Bicalutamide - an anti-androgen for men (Casodex)

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Treatment with bicalutamide will be started by a specialist doctor.

The usual dose is one tablet daily (either 50 mg or 150 mg).

Remember to keep your regular appointments with your doctor and clinic so that your progress can be monitored.

Type of medicineAn anti-androgen
Used forTreatment of prostate cancer in adult men
Also calledCasodex®
Available asTablets

Bicalutamide belongs to a group of medicines known as anti-androgens. This means that it blocks the actions of male sex hormones called androgens and it also reduces the amount of male hormones (such as testosterone) that your body produces.

In prostate cancer, the cancer cells need the male hormone testosterone to grow and multiply well. Hormone treatments like bicalutamide block the effect of testosterone on prostate cancer cells. This slows down the growth of the cancer. Bicalutamide also helps to reduce symptom 'flares' and side-effects from other treatments which may be used for the cancer, or following surgery.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking bicalutamide it is important that your doctor knows:

  • If you have any problems with the way your liver works.
  • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.
  • Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about bicalutamide and will provide you with a full list of the side-effects which you may experience from taking it.
  • Take bicalutamide exactly as your doctor tells you to. Your dose will be printed on the label of the pack of tablets to remind you about what the doctor said to you. The usual dose is one tablet each day. There are two strengths of tablet available: 50 mg and 150 mg. The strength of tablet that you are prescribed will depend on whether you are also having other treatments.
  • You can take bicalutamide tablets either before or after meals. Taking the tablet with a drink of water will help you to swallow it.
  • Try to take the tablet at the same time of day each day. This will help you to remember to take your doses regularly.
  • If you forget to take a dose at your usual time, take it when you remember. If you do not remember until the following day then leave out the forgotten dose and take your next dose when it is due. Do not take two doses on the same day to make up for a missed dose.
  • Please keep your regular appointments with your doctor. Your doctor may want you to have some blood tests from time to time to check that your liver is staying healthy.
  • Treatment with bicalutamide is often long-term. You should continue to take the tablets regularly unless you are told otherwise by your doctor.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with bicalutamide. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Very common bicalutamide side-effects (these affect more than 1 in 10 men)What can I do if I experience this?
Feeling weak, tired or dizzyDo not drive or use tools or machines while affected
Rash, breast swelling or tenderness, hot flushesIf troublesome, speak with your doctor
Feeling sick, indigestion, tummy (abdominal) painEat simple meals - avoid rich or spicy foods
Common bicalutamide side-effects (these affect less than 1 in 10 men)What can I do if I experience this?
ConstipationEat a well-balanced diet and drink several glasses of water each day
Feeling depressed, itchy dry skin, changes in hair thickness, reduced sex drive, erectile dysfunction,
loss of appetite, swollen ankles, increased weight, chest pain
If any of these become troublesome, speak with your doctor
Yellowing of your skin or the whites of your eyes, stomach discomfort or pain that does not go away quicklySpeak with your doctor as soon as possible. These can be signs that your liver is being affected.
Blood in your urineSpeak with your doctor as soon as possible so that this can be investigated

Important: bicalutamide can sometimes cause other side-effects such as breathing problems and allergic reactions. Although these occur less commonly than the ones listed above, they are symptoms that you should tell your doctor about as soon as possible.

If you experience any other symptoms which you think may be due to the tablets, please speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Do not give it to other people even if their condition appears to be the same as yours.

If you are due to have an operation or dental treatment, please tell the person carrying out the treatment which medicines you are taking.

If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr Adrian Bonsall
Document ID:
3787 (v24)
Last Checked:
Next Review:
The Information Standard - certified member

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