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Trade/other name(s): Casodex

Why would this drug be used?

Bicalutamide blocks the action of androgens (male hormones) and is used to treat advanced prostate cancer.

How does this drug work?

Bicalutamide belongs to the group of drugs called hormone antagonists. It stops the growth of cancer cells that need male hormones.

Before taking this medicine

Tell your doctor…

  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, diabetes, gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. This drug is only approved for use in men, and has not been studied in women. Check with your doctor about what kinds of birth control can be used with this medicine.
  • If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could harm the baby.
  • If you think you might want to have children in the future. This drug may reduce fertility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

This drug can increase the risk of bleeding when taken with warfarin (Coumadin, a "blood thinner"). Your doctor may do more frequent blood testing while you are on this drug.

Bicalutamide can also cause other drugs to build up in your system, such as certain tranquilizers, antibiotics, blood pressure medicines, antidepressants, sildenafil (Viagra), and others. Be sure your doctor and pharmacist know all the drugs you are taking; you may need to be watched more closely so that any problems can be addressed quickly.

Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

The bicalutamide tablet should be taken by mouth with a full glass of water. It can be taken with or without food. Take it about the same time each day. Everyone takes the same dose. Bicalutamide treatment is usually started at the same time as another drug in injection form called a luteinizing hormone-releasing hormone (LHRH) analog, which helps stop the body from making testosterone.

Take this drug exactly as your doctor tells you to. If you do not understand these instructions, your doctor or nurse can explain them to you.

Protect the pills from light, heat, and moisture. Store in a tightly closed container away from children and pets.


Bicalutamide can cause severe liver damage in a few people. Your doctor will likely check your blood so that if this happens, it can be found early. Call your doctor right away if you notice nausea, vomiting, fatigue, poor appetite, dark urine, yellowing skin or eyes, or tenderness under the right side of the rib cage.

It is important to keep taking this drug, even if you feel well. If you are bothered by side effects, talk to your doctor or nurse to find out if the problems are serious. Many side effects can be managed with help from your doctor.

This drug has not been tested in women or children and is not recommended for their use.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.


  • swelling of the breasts
  • tenderness or pain in the breasts
  • hot flashes

Less common

  • low red blood cell count (anemia) which can cause tiredness and shortness of breath
  • swollen feet or legs
  • decreased sexual desire
  • impotence (erectile dysfunction)
  • constipation
  • high blood pressure
  • pain in bones, joints, and muscles
  • muscle weakness


  • nausea
  • diarrhea
  • constipation
  • headache
  • allergic reaction
  • rash
  • severe liver injury, usually within the first 3 to 4 months of taking the drug*

*See "Precautions" section for more detailed information.

There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1995

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.

Last Medical Review: 12/07/2009
Last Revised: 12/07/2009