Indications
Flutamide is indicated for use in combination with LHRH agonists for the management of locally confined Stage B2-C and Stage D2 metastatic carcinoma of the prostate.
Stage B2-C Prostatic Carcinoma: Treatment with Flutamide and the LHRH agonist should start 8 weeks prior to initiating radiation therapy and continue during radiation therapy.
Stage D2 Metastatic Carcinoma: To achieve benefit from treatment, Flutamide should be initiated with the LHRH agonist and continued until progression.
Pharmacology
Flutamide is a nonsteroidal 'pure' antiandrogen which acts directly on the target tissues either by blocking androgen uptake or by inhibiting cytoplasmic and nuclear binding of androgen.
Dosage And Administration
Oral (Adult)-
Palliative treatment of prostatic carcinoma: 250 mg tid preferably at least 3 days before gonadorelin analogue treatment. May be taken with or without food.
Interaction
Increased prothrombin time in patients on long-term warfarin treatment.
Contraindications
Hypersensitivity, severe hepatic impairment, pregnancy and lactation.
Side Effects
Hot flushes, loss of libido, impotence, gynaecomastia, nausea, vomiting, diarrhoea, increased appetite, sleep disturbances, skin reactions, anaemias, headache, dizziness, malaise, anxiety, hypertension, gastric and chest pain, oedema, blurred vision, hepatitis, jaundice, rash, thirst, pruritus, SLE-like syndrome, drowsiness, confusion, depression, nervousness.
Pregnancy And Lactation
Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
Precautions And Warnings
Perform liver function tests before starting treatment and at regular intervals. Treatment is not recommended in patients whose ALT values exceed twice the upper limit of normal. Regular assessment of prostate specific antigen level may help to monitor disease progression. Advise patient against discontinuing drug on their own. Exercise caution in patients with cardiac disease.
Therapeutic Class
Hormonal Chemotherapy
Storage Conditions
Store at 25° C.