Pregnancy Category: D
Treatment of prostate carcinoma in conjunction with luteinizing hormone–releasing hormone (LHRH) analogues such as leuprolide.
Antagonizes the effects of androgen (testosterone) at the cellular level.
Decreased growth of prostate carcinoma, an androgen-sensitive tumor.
Absorption: Well absorbed after oral administration.
Metabolism and Excretion: Mostly metabolized by the liver. Some conversion to another antiandrogenic compound (2-hydroxyflutamide).
Contraindicated in: Hypersensitivity; Severe hepatic impairment.
Use Cautiously in: Severe cardiovascular disease.
Adverse Reactions/Side EffectsSide effects primarily caused by LHRH antagonist
Central nervous system
- mental depression
- hepatotoxicity (life-threatening)
- diarrhea (most frequent)
- nausea (most frequent)
- vomiting (most frequent)
- erectile dysfunction (most frequent)
- loss of libido (most frequent)
- gynecomastia (most frequent)
- hot flashes (most frequent)
Drug-Drug interactionActs synergistically withLHRH analogues (leuprolide ).
Oral (Adults) 250 mg q 8 hr; given concurrently with leuprolide.
Capsules: 125 mg, 250 mg
- Monitor for diarrhea, nausea, and vomiting. Adjust diet as tolerated. Notify physician if these symptoms become severe.
- Lab Test Considerations: May cause elevated AST, ALT, bilirubin, and serum creatinine values. Monitor ALT before therapy, monthly for the first 4 mo of therapy, and periodically thereafter. If ALT rises above 2 times the upper limit of normal, flutamide should be discontinued immediately. Liver function tests should also be obtained at the first sign of nausea, vomiting, abdominal pain, fatigue, anorexia, or hyperbilirubinemia.
- May cause increased plasma estradiol and testosterone concentrations.
Potential Nursing DiagnosesSexual dysfunction (Side Effects)
- Used in combination with LHRH agonist, such as leuprolide.
- Explain that flutamide must be taken in conjunction with leuprolide. Instruct patient to take flutamide exactly as directed. If a dose is missed, take as soon as possible unless almost time for next dose. Do not double doses.
- Warn patient that side effects such as hot flashes, loss of sex drive, erectile dysfunction, and breast enlargement may be caused by the LHRH agonist. The primary side effect of flutamide alone is diarrhea, but the combination of drugs is necessary to achieve the therapeutic effect.
- Advise patient to notify health care professional immediately if dark urine, itching, loss of appetite, nausea, vomiting, pain in right side, or yellow eyes or skin occurs. Hepatotoxicity usually resolves when flutamide is discontinued, but it may be progressive and fatal; requires immediate medical attention.
- Decrease in the spread of prostate cancer.
a trademark for an antiandrogen antineoplastic agent (flutamide).