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Precautions and Warnings With Bicalutamide

Bicalutamide has the potential to cause high blood sugar, drowsiness, and liver problems. Therefore, it's important to understand the warnings and precautions for this drug before starting treatment. If you are taking bicalutamide, your treatment regimen will also include another prostate cancer medication. Do not stop taking either one of these drugs without consulting your healthcare provider.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking bicalutamide (Casodex®) if you have:
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Diabetes
  • Anemia or other blood cell problems
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Bicalutamide Warnings and Precautions

Some warnings and precautions to be aware of prior to taking this medication include the following:
  • Bicalutamide has been reported to cause drowsiness. Do not drive, operate heavy machinery, or do anything else that could be dangerous until you know how the medication affects you.
  • This medication is used as part of combination prostate cancer treatment with a gonadotropin-releasing hormone (GnRH) agonist medication, sometimes called luteinizing hormone-releasing hormone (LH-RH) agonists. Make sure to take both medicines as prescribed. Do not stop either one without talking to your healthcare provider.
  • Taking bicalutamide in combination with a GnRH agonist can increase the risk of high blood sugar or developing diabetes. Your healthcare provider may monitor you for diabetes during treatment, or if you have diabetes, recommend you check your blood glucose levels more often.
  • Some people may experience a worsening of prostate cancer while taking bicalutamide. Your healthcare provider will closely monitor your prostate cancer during treatment, which may include checking your prostate-specific antigen (PSA) levels. If your cancer progresses and your PSA increases, your healthcare provider may recommend that you stop taking this drug.
  • There have been cases of serious liver problems in people taking bicalutamide. Your healthcare provider will monitor your liver function, using blood tests, before you start treatment, and routinely thereafter. Contact your healthcare provider right away if you experience signs of liver problems, including:
    • Yellowing of the skin or whites of the eyes (jaundice)
    • Loss of appetite
    • Nausea and vomiting
    • Stomach pain
    • Fatigue.
  • Bicalutamide may react with a number of other medications (see Drug Interactions With Bicalutamide for more information).
  • This product is considered a pregnancy Category X medication. It should not be used in women who are pregnant or who may become pregnant (see Casodex and Pregnancy).
  • It is unknown if bicalutamide passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Casodex and Breastfeeding).
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Bicalutamide Drug Information

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