Eulexin


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Eulexin

 [u-lek´sin]
trademark for a preparation of flutamide, an antiandrogenantineoplastic agent.

flutamide

(floo-ta-mide) ,

Eulexin

(trade name)

Classification

Therapeutic: antineoplastics
Pharmacologic: antiandrogens
Pregnancy Category: D

Indications

Treatment of prostate carcinoma in conjunction with luteinizing hormone–releasing hormone (LHRH) analogues such as leuprolide.

Action

Antagonizes the effects of androgen (testosterone) at the cellular level.

Therapeutic effects

Decreased growth of prostate carcinoma, an androgen-sensitive tumor.

Pharmacokinetics

Absorption: Well absorbed after oral administration.
Distribution: Unknown.
Metabolism and Excretion: Mostly metabolized by the liver. Some conversion to another antiandrogenic compound (2-hydroxyflutamide).
Half-life: Unknown.

Time/action profile

ROUTEONSETPEAKDURATION
POunknownunknownunknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Severe hepatic impairment.
Use Cautiously in: Severe cardiovascular disease.

Adverse Reactions/Side Effects

Side effects primarily caused by LHRH antagonist

Central nervous system

  • anxiety
  • confusion
  • drowsiness
  • mental depression
  • nervousness

Cardiovascular

  • edema
  • hypertension

Gastrointestinal

  • hepatotoxicity (life-threatening)
  • diarrhea (most frequent)
  • nausea (most frequent)
  • vomiting (most frequent)

Genitourinary

  • erectile dysfunction (most frequent)
  • loss of libido (most frequent)

Dermatologic

  • photosensitivity
  • rash

Endocrinologic

  • gynecomastia (most frequent)

Miscellaneous

  • hot flashes (most frequent)

Interactions

Drug-Drug interaction

Acts synergistically withLHRH analogues (leuprolide ).

Route/Dosage

Oral (Adults) 250 mg q 8 hr; given concurrently with leuprolide.

Availability

Capsules: 125 mg, 250 mg

Nursing implications

Nursing assessment

  • 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 Diagnoses

Sexual dysfunction (Side Effects)

Implementation

  • Used in combination with LHRH agonist, such as leuprolide.

Patient/Family Teaching

  • 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.

Evaluation/Desired Outcomes

  • Decrease in the spread of prostate cancer.

Eulexin

a trademark for an antiandrogen antineoplastic agent (flutamide).
References in periodicals archive ?
His aggressive prostate cancer was treated with hormones (Lupron, Eulexin and Proscar for a year followed by Proscar only continuously) and Hoffer's multivitamins that included 10,000 mg/day of vitamin C.
Current therapies Androgen inhibitors overview Zytiga (abiraterone acetate; Johnson & Johnson) Xtandi (enzalutamide; Medivation/Astellas) Cytotoxic therapies overview Taxotere (docetaxel; Sanofi) Jevtana (cabazitaxel; Sanofi) Hormonal therapy overview Lupron (leuprolide acetate; Takeda/Abbott) Casodex (bicalutamide; AstraZeneca) Nilandron (nilutamide; Sanofi/Astellas) Eulexin (flutamide; Merck & Co.
Avodart, Zoladex, Proscar, Casodex, Taxotere, Satraplatin, Plenaxis, EULEXIN, Trelstar Depot, Trelstar LA, Viadur, Gleevec, Avastin, Herceptin, Atrasentan, Acapodene, Actimid, OSI-461, Revimid, Eladem, GTI-2501, ILX-651, calcitrol, Genasense, Provenge , GVAX, SGN-15, Thalomid, Velcade, Lupron Depot, Histrelin, Eligard, ILX651, Vitaxin, J591, CG7870, BBR-3576, PCK3145, Leuvectin, Leuprolide, ProMaxx-100, Osaterone, Prinomastat, BLP25, Metaret, Chimax, Drogenil, Flutamide, EULEXIN, Onconase, IM862, MDX-010, Erbitux, Eladem, GTI-2040, Apomine, Eflornithine, Doxil, GTI-2501, Thalidomide, TG4010, KRX-0401, Yondelis, TRICOM Vaccine, Zarnestra
Sales of Eulexin Capsules were approximately $48 million in 2000.
Table: Overview of pivotal trial data for Eulexin in prostate cancer
Figure: Eulexin - SWOT analysis in prostate cancer, 2011
Figure 67: Prostate Cancer, Global, Eulexin, Chemical Structure 112
Figure 35: Prostate Cancer, Global, Eulexin, Chemical Structure 72
Figure 41: Prostate Cancer, Global, Eulexin, Chemical Structure 82
Figure 44: Prostate Cancer, Global, Eulexin, Chemical Structure