tend to accumulate in your body, thus potentially bringing up the risk of unintended effects. Under circumstances such that you have to combine these drugs, and side effects bother you, consult with your doctor and take a lower dose of antidepressants.

Certain antipsychotics
When combined with this medicine, certain antipsychotics tend to accumulate in your body, thus potentially bringing up the risk of unintended effects. The need of taking these medicines in a combination should be discussed with your doctor.

Certain benzodiazepines
When combined with this medicine, certain benzodiazepines (but not every one of them) tend to accumulate in your body, thus potentially bringing up the risk of unintended effects. The need of taking these medicines in a combination should be discussed with your doctor.

Clarithromycin
This medicine combined with Casodex is reported to cause clarithromycin toxicity in your body, thus bringing up the risk of unintended effects. Under circumstances such that you have to combine these drugs, consult with your doctor and observe his recommendation. Also, you may have to stay in hospital for monitoring.

Colchicine
When combined with this medicine, colchicine tends to accumulate in your body, thus potentially bringing up the risk of unintended effects. You may have to stay in hospital for monitoring after taking this combination if your doctor will find it necessary.

Cyclosporine
When combined with this medicine, cyclosporine tends to accumulate in your body, thus potentially bringing up the risk of unintended effects. You may have to stay in hospital for monitoring after taking this combination if your doctor will find it necessary.

Eplerenone
When combined with this medicine, eplerenone tends to accumulate in your body, thus potentially bringing up the risk of unintended effects. Your doctor may choose to lower the dosage of the latter and monitor you if necessary.

Ergot medications
When combined with this medicine, Ergot Medications can lead to increased toxicity in your body. The need of taking these medicines in a combination should be discussed with your doctor.

Erythromycin
When combined with this medicine, erythromycin tends to accumulate in your body. The need of taking these medicines in a combination should be discussed with your doctor.

Everolimus
When combined with this medicine, everolimus tends to accumulate in your body, thus potentially bringing up the risk of unintended effects. Your doctor may choose to lower the dosage of the latter and monitor you if necessary.

Fentanyl
When combined with this medicine, Fentanyl tends to accumulate in your body, thus potentially bringing up the risk of unintended effects. Your doctor may choose to lower the dosage of the latter and ask you to stay in hospital for monitoring you if necessary.

Pimecrolimus
When combined with this medicine, pimecrolimus tends to accumulate in your body, thus potentially bringing up the risk of unintended effects. You may have to stay in hospital for monitoring after taking this combination if your doctor will find it necessary.

Phosphodiesterase type 5 inhibitors (PDE5 inhibitors)
When combined with this medicine, PDE5 inhibitors tend to accumulate in your body. The need of taking these medicines in a combination should be discussed with your doctor. It is advised to take lower dosage of PDE5 inhibitors under such circumstances.

Ranolazine
When combined with this medicine, ranolazine tends to accumulate in your body. The need of taking these medicines in a combination should be discussed with your doctor. It is advised to take lower dosage of ranolazine under such circumstances.

Salmeterol
When combined with this medicine, Salmeterol tends to accumulate in your body, thus potentially bringing up the risk of unintended effects such as increased heart rate. You may have to stay in hospital for monitoring after taking this combination if your doctor will find it necessary.

Saxagliptin
When combined with Casodex, Saxagliptin can cause glucose level to decrease in your body, thus potentially bringing up the risk of dangerous side effects. You are advised to stay under monitoring in hospital when taking this combination.

Statins
When combined with this medicine, certain statin cholesterol drugs tend to accumulate in your body, potentially leading to unintended effects. The need of taking these medicines in a combination should be discussed with your doctor.

Theophylline
When combined with this medicine, Theophylline tends to accumulate in your body, thus potentially bringing up the risk of unintended effects. Your doctor may choose to lower the dosage of the latter and monitor you if necessary.

Tolvaptan
When combined with this medicine, tolvaptan tends to accumulate in your body resulting in increased risk of unintended effects. The need of taking these medicines in a combination should be discussed with your doctor.

Warfarin
Casodex combined with warfarin, particularly at the first taking of medicines, are known to potentially cause bleeding. Doctor may advise you to stay under monitoring in hospital in case you need to take this combination.


Conclusion


Casodex has been reported to react abnormally when taken with other drugs. The complete list won't fit in this article, so whenever you are about to start taking Casodex combined with some other medicine, consult with your doctor.

General keywords

User discussion about Casodex

Rimond
12 April 2012
Can generic version of Casodex be so effective in therapeutic way?
reply quote
Jack
13 April 2012
Rimond - yes, the medicine is effective in this way. This version just has other inert ingredients or as they call them compounding ingredients that help to keep the tablet together. The difference is in the dissolving if a pill in your body. Active ingredients remain as they are in the brand version. The active ingredients are totally the same.
reply quote
Jensen
10 December 2012
My PSA is equal to 3.7 when I began to take this medication. I didn't have any surgery and the only side effect that I had, was enlargement of my breasts. I am 79 and have strength enough to swim 1 mile once a day. I am doing well and my condition is great.
reply quote

Casodex image
Casodex
ADS
Site indexMedicines onlineInteresting to readCommentariesAuthor
TabletsManual.com © 2012