Flutamide (Drogenil)

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Your doctor has recommended a medication called Flutamide as treatment for your cancer. This page provides extra information about your medicine, summarises possible side effects and methods to alleviate them.

What is in Drogenil? Flutamide in an oral tablet taken at a dose of 250mg three times a day, belongs to group of medicines called testosterone antagonists . They are used to treat male patients with prostate cancer and sometimes patients with cancer of the pancreas. Many people like to take it at the same time each day – the actual time does not matter. Some prefer to take it with food some after meals  - try to find a convenient time and stick to it as its easier to remember to take the tablets in the long term.

If you forget to take your tablet, do not panic – levels of the drug in your blood will not change very much –   not to miss more than one or two tablets in a row. Remember to get a new prescription a couple of weeks before you run out of the tablets and make sure you have plenty for holidays etc.

How do they work? Some tumours such as prostate cancer are stimulated by the bodies own male hormone (Testosterone). Stopping the bodies testosterone reaching the tumour can cause the cancer cells to stop growing and in some cases shrivel up and die completely (self destruct - apoptosis).  Flutamide stops testosterone stimulating a cancer cell by stopping  the cancer cells ability to read the testosterone in the blood stream. Cancer cells have receptors in the same way as a TV needs an aerial. If the aerial is damaged the TV can't show a clear picture. In the same way if the receptor on the cell is blocked it can't be influences by the bodies hormones, despite often normal levels in the blood stream. In this case the receptors is called androgen receptors and is blocked by casodex. This is way Flutamide is sometimes referred to as a receptor antagonists.

How will I & the doctor know they are working? In most cases there is something the doctor can measure. This may be how you feel, a symptom related to your cancer, something which can be felt on examination (e.g. a lump or size of prostate),   something seen on a scan or xray. or a blood test called PSA, (the level of which will get lower if you are responding).

Possible side effects All medications have side effects. These can effect some people more than others. It its hard to predict the level and type of side effect for each individual. Listed below is an overview of the more common side effects you may encounter, however, you may experience none, all, or only a few of these. You may also have a rare side effect not listed here. If you become aware of any other side effects, please report them to your clinic.

If side effects are severe, you may have to stop taking the drug and a different hormonal drug may be prescribed.

  • Breast swelling (gynaecomastia) - Often the breasts can become tender and enlarge (this can be prevented by a low dose of radiotherapy to the nipples).
  • A feeling of depression - It is common to have a change in mood with flutamide this may lead to or exacerbate depressive illness in some cases.
  • Change in bowel habit - Some people experience diarrhoea - it is usually mild and can often be corrected by a moderate dietary change.
  • Damage to the liver - Rarely flutamide can interfere with the function of the liver. This is very rarely more than very mild but if you have a pre-existing liver condition you must tell your doctor.
  • Sex drive (libido) The advantage of flutamide is that it should not have a significant impact on the sex drive. It may in some cases impairs the ability to have erections.
  • Lethargy It is common to have mild lethargy with flutamide - it is most severe at the beginning but can wear off over time. In some men it occasionally has the opposite effect and they experience wakefulness.
  • Nausea and indigestion   Feelings of mild sickness (nausea) and indigestion can occur but t usually wears off after a few weeks.  
  • Weight gain Weight gain can be a side effect of flutamide and this is sometimes due to water retention but at other times a consequence of a eating more either due to a increased appetite or mild nausea - "to settle the stomach" . 

Other issues There is no interaction between flutamide and moderate amounts of alcohol.  Flutamide does not usually affect your ability to drive.  

 

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.


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