Casodex (Bicalutamide) belongs to a group of medications known as nonsteroidal antiandrogens. Nonsteroidal antiandrogens such as Casodex (Bicalutamide) block the effect of the male hormone testosterone in the body.

Casodex (Bicalutamide) is used in combination with another treatment that reduces the amount of testosterone in the body (either with medications called luteinizing hormone releasing hormone [LHRH] analogues or with surgery to remove the testicles) to treat late stage (metastatic) Prostate Cancer.

Casodex (Bicalutamide) may be available under multiple brand names and/or in several different forms. Any specific brand name of Casodex (Bicalutamide) may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Casodex (Bicalutamide) may not be used for all of the conditions discussed here.

Your doctor may have suggested Casodex (Bicalutamide) for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking Casodex (Bicalutamide), speak to your doctor. Do not stop taking Casodex (Bicalutamide) without consulting your doctor.

Do not give Casodex (Bicalutamide) to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Casodex (Bicalutamide) if their doctor has not prescribed it.

The recommended dose for Casodex (Bicalutamide) is one 50 mg tablet taken once daily at approximately the same time each day.

Casodex (Bicalutamide) may be taken with or without food. This treatment should be started at the same time as treatment with an LHRH analogue (e.g., Goserelin), or after surgical removal of the testicles.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Casodex (Bicalutamide) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Casodex (Bicalutamide). If you are concerned about side effects, discuss the risks and benefits of Casodex (Bicalutamide) with your doctor.

The following side effects have been reported by at least 1% of people taking Casodex (Bicalutamide). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• Constipation
• decrease in appetite
• dizziness
• dry skin
• feeling weak
• flatulence (passing gas)
• hair loss or decreased hair regrowth
• hot flashes
• impotence or reduction in sexual desire
• increased sensitivity of the skin to sun; increased risk of Sunburn
• indigestion
• itching
• nausea
• puffiness
• skin rash
• swelling of breasts with pain or tenderness
• tiredness
• weight gain

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Contact your doctor as soon as possible if the following side effects occur:

• abdominal pain
• blood in the urine
• chest pain
• severe itching
• signs of Anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
• signs of Depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of liver problems (e.g., nausea, vomiting, Diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of heart failure (e.g., tiredness, shortness of breath especially when lying down, swelling of the feet or ankles)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• pain or tenderness in stomach
• signs of a Heart Attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)
• symptoms of lung problems (e.g., shortness of breath, painful breathing, sudden shortness of breath, cough, Fever)
• symptoms of a serious allergic reaction (e.g., Hives, shortness of breath, difficulty swallowing, swelling of the face, lips, tongue or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Casodex (Bicalutamide).

Each white, film-coated tablet, intagliated with "CDX50" on one side and a logo (an arrow attached to the arc of a circle) on the other side, contains 50 mg of Casodex (Bicalutamide). Nonmedicinal ingredients: lactose monohydrate, magnesium stearate, methylhydroxy-propylcellulose, polyethylene glycol, polyvidone, sodium starch glycolate, and titanium dioxide.

Do not take Casodex (Bicalutamide) if you:

• are allergic to Casodex (Bicalutamide) or any ingredients of the medication
• have early-stage (localized) prostate cancer and would otherwise undergo watchful waiting

Casodex (Bicalutamide) is not intended to be used by women or children.

There may be an interaction between Casodex (Bicalutamide) and any of the following:

• amiodarone
• anti-psychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Pimozide, Quetiapine, Risperidone)
• Aripiprazole
• "azole" antifungals (e.g., ketoconazole, fluconazole)
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• Disopyramide
• dofetilide
• Dronedarone
• flecainide
• Hydrocodone
• Lomitapide
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Porfimer
• Propafenone
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, moxifloxacin)
• salbutamol
• salmeterol
• sotalol
• Verteporfin
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Casodex (Bicalutamide). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Casodex (Bicalutamide).

Abnormal heart rhythm: Casodex (Bicalutamide) can cause changes to the normal rhythm of the heart, called QT prolongation. QT prolongation is a serious life-threatening condition. If you are at risk for heart rhythm problems (e.g., have heart failure, Angina, low potassium or magnesium levels; have congenital long QT syndrome; or are taking medications that can prolong the QT interval, such as quinidine, procainamide, Amiodarone, Sotalol, Flecainide), discuss with your doctor how Casodex (Bicalutamide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Casodex (Bicalutamide), and whether any special monitoring is needed.

Anemia: Casodex (Bicalutamide) may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired, or pale skin, contact your doctor as soon as possible.

Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.

Diabetes: Casodex (Bicalutamide) may cause an increase in blood sugar levels. People with diabetes may find it necessary to monitor their blood sugar more frequently while using Casodex (Bicalutamide).

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Casodex (Bicalutamide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Casodex (Bicalutamide), and whether any special monitoring is needed.

Drowsiness/reduced alertness: Casodex (Bicalutamide) may cause drowsiness. Do not drive, operate machinery, or perform other hazardous tasks until you have determined how Casodex (Bicalutamide) affects you.

Heart disease: The risk of heart attack or heart failure is increased for people taking Casodex (Bicalutamide). If you have risk factors for heart disease (Obesity, high blood cholesterol, smoking), discuss with your doctor how Casodex (Bicalutamide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Casodex (Bicalutamide), and whether any special monitoring is needed.

Liver function: Casodex (Bicalutamide) is broken down by the liver. Liver disease or reduced liver function may cause Casodex (Bicalutamide) to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Casodex (Bicalutamide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Casodex (Bicalutamide), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Casodex (Bicalutamide).

Casodex (Bicalutamide) may also cause liver problems. Contact your doctor immediately if you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin.

Lung disease: Rarely, and particularly when higher doses are used, cases of interstitial lung disease have been reported with Casodex (Bicalutamide). If you experience any symptoms of lung problems such as breathing difficulties, wheezing, cough, fever, or shortness of breath, contact your doctor immediately.

Osteoporosis: Long-term use of Casodex (Bicalutamide) has been shown to cause reduced bone strength and may increase the risk of bone fractures. If you have osteoporosis or are at increased risk of developing osteoporosis, discuss with your doctor how Casodex (Bicalutamide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Casodex (Bicalutamide), and whether any special monitoring is needed.

Sensitivity to sunlight: Casodex (Bicalutamide) may increase the sensitivity of the skin to sunlight, increasing the risk of sunburn. Avoid exposure to sunlight for long periods of time, particularly between the hours of 10 am and 2 pm, while you are taking Casodex (Bicalutamide) and for 7 days after completing treatment. Wear a broad-spectrum sunscreen and lip balm with an SPF of 50 or greater. If you notice any unusual skin rash or peeling, contact your doctor immediately.

Children: The safety and effectiveness of Casodex (Bicalutamide) have not been determined for children.