Dr. med. Dirk Manski

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Bicalutamide: Hormonal Treatment of Advanced Prostate Cancer

Indications for Bicalutamide

Anti-androgen hormone treatment of prostate cancer with bicalutamide is a therapeutic option against prostate cancer in the following situations:

Mechanism of Action of Bicalutamide

Bicalutamide is a nonsteroidal anti-androgen drug, which shows competitive antagonism in relation to the androgen receptor. The central inhibition of androgen receptors leads to an increase in LH, testosterone and estrogen.

Pharmacokinetics of Bicalutamide

Side Effects of Bicalutamide

Interactions with Bicalutamide

Increased effect of warfarin (displacement from the plasma protein binding), terfenadine or cisapride (inhibition of cytochromes).

Contraindications for Bicalutamide

Increased liver enzymes warrant dose reduction and regular laboratory monitoring. Bicalutamide should be stopped in progressive elevation of liver transaminases without evidence of liver metastases. Further contraindications are allergy, bicalutamide has no indications in women and children.

Dosage of Bicalutamide

In the EU and some other countries, two dosages of bicalutamide for oral administration are approved: 50 mg/day or 150 mg/day. In the USA, the usage of bicalutamide is only approved for the 50 mg indication:

150 mg/day bicalutamide is recommended for antiandrogenic monotherapy (as an alternative to treatment with GnRH modulators or surgical castration).

50 mg/day bicalutamide is sufficient to prevent the testosterone flare at the beginning of GnRH agonist therapy or in combination with GnRH agonist treatment (maximal androgen blockade, MAB).






Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z



References

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