Posted on April 28th, 2009 by
Class: Hormonal therapy
Generic Name: Flutamide (FLOO-ta-mide)
Trade Name: Eulexin®
For which conditions is this drug approved? Flutamide is approved for the treatment of stage D2 prostate cancer, where cancer has spread from its site of origin to different sites in the body. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Flutamide belongs to a group of drugs referred to as anti-androgens. Prostate cancer is stimulated to grow by the male hormone, testosterone. Anti-androgens inhibit the effects of testosterone on cancer cells, thereby removing the growth stimulus. Flutamide is often given in combination with another hormone agent, classified as a leuteinizing hormone – releasing hormone (LHRH) agonist, which helps to block the production of testosterone in the body.
How is flutamide typically given (administered)? Flutamide is a capsule that is taken orally and the dose depends on several factors, including the condition being treated, the size of the patient, the particular regimen being used and the overall health of the patient. Dosing of flutamide should be spaced out evenly during the day if patients take more than one dose per day. The capsules can be opened and mixed with soft foods, but not liquids. Patients and their physicians will discuss optimal scheduling for flutamide.
How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with flutamide. Typically, blood will be drawn to monitor functions of some organ systems, especially the liver. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy. Patients should notify their physician if they notice their skin or eyes turn yellow, they experience loss of appetite, nausea, vomiting, rash, or a general feeling of being tired, abdominal pain or flu-like symptoms as these symptoms may indicate damage to the liver.
What are the common (occur in 30% or more of patients) side effects of treatment with flutamide?
• Swelling or tenderness of the breasts
• Hot flashes
• Reduced sexual drive
• Erectile dysfunction
• Nipple discharge
What are the less common (occur in 10% to 29% of patients) side effects of treatment with flutamide?
• Abnormalities in liver function levels, as determined by blood tests
• Nausea and vomiting
• Appetite changes
• Discoloration of urine (yellow-greenish)
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• Eat small meals frequently to help alleviate nausea.
• Patients who experience hot flashes may wish to wear light clothing, stay in a cool environment, and place cool cloths on their body or head to relieve their symptoms.
Are there any special precautions patients should be aware of before starting treatment?
• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician if they have glucose-6-phosphate dehydrogenase (G6PD) deficiency, blood disorders, or are a smoker as patients with these conditions may be at increased risk of toxicity.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should inform their physician if they are taking warfarin as they may require additional monitoring and dose adjustment to decrease the risk of bleeding.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• If an oral dose is missed, do not double up on doses. Patients should contact their physician in this event.
• Keep tablets out of reach of children and return to the pharmacy for safe disposal if treatment is terminated.
When should patients notify their physician?
• Chest pain or fast heart beat
• Difficulty breathing
• Yellowing of the eyes or skin, loss of appetite, nausea, vomiting, rash, generalized fatigue, abdominal pain, or flu-like symptoms
• Persistent or severe nausea or vomiting
• Persistent or severe diarrhea
• Pain, numbness or tingling of arms or legs
• Swelling of arms or legs, or weight gain
• Depression or nervousness
What is a package insert? A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.
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