Antiandrogens, Nonsteroidal (Systemic)
Before Using This Medicine
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 the nonsteroidal
antiandrogens, the following should be considered:
Allergies - Tell your doctor if you have ever had any unusual or
allergic reaction to any of the nonsteroidal antiandrogens. Also tell your
health care professional if you are allergic to any other substances, such
as foods, preservatives, or dyes.
Fertility - Nonsteroidal antiandrogens, and other treatments for prostate cancer that
are used together with these medicines, may cause low sperm counts or otherwise
decrease a man's ability to father a child. In some cases, these effects may
be permanent. Men who wish to have children should discuss this with their
doctors before starting treatment.
Pregnancy - Nonsteroidal antiandrogens are usually given to
men. However, if one of these medicines is needed by a woman, it is very important
that an effective method of avoiding pregnancy be used during treatment. Because
these medicines block the effect of the male hormone, testosterone, they may
interfere with the normal development of a male fetus.
Breast-feeding - Nonsteroidal antiandrogens are usually given to
men, and it is not known whether any of these medicines passes into breast
milk. However, nonsteroidal antiandrogens can cause serious side effects.
Therefore, if a woman needs one of these medicines, she should not breast-feed
Children - Studies with the nonsteroidal antiandrogens have
been done only in adults, and there is no specific information comparing the
use of these medicines in children with use in other age groups. There is
a chance that a nonsteroidal antiandrogen could interfere with the development
of boys. However, cancer of the prostate gland usually occurs in middle-aged
or older men, so it is very unlikely that a child would need these medicines.
Older adults - Nonsteroidal antiandrogens have been tested in elderly
people and have not been shown to cause different side effects or problems
than they do in younger adults.
Race - A serious side effect of nilutamide that affects the lungs may be more
likely to occur in Asian patients than in Caucasian patients.
Other medicines - 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
a nonsteroidal antiandrogen, it is especially important that your health care
professional know if you are taking any of the following:
Anticoagulants such as warfarin (e.g., Coumadin) - Bicalutamide,flutamide,
or nilutamide may increase the effects of the anticoagulant. Your doctor may
recommend having your blood tested more often so that the dose of anticoagulant
can be changed if necessary
Phenytoin (e.g., Dilantin) or
Theophylline (e.g., Theo-Dur; Theolair) - Nilutamide may increase
the blood levels of these medicines in your body, which can increase the risk
of serious side effects
Also tell your doctor if you smoke tobacco. Tobacco smoking may increase
the risk of a rare side effect of flutamide.
Other medical problems - The presence of other medical
problems may affect the use of nonsteroidal antiandrogens. Make sure you tell
your doctor if you have any other medical problems, especially:
Certain blood deficiencies or disorders or
Tobacco smoking - Increased risk of anemia, other blood disorders,
Liver disease - The chance of serious side effects may be increased
Lung disease or other breathing problems - One side effect of
nilutamide can make your condition worse; your doctor may want to select a