Non-steroidal anti-androgen
Bicalutamide
Brand names: Casodex
Adult dose
Dose: 50mg OD (advanced prostate cancer with LHRH); 150mg OD (locally advanced monotherapy)
Route: Oral
Frequency: OD
Clinical pearls
- NICE NG131 prostate cancer: flare prevention with LHRH agonists; monotherapy in selected localised disease
- ESMO / BAUS prostate cancer
- Tamoxifen 20mg OD or breast irradiation prophylaxis for gynaecomastia (150mg dose)
Contraindications
- Severe hepatic impairment
- Pregnancy (no female indication)
- Children
- Hypersensitivity
Side effects
- Gynaecomastia
- Hot flushes
- Erectile dysfunction
- Hepatotoxicity
- QT prolongation
- Anaemia
Interactions
- Warfarin (significant INR elevation)
- CYP3A4 substrates
- QT-prolonging drugs
Monitoring
- LFTs
- PSA
- Testosterone
- INR if on warfarin
Reference: BNF; NICE NG131; ESMO prostate cancer; BAUS; https://bnf.nice.org.uk/drugs/bicalutamide/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
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