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Precautions and Warnings With Estramustine

Specific Estramustine Precautions and Warnings

Some warnings and precautions to be aware of prior to taking estramustine include the following:
  • Estramustine contains a form of estrogen. Men who receive estrogen for prostate cancer treatment may have an increased risk for developing a blood clot, which could cause serious problems, such as a heart attack or stroke. Therefore, estramustine should be used cautiously in men who have problems with blood clots, especially those who developed a blood clot while receiving estrogen treatment in the past.
  • Estramustine can increase blood glucose (sugar) levels. If you have diabetes, your healthcare provider may recommend you check your blood glucose levels more often. Your healthcare provider may need to adjust your diabetes medicines during treatment.
  • This medicine may worsen edema (fluid retention) and congestive heart disease. You may need to be monitored more carefully if you have these conditions, or any condition that can be affected by fluid retention, such as:
  • Because it contains a form of estrogen, this medicine can cause breast tenderness and swelling. It can also cause impotence (erectile dysfunction, or ED).
  • There have been reports of people developing allergic reactions to estramustine, including reactions involving the airways. Seek immediate medical attention if you have signs of an allergic reaction while taking this medicine, such as:
    • An unexplained rash
    • Hives
    • Difficulty breathing
    • Swelling of the mouth or throat.
  • This medicine can alter the balance of calcium and phosphorous in your body. You will need to have your calcium levels closely monitored with blood tests if you have certain medical conditions, such as:
    • Certain bone diseases
    • Kidney disease
    • Cancer that has spread to the bone.
  • You should know that estrogens have been reported to cause cancers, including breast and liver cancer, in animal studies. Estramustine contains estradiol, a form of estrogen. However, the potential risk for cancer developing in humans taking the drug has not been adequately studied.
  • Estramustine should be used with caution in people with kidney and liver disease.
  • Estramustine is not approved for use in women and may cause harm to an unborn child if taken by a pregnant woman. Men who use estramustine and their female partners should use adequate forms of birth control to avoid pregnancy (see Emcyt and Pregnancy for more information).
  • It is unknown if estramustine passes through breast milk. Therefore, if you are breastfeeding or plan to start, talk with your healthcare provider about using this drug (see Emcyt and Breastfeeding).
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