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Casodex (Bicalutamide)  


Casodex (Bicalutamide) is a non – steroidal androgen receptor containing Bicalutamide which has a molecular weight of 430.37. Lactose, magnesium stearate, hypromellose, polyethylene glycol, titanium oxide and sodium starch glycollate are some of the ingredients of Casodex (Bicalutamide). It is a valuable drug which is used for imparting relief to patients suffering from prostate cancer. 


Indications: Casodex is a part of hormonal therapy which is used to treat men with advanced prostate cancer. This drug is indicated when there are evidences for metastases (spreading of the cancer into other parts of the body). This therapy hinders the production of particular hormones in the body, thus preventing the tumour from reproducing. This drug is habitually taken in combination with LHRH (leutenizing hormone-releasing hormone).  


Dosage: Casodex which is classified as an anti-androgen is a tablet. It is to be taken orally once in a day, with or without food. The drug should be taken at the same time each day after urination. The dosage generally is decided by the doctor depending on severity of disease and the overall health of the patient. It is generally available in tablet form of 50 mgs and 150 mgs. The intake of Casodex is advised for as long as it is successful in controlling the cancer.  


Contraindications: Casodex (Bicalutamide) faces contraindications in following conditions:  

  • If the patient suffers from nausea, vomiting and/or diarrhoea 
  • If the patient is experiencing urinary retention or inability to urinate 
  • When patient breathes with difficulty 
  • Consumption of alcohol during the course of the treatment  
  • The doctor should be informed about the medications that being taken by the patient before the commencement of this drug’s intake. Diabetic patients should monitor their serum glucose regularly. 

Mechanism of Action (MOA): Testosterone is a hormone produced by the adrenal glands. Proteins, present as receptors in the prostate cancer cells, are attached to the testosterone and cause the cancer cells to grow. Casodex, which is a similar composition of testosterone, prevents the growth of cancerous cells. The result of this procedure minimizes the size of the tumour. It also acts as the accelerator of the degradation of androgen receptor.  


Interaction: Casodex may be used in combination with warfarin (Coumadin). The dosage of Coumadin may be adjusted depending upon the cases. Bicalutamide must not be given along with a gonadotrophin factor for the treatment of advanced prostate cancer. Periodic blood tests to monitor CBC (Complete Blood Count) and the functioning of kidneys and liver must be performed with the Casodex therapy. In rare cases Bicalutamide may cause growth of other types of tumours or liver diseases.  


Side Effects: Sensitive patients may experience some of the following side effects of this medication: 

  • hot flashes 
  • pains 
  • body aches 
  • breast swelling 
  • headache 
  • giddiness 
  • drowsiness 
  • fatigue 
  • hair loss 
  • constipation or diarrhoea 
  • nausea 
  • loss of appetite.  

Consult doctor at earliest on experiencing any of the minor side lest they may lead to severe complications such as erectile dysfunction (or decrease in sexual desire), numbness in limbs, vision changes, swelling, unusual bleeding, painful urination, chills, fever, troubled breathing, anxiety, mood changes or depression.