Casodex

Why is this drug prescribed?
Casodex is prescribed for prostate cancer. Male hormones are responsible for the growth of most prostate cancers. Most of the male hormones are reduced by removal of the testicles or by use of a special monthly hormone injection (Lupron or Zolodex). Other male hormones are made in the adrenal glands and these may also stimulate the growth of prostate cancer. Casodex is a drug that stops the action of these male hormones on prostate cancer cells.
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When should it be used and are there any special instructions?
Casodex usually is taken as one 50 milligram tablet daily (morning or evening). It is acceptable to take Casodex with food.
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What should I do if I forget to take a dose?
Take the missed dose as soon as you remember it, if it is on the same day. If you remember a missed dose near the time you are scheduled to take the next dose or the next day, take only the regularly scheduled dose. Do not take a double dose.
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What side effects can this drug cause? What can I do about them?
About one in 10 people will have mild diarrhea. One in 15 will have severe diarrhea. If you develop diarrhea drink plenty of liquids to avoid becoming dehydrated. If the diarrhea doesn't end in a few days, call us so that we can recommend medication or reduce the dosage temporarily. Diarrhea may be less severe by eating a diet high in complex carbohydrates (whole grain cereals and breads), and by reducing dairy products and eating smaller food portions. There are no dietary restrictions if you don't have diarrhea.

About one in 10 men will have some nausea and vomiting. Try taking antacids, such as Tums, Rolaids, or Maalox, to see if you can settle your stomach. If the nausea continues, call us.

Because of the reduction in male hormone levels, you may develop hot flashes -- episodes of chest and face flushing, warmth and sweating that last about 10 minutes and may return many times a day. Usually these effects stop after a few months but can be problematic.

Rarely, we see some breast enlargement or liver abnormalities, including a form of hepatitis. The liver problems should go away if the medicine is discontinued. If you have a persistent loss of appetite, dark urine, pain in the upper right abdomen, or unexplained flu-like symptoms, or excessive fatigue, you might have hepatitis. Some physicians will follow liver function tests at intervals to make certain that hepatitis is not occurring.

Casodex, alone or in combination with Lupron or Zolodex, may cause a reduction in sex drive, and impotence (difficulty achieving or maintaining an erection). Your personality and masculine identity will NOT be changed. Patients taking Coumadin, a blood thinner, should notify their physician that Casodex may affect the dosage of their drug.

Your hair will NOT fall out with Casodex or other hormone treatments. Casodex does NOT make you sun-sensitive, so you can feel free to enjoy outdoor activity.
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