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Bicalutamide (Oral Route)


Description and Brand Names of Bicalutamide (Oral Route)

US Brand Name

  1. Casodex


Bicalutamide is used together with another medicine to treat stage D2 metastatic prostate cancer (cancer that has spread) in men. Bicalutamide belongs to the group of medicines called antiandrogens. It works by blocking the effects of testosterone (a male hormone), which helps stop the growth and spread of cancer cells. Bicalutamide will always be given together with a luteinizing hormone-releasing hormone (LHRH) analog (e.g., goserelin or leuprolide).

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

  • Tablet

Before Using Bicalutamide (Oral Route)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Appropriate studies have not been performed on the relationship of age to the effects of bicalutamide in the pediatric population. Safety and efficacy have not been established.


Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of bicalutamide in the elderly.



There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acenocoumarol
  • Amiodarone
  • Dicumarol
  • Domperidone
  • Fentanyl
  • Phenprocoumon
  • Piperaquine

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Diabetes or
  • Liver disease (including hepatitis) – Use with caution. May make these conditions worse.

Proper Use of Bicalutamide (Oral Route)

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine usually comes with a patient information leaflet. Read it carefully and make sure you understand it before taking this medicine. If you have any questions, ask your doctor.

It is best to take this medicine at the same time each day. If you have been directed to take the medicine once a day, you may take it either in the morning or in the evening.

This medicine should be started at the same time as treatment with a luteinizing hormone-releasing hormone (LHRH) analog (such as goserelin, leuprolide, Lupron®, or Zoladex®). Do not stop taking these medicines without checking with your doctor first.

You may take this medicine with food or on an empty stomach.


The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):

    • For prostate cancer:

      • Adults – 50 milligrams (mg) once a day.
      • Children – Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.


It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Women who are pregnant or may become pregnant should not use bicalutamide tablets. Bicalutamide may cause harm in unborn babies.

Liver problems may occur while you are taking this medicine. Stop using this medicine and check with your doctor right away if you are having more than one of these symptoms: clay-colored stools; dark urine; fever; headache; loss of appetite; nausea and vomiting; pain or tenderness in the upper right side of the stomach; unusual tiredness or weakness; or yellow eyes or skin.

This medicine may cause swelling of the breasts (gynecomastia) and breast pain in some patients. If you have questions about this, talk to your doctor.

Using this medicine with an LHRH analog may affect blood sugar levels. If you notice a change in the results of your blood sugar tests or if you have any questions, check with your doctor.

This medicine may affect the results of the prostate specific antigen (PSA) test, which may be used to detect prostate cancer. Make sure you tell all of your doctors that you are using this medicine.

If you plan to have children, talk with your doctor before using this medicine. This medicine may cause some men to become infertile (unable to have children), at least temporarily.

This medicine may make you sleepy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of Bicalutamide (Oral Route)

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Bloating or swelling of the face, arms, hands, lower legs, or feet
  2. blood in the urine
  3. blurred vision
  4. body aches or pain
  5. congestion
  6. cough or hoarseness
  7. cough producing mucus
  8. difficult or labored breathing
  9. dizziness
  10. dryness or soreness of the throat
  11. fever or chills
  12. headache
  13. lower back or side pain
  14. nervousness
  15. painful or difficult urination
  16. pounding in the ears
  17. rapid weight gain
  18. runny nose
  19. shortness of breath
  20. slow or fast heartbeat
  21. sweating
  22. tender, swollen glands in the neck
  23. tightness in the chest
  24. tingling of the hands or feet
  25. trouble with swallowing
  26. unusual weight gain or loss
  27. voice changes
  28. wheezing

Less common

  1. Abnormal growth filled with fluid or semisolid material
  2. ankle, knee, or great toe joint pain
  3. arm, back, or jaw pain
  4. bleeding from the rectum or bloody stools
  5. blindness
  6. bloody nose
  7. burning while urinating
  8. burning, tingling, numbness, or pain in the hands, arms, feet, or legs
  9. change in bowel habits
  10. chest pain or discomfort
  11. chest tightness or heaviness
  12. chills
  13. confusion
  14. decrease in frequency of urination
  15. decrease in urine volume
  16. decreased vision
  17. difficulty in passing urine (dribbling)
  18. difficulty with swallowing or eating
  19. dilated neck veins
  20. dry mouth
  21. fainting
  22. fast or irregular heartbeat
  23. fever
  24. irregular breathing
  25. joint stiffness or swelling
  26. lightheadedness
  27. loss of appetite
  28. lump or swelling in the abdomen
  29. nausea
  30. no blood pressure or pulse
  31. noisy breathing
  32. pain in the neck
  33. pain or discomfort in the arms, jaw, back, or neck
  34. painful blisters on trunk of the body
  35. persistent non-healing sore
  36. rapid, shallow breathing
  37. reddish patch or irritated area
  38. sensation of pins and needles
  39. shiny bump
  40. stabbing pain
  41. stomach discomfort
  42. stopping of heart
  43. sunken eyes
  44. swelling of the face, fingers, feet, or lower legs
  45. thirst
  46. tumor
  47. unconsciousness
  48. unexplained weight loss
  49. unusual tiredness or weakness
  50. vomiting
  51. weight gain
  52. white, yellow or waxy scar-like area
  53. wrinkled skin
  54. yellow skin or eyes

Incidence not known

  1. Hives or welts
  2. itching
  3. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  4. redness of the skin
  5. skin rash

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Acid or sour stomach
  2. belching
  3. breast pain
  4. constipation
  5. decreased interest in sexual intercourse
  6. diarrhea
  7. difficulty with moving
  8. dry skin
  9. hair loss or thinning of the hair
  10. heartburn
  11. inability to have or keep an erection
  12. indigestion
  13. lack or loss of strength
  14. leg cramps
  15. loss in sexual ability, desire, drive, or performance
  16. loss of strength or energy
  17. muscle aching or cramping
  18. muscle pain or weakness
  19. nervousness
  20. pain in the pelvis
  21. pain or tenderness around the eyes and cheekbones
  22. passing of gas
  23. sleepiness or unusual drowsiness
  24. stomach pain, fullness, or discomfort
  25. stuffy or runny nose
  26. swelling of the breasts or breast soreness in both females and males

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.