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an androgen antagonist used as an adjunct, in combination with a luteinizing hormone–releasing hormone analogue, in treatment of prostatic carcinoma; administered orally.


Apo-Bicalutamide (CA), Casodex, Dom-Bicalutamide (CA), Gen-Bicalutamide (CA), Novo-Bicalutamide (CA), PHL-Bicalutamide (CA), PMS-Bicalutamide (CA), Ratio-Bicalutamide (CA), Sandoz Bicalutamide (CA)

Pharmacologic class: Nonsteroidal antiandrogen

Therapeutic class: Antineoplastic

Pregnancy risk category X


Antagonizes effects of androgen at cellular level by binding to androgen receptors on target tissues


Tablets: 50 mg

Indications and dosages

Metastatic prostate cancer

Adults: 50 mg P.O. once daily


• Hypersensitivity to drug
• Women who are or may become pregnant


Use cautiously in:
• previous hypersensitivity or serious adverse reaction to flutamide or nilutamide
• moderate to severe hepatic impairment
• children.


• Know that drug is given in combination with luteinizing hormone-releasing hormone (LHRH).
• Administer at same time each day.

Adverse reactions

CNS: headache, weakness, dizziness, depression, hypertonia, paresthesia, lethargy

CV: chest pain, peripheral edema, vasodilation, hypertension, thromboembolic disease

EENT: pharyngitis, bronchitis

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, anorexia, dry mouth

GU: urinary tract infection, impotence

Musculoskeletal: bone and back pain

Respiratory: dyspnea, cough

Skin: rash, alopecia

Other: food distaste, weight gain, edema, pain, hot flashes, flulike symptoms


Drug-drug.Warfarin: increased bicalutamide effects

Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, cholesterol, BUN, creatinine: increased levels

Hemoglobin, white blood cells: decreased values

Patient monitoring

• Monitor prostate-significant antigen levels, CBC, and liver and kidney function test results.
• If patient is receiving warfarin concurrently, evaluate prothrombin time and International Normalized Ratio.

Patient teaching

• Instruct patient to take drug at same time each day, along with prescribed LHRH analog.
• Tell patient that any drug-related hair loss should reverse once therapy ends.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.


/bi·ca·lu·ta·mide/ (bi″kah-loo´tah-mīd) an antiandrogen used in the treatment of prostatic carcinoma.


an anticancer chemotherapy agent.
indications It is prescribed in the treatment of metastatic prostate cancer. The drug acts by binding to androgen receptors within target cells, preventing androgens from binding to them.
contraindications The drug should not be given to patients who have an allergic reaction to it. Bicalutamide should be used with caution in patients with moderate to severe liver dysfunction.
adverse effects The side effects most often reported include hot flashes, general body pain, asthenia, constipation, nausea, and diarrhea.


An oral non-steroidal antiandrogenic used to manage prostate cancer and hirsutism.

Adverse effects
Breast tenderness, gynaecomastia, hot flushes, gastrointestinal disorders, diarrhoea, nausea, elevated transaminases, jaundice, asthenia, pruritus.


An anti-androgen, antineoplastic drug used in the treatment of advanced prostate cancer. A brand name is Casodex.
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In patients treated with luteinizing hormone-releasing hormone (LHRH) agonist/antagonist monotherapy or who have had an orchidectomy, the addition of total androgen blockade (TAB) with androgen receptor antagonists, such as bicalutamide, can offer modest PSA responses that are short-lived in 30% to 35% of patients.
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