To begin with, it is usual to be prescribed 4-6 capsules to take over the course of a day. This dose may be adjusted as your treatment continues.
Do not eat any food or drink any milk for one hour before you take estramustine, or for two hours afterwards.
If you feel suddenly unwell or experience any worrying symptoms, speak with your doctor or clinic straightaway.
|Type of medicine||An alkylating chemotherapy medicine|
|Used for||Treatment of advanced prostate cancer|
Prostate cancer is a cancer which develops from cells in the prostate gland. It is the most common cancer in men in the UK. If the cancer spreads to other parts of your body, it is referred to as advanced prostate cancer. You may be offered anti-cancer medicine (chemotherapy) if you have advanced prostate cancer.
Estramustine is a chemotherapy medicine which reduces the number of cancer cells in your body by stopping cancer cells from multiplying. It also reduces the concentration of the male hormone testosterone. Cancer cells in other parts of your body need testosterone to grow and multiply, so this slows down the growth of the cancer which has spread.
Before taking estramustine
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 estramustine it is important that your doctor or pharmacist knows:
- If your partner is pregnant or breastfeeding.
- If you have high blood pressure (hypertension).
- If you have any heart problems.
- If you have blood vessel disease, or if you have had any blood clot problems.
- If you have high blood sugar levels (diabetes mellitus).
- If you have ever had a stomach or duodenal ulcer.
- If you have epilepsy or if you get migraine headaches.
- If you have been told you have high levels of calcium in your blood.
- If you have any liver or kidney problems.
- If you have problems with fluid retention, such as swollen feet or ankles.
- If you have an infection or feel unwell.
- If you have a rare inherited blood disorder called porphyria.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take estramustine
- Estramustine will be prescribed for you by a doctor who is a specialist and experienced in treating your condition. Take the capsules exactly as your doctor tells you to. It is usual to be prescribed 4-6 capsules to take over the course of a day to begin with, although this may be adjusted as your treatment continues. Doses may range between 1-10 capsules taken daily. If you are unsure about how or when to take the capsules, or if you have any other concerns, you should contact your doctor or hospital clinic for advice.
- You should take the capsules when your stomach is empty, which means taking them one hour before eating food, or waiting until two hours afterwards. This is because food prevents estramustine from being absorbed by your body, which means the medicine is much less effective for you.
- Swallow the capsules with a drink of water. Do not open, crush or chew them.
- Before you start this treatment, read any printed information you have been given by your doctor, and the leaflet from inside your pack. The leaflet will give you more information about estramustine and a full list of side-effects which you may experience from taking it.
- If you are sick shortly after taking a dose, or if you forget a dose, contact your doctor or clinic for advice on what to do. You will be told whether to take the dose again, or wait until the next dose is due.
- Do not drink any milk, or take any medicines containing calcium, magnesium or aluminium at the same time as you take estramustine. Some antacid and laxative preparations contain these, so ask your pharmacist for advice before you buy or take any 'over-the-counter' medicines.
Getting the most from your treatment
- You must try to keep your regular appointments with your doctor or hospital. This is so your doctor can check on your progress. You will need to have regular check-ups during your treatment, to monitor for unwanted side-effects.
- Estramustine may lower the number of white cells in your blood, increasing the chance of you getting an infection. If possible, avoid people who you know are ill, and let your doctor know if you feel you are getting an infection.
- While you are taking estramustine do not have any immunisations (vaccinations) without talking to your doctor first. Estramustine lowers your body's resistance so there is a chance that you may get an infection from some vaccines.
- If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
- Although there is a risk of reduced fertility with estramustine treatment, it is important that you do not father a child while you are being treated. Make sure you have discussed these issues with your doctor if you are sexually active.
Can estramustine cause problems?
Along with their useful effects, most medicines can cause side-effects although not everyone experiences them. Before you start treatment with estramustine, your doctor will discuss with you the possibility of unwanted side-effects occurring. The table below lists some of the most common ones associated with estramustine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. You should let your doctor or clinic know as soon as possible if you experience any of the following:
|Common estramustine side-effects - these affect less than 1 in 10 people who take this medicine||What can I do if I experience this?|
|Feeling sick (nausea) or being sick (vomiting), diarrhoea (during the first couple of weeks)||Drink plenty of water to replace lost fluids and stick to simple foods. Let your doctor know, as medicines can be prescribed to help|
|Swollen feet and ankles||If troublesome, speak with your doctor|
|Erectile dysfunction (impotence), and breast swelling||Your doctor will discuss these with you before you start treatment|
|Less common, but more serious side-effects||What can I do if I experience this?|
|A high temperature (fever), or symptoms of an infection||Let your doctor know straightaway|
|Sudden chest pain, or any difficulties breathing||Let your doctor know straightaway|
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store estramustine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Return any unused or unwanted capsules to your pharmacy to destroy. They will need special disposal.
Important information about all medicines
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. Never give it to other people even if their condition appears to be the same as yours.
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 and references
Manufacturer's PIL, Estracyt Capsules®; Pfizer Limited, The electronic Medicines Compendium. Dated December 2018.
British National Formulary, 78th Edition (Sep 2019); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.