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Nilutamide

(nye-loo-tuh-mide)

Trade/other name(s): Nilandron

Why would this drug be used?

Nilutamide is used to treat advanced prostate cancer.

How does this drug work?

Nilutamide is a part of the general group of drugs called hormone antagonists. Antagonists block the effect of a hormone. Nilutamide blocks the action of androgens (male hormones, such as testosterone.) When you take this drug, cancer cells that depend on testosterone are no longer able to grow.

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 have any lung problems or trouble breathing. In a few men, nilutamide can worsen these problems.
  • 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. 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").

In some men taking nilutamide, alcohol can make the blood pressure go abnormally low.

Check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements 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?

Nilutamide is a pill that is given by mouth daily. Most people start taking this medicine the day of or the day after surgery to remove the testicles. Usually, for the first month you will receive twice the regular dose. Starting the second month, you will receive the regular dose. Take the pills once a day, with or without food. If you are uncertain of the instructions for taking this medicine, ask your doctor or nurse to explain them to you.

Keep the medicine in a tightly closed container away from heat and moisture and out of the reach of children and pets.

Precautions

Rarely, nilutamide can cause irritation and scarring of the lungs. If it is found early, this usually goes away after the drug is stopped. Your doctor may do a chest x-ray and test your lungs before you start taking the drug. Tell your doctor or nurse right away if you notice cough, fever, or any trouble breathing. If you already have shortness of breath, tell your doctor if it gets worse.

Some men taking nilutamide get flushing of the face or feel bad or dizzy from low blood pressure after drinking alcohol. If this happens, you should stop drinking alcohol while taking the medicine.

Nilutamide can make it hard for your eyes to adapt to the dark after you have been in the light. This can cause problems driving at night or going through tunnels. Dark glasses can be used to help reduce this effect. Nilutamide can also change the way you see colors.

Nilutamide 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 nilutamide, 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.

Common

  • hot flashes

Less common

  • nausea
  • indigestion or acid stomach
  • loss of appetite
  • higher blood pressure
  • abnormal blood tests which suggest that the drug is affecting the liver (Your doctor will discuss the importance of this finding, if any.)*
  • decreased sexual ability (impotence or erectile dysfunction)
  • decreased sexual interest (libido)
  • flushing, feeling bad, and low blood pressure after drinking alcohol*
  • vision problems, such slow adjustment to darkness and changes in how colors are seen*

Rare

  • diarrhea
  • severe liver injury and damage*
  • inflammation and scarring of lungs*

*See "Precautions" section for more detailed information.

Other side effects not listed above 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 1996.

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: 12/08/2009
Last Revised: 12/08/2009