Flutamide treatment is used in men with advanced prostate cancer at stage D2, where there is evidence of metastases (cancer spread) in other regions of the body.
Note: If a medication has been licensed for one use, doctors might continue to use the same medication for other uses if they think it may be beneficial.
How is it given?
-Flutamide is a capsule ingested by mouth.
The capsule contents can be opened and mixed with soft food, such as apple sauce. It is not advised to blend with a liquid.
-Regular dosing should be evenly distributed during the day (e.g., three times a day should be given every 8 hours).
-It is usually started at the same time as LHRH therapy is initiated.
-In some cases (e.g., spinal cord metastases), flutamide can start about 5-7 days before you receive the LHRH agonist. This is done to suppress the “flare” or testosterone spike after the LHRH agonist is given.
-The amount of Eulexin you get depends on a variety of factors. Your doctor will decide your dosage and your timetable.
Some warnings for Eulexin
Eulexin – Post-marketing cases of hospitalization and occasionally death due to liver failure have been reported in patients taking flutamide. Evidence of hepatic damage included increased serum transaminase levels, jaundice, hepatic encephalopathy, and mortality due to acute hepatic failure. Hepatic damage was reversible in some cases after discontinuation of treatment. About half of the reported cases happened within the first 3 months of therapy with flutamide.
Eulexin – Serum transaminase levels should be assessed before beginning therapy with flutamide. Flutamide is not approved for patients whose ALT values surpass twice the upper limit of average. Serum transaminase levels can then be assessed monthly for the first 4 months of treatment and annually afterward. Liver function examinations may also be done for the first signs and symptoms indicative of liver disease, e.g., nausea, vomiting, stomach pain, weakness, anorexia, “flu-like” symptoms, hyperbilirubinemia, jaundice, or upper right quadrant tenderness. If at any point, a patient has jaundice or their ALT increases above 2 times the upper limit of average, flutamide should be stopped promptly with near follow-up of liver function tests before it is resolved.
Interactions of Eulexin.
Increases in prothrombin time have been identified in patients undergoing long-term warfarin treatment following flutamide. Therefore, careful monitoring of prothrombin duration is advised, and an anticoagulant dose change may be appropriate when EULEXIN (flutamide) capsules are administered concomitantly with warfarin.
Overdose case.
In animal experiments of flutamide alone, overdose symptoms included hypoactivity, piloerection, sluggish breathing, ataxia and/or lacrimation, anorexia, tranquilization, emesis, and methemoglobinemia.
Clinical trials have been performed with flutamide at doses up to 1500 mg per day for periods of up to 36 weeks without any significant adverse reactions recorded. The adverse reactions reported included gynecomastia, breast tenderness, and some rise in SGOT. The single dose of flutamide normally associated with symptoms of overdose or considered life-threatening has not been identified.
Flutamide is strongly bound to proteins and is not cleared by hemodialysis. As for the treatment of overdose of any medication, it should be borne in mind that several agents might have been taken. If there is no involuntary vomiting, it can be triggered if the patient is aware. General supportive treatment, including regular monitoring of vital signs and direct patient examination, is suggested.
Capsules are contraindicated in patients who are hypersensitive to flutamide or any part of this preparation. flutamide Capsules are contraindicated in patients with a serious hepatic deficiency (baseline hepatic enzymes should be tested before treatment).
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