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Bicalutamide

5.32
Generic Bicalutamide is a non-steroidal anti-androgen used primarily in the treatment of prostate cancer. It works by blocking the action of testosterone, which can stimulate the growth of cancer cells in the prostate gland. Bicalutamide is typically used as part of a comprehensive hormone therapy plan for men's health.


Ingredient
Availability
In Stock
Delivery Time
Airmail (14-21 days) | EMS trackable (5-9 days)
Product is shipped in a fully discreet envelope with no content disclosure, including all required documentation inside

Product Sheet

Active Ingredient(s)
Bicalutamide
Reference Brand
Casodex
Manufacturer
AstraZeneca UK Limited
Product Form
Tablet
Regulatory Classification
Rx
Primary Category
Cancer Treatment
Product Category
Endocrine therapy, Anti-androgens
Pharmacological Class
Non-steroidal anti-androgens
Clinical Indications
Manufacturer Description
An anti-androgen medication used in the treatment of advanced prostate cancer.
Mechanism of Action
Bicalutamide works by blocking androgen (male hormone) receptors in the body. Since prostate cancer cells often need testosterone to grow, blocking these receptors helps slow or stop the progression of the cancer.
Route of Administration
Oral
Onset Time
Several weeks
Duration
Long-term (half-life of approx. 6 days)
Contraindications
Women, Children, Co-administration with terfenadine or astemizole
Severe Adverse Events
Liver damage (jaundice), Shortness of breath, Lung inflammation, Severe skin reactions
Common Side Effects
Hot flushes, Breast tenderness, Weakness, Nausea
Uncommon Side Effects
Weight gain, Reduced sex drive, Dizziness, Constipation
Drug Interactions
Warfarin, Ciclosporin, Calcium channel blockers
Pregnancy Safety Warnings
Contraindicated; not intended for use in women.
Age Restrictions
Not for use in children
Storage Guidelines
Store in the original package at room temperature.
Related Products
Enzalutamide, Abiraterone, Flutamide

Bicalutamide FAQ

Can I travel internationally with bicalutamide tablets?

Yes, you may take bicalutamide abroad, but keep the medication in its original packaging with the prescription label, and carry a copy of the prescribing doctor’s note. Some countries require a declaration for controlled cancer drugs, so check the destination’s customs regulations beforehand.

Does bicalutamide affect drug testing for athletes?

Bicalutamide is not a banned substance under the World Anti-Doping Agency (WADA) list. However, its anti-androgenic properties could be scrutinised in sports that monitor hormone levels, so athletes should disclose usage to their medical team.

What do the markings on a bicalutamide pill look like?

A 50 mg bicalutamide tablet is typically round, white to off-white, and may bear an imprint such as “BIC-50” or a manufacturer’s logo. Imprints can vary between generic suppliers.

Are there any special considerations for pilots or drivers?

Bicalutamide does not impair cognition or motor skills, but severe fatigue or hepatic side effects could affect safety. Pilots and professional drivers should report any significant adverse events to their occupational health service.

How does bicalutamide differ from flutamide?

Both are non-steroidal antiandrogens, but bicalutamide has a longer half-life, allowing once-daily dosing, and generally exhibits a more favorable safety profile, especially regarding liver toxicity.

Is bicalutamide covered by the NHS in the UK?

Yes, bicalutamide is listed on the NHS Drug Tariff for approved indications such as advanced prostate cancer, and it is typically prescribed at no direct cost to eligible patients.

Can bicalutamide be taken with herbal supplements like St John’s Wort?

St John’s Wort induces CYP3A4, which can lower bicalutamide concentrations and reduce its effectiveness. Patients should avoid such supplements unless advised otherwise by their physician.

What should I do if I develop a rash while on bicalutamide?

A mild rash is usually benign, but if it spreads, becomes blistered, or is accompanied by fever, seek immediate medical attention as it may signal a serious skin reaction.

Do I need to adjust my diet while on bicalutamide?

No specific dietary restrictions are required, but maintaining a balanced diet and limiting excessive alcohol can help protect liver health during therapy.

How long can I stay on bicalutamide therapy?

Duration is individualized; many patients remain on bicalutamide for months to years as part of ongoing cancer management, with periodic reassessment by the oncology team.

Bicalutamide: Generic Medication Overview

Bicalutamide is a prescription-only medication classified under men’s health and oncology support. It contains the active ingredient bicalutamide, supplied as a 50 mg oral pill. In the United Kingdom, the drug is regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) and is typically prescribed by oncologists and urologists for the management of prostate cancer. Because it is a branded generic, there are no specific manufacturer details required for this overview.

How Bicalutamide Works in the Body

Bicalutamide is a non-steroidal antiandrogen. It binds competitively to androgen receptors (AR) in prostate cells and other androgen-responsive tissues, blocking the actions of testosterone and dihydrotestosterone (DHT). By preventing androgen-driven signaling, bicalutamide reduces tumor growth and proliferation in androgen-dependent prostate cancer.

Key pharmacologic points:

  • Receptor binding: High affinity for the AR, preventing natural androgen attachment.
  • Onset of action: Clinical effects typically begin within a few weeks of daily dosing.
  • Metabolism: Primarily hepatic via CYP3A4; metabolites are excreted in the urine and feces.
  • Half-life: Approximately 5-7 days, allowing once-daily dosing.

Conditions Treated by Bicalutamide

  • Locally advanced or metastatic prostate cancer - Used as monotherapy in patients unsuitable for surgical castration, or more commonly in combination with a luteinising hormone-releasing hormone (LHRH) analogue (combined androgen blockade).
  • Adjuvant therapy - Post-radiotherapy to reduce the risk of disease recurrence in high-risk prostate cancer.

These indications are approved by the MHRA and reflect the drug’s role in suppressing androgen-driven tumour growth.

Evidence-Based Off-Label Uses

  • Hirsutism in women - Small observational studies and case series have reported improvement in excessive facial and body hair when bicalutamide is added to oral contraceptives. This use is not approved by the MHRA and requires close monitoring for liver toxicity and hormonal side effects.
  • Male hormone-sensitive breast cancer - Limited case reports describe disease control when bicalutamide is combined with other endocrine agents. Again, this application is off-label and should only be considered within a specialist clinical trial or compassionate-use setting.

Disclaimer: Off-label use of bicalutamide must be supervised by a qualified healthcare professional, with individualized risk assessment and regular monitoring.

Who Should (Not) Use Bicalutamide?

Absolute Contraindications

  • Known hypersensitivity to bicalutamide or any of its excipients.
  • Severe hepatic impairment (e.g., cirrhosis, Child-Pugh class C).
  • Pregnancy and breastfeeding (the drug is contraindicated in women of child-bearing potential unless contraception is reliably employed).

Relative Contraindications

  • Mild to moderate hepatic dysfunction - dose adjustment and close liver-function monitoring are advised.
  • Elderly patients - increased susceptibility to hepatic side effects; monitor closely.
  • Concomitant use of strong CYP3A4 inhibitors (e.g., ketoconazole) - may raise plasma concentrations.

Special Populations

  • Pregnancy: Anti-androgenic activity may cause fetal harm. Women of reproductive age must use effective contraception.
  • Lactation: Bicalutamide is excreted in breast milk; breastfeeding should be avoided.
  • Pediatrics: Safety and efficacy have not been established in children; the drug is not indicated for use under 18 years.

If any of the above conditions apply, discuss alternative therapeutic options with your oncologist.

Safety Profile: Side Effects and Interactions

Common Side Effects

  • Hot flashes - Frequently reported; usually mild and transient.
  • Gynecomastia and breast tenderness - Occur in up to 30 % of male patients; may be managed with radiotherapy or surgical intervention if severe.
  • Nausea, diarrhoea, and abdominal discomfort - Typically mild; advise taking the pill with food if gastrointestinal upset occurs.
  • Fatigue - Common during the initial weeks of therapy.
  • Elevated liver enzymes (ALT/AST) - Observed in routine monitoring; usually reversible upon dose adjustment or discontinuation.

Serious Adverse Events

  • Hepatotoxicity - Rare but potentially severe; symptoms include jaundice, dark urine, and right-upper-quadrant pain. Immediate medical review is essential.
  • Severe skin reactions (e.g., Stevens-Johnson syndrome) - Extremely rare; discontinue immediately if rash spreads.
  • Interstitial lung disease - Very uncommon; consider if new respiratory symptoms develop.

Black-Box Warning: Bicalutamide carries a risk of serious liver injury; regular hepatic function tests are mandatory.

Drug Interactions

  • Warfarin: Bicalutamide may increase INR; monitor coagulation parameters closely.
  • CYP3A4 inhibitors (ketoconazole, erythromycin): May raise bicalutamide plasma levels → higher risk of toxicity.
  • CYP3A4 inducers (rifampicin, carbamazepine): May reduce effectiveness; dose adjustment may be required.
  • Other antiandrogens or hormonal therapies: Combined use can amplify anti-androgenic effects and hepatic burden.

Food and Lifestyle Interactions

  • Food: Can be taken with or without meals; a light snack may reduce mild nausea.
  • Alcohol: Excessive intake can exacerbate liver enzyme elevations; moderation is advised.
  • Driving: No known impairment; however, severe fatigue may affect concentration.

General Advice: Always disclose all current medications, supplements, and herbal products to your healthcare provider before starting bicalutamide.

How to Take Bicalutamide

  • Standard dosing: One 50 mg pill taken once daily. Most patients receive this dose in combination with an LHRH analogue.
  • Renal impairment: No dosage change is required for mild to moderate renal dysfunction.
  • Hepatic impairment: For mild liver disease, the same dose may be used with intensified monitoring; severe disease is contraindicated.
  • Administration: Swallow the tablet whole with a glass of water; no crushing or chewing is recommended.
  • Missed dose: Take the missed dose as soon as you remember unless it is almost time for the next dose; do not double-dose.
  • Overdose: Symptoms may include nausea, vomiting, abdominal pain, and marked liver enzyme elevation. Seek emergency medical care; treatment is supportive and may involve activated charcoal if presentation is early.
  • Discontinuation: Abrupt cessation is generally acceptable, but any change should be directed by the treating oncologist to avoid disease flare.

Monitoring and Follow-Up

  • Liver function tests (ALT, AST, bilirubin): Baseline, then monthly for the first three months, followed by quarterly checks.
  • Prostate-specific antigen (PSA): Every 3-6 months to assess therapeutic response.
  • Clinical assessment: Evaluate for gynecomastia, breast pain, and any new respiratory or dermatologic symptoms at each visit.
  • Imaging: As recommended by the oncology team to monitor disease progression.

Regular follow-up with your oncology specialist is essential to optimise treatment efficacy and safety.

Storage and Handling

  • Store the tablets at room temperature (15-30 °C), protected from moisture and direct sunlight.
  • Keep the bottle tightly closed and out of reach of children or pets.
  • Do not use the medication after the expiry date printed on the packaging.
  • Dispose of unused tablets according to the UK NHS Drug Disposal Programme or local pharmacy guidelines.

Medication-Specific Glossary

Androgen Receptor
A protein inside cells that binds testosterone and DHT, triggering growth signals in prostate tissue.
Non-steroidal Antiandrogen
A class of drugs, like bicalutamide, that block androgen receptors without being steroid hormones themselves.
Gynecomastia
Benign enlargement of male breast tissue, commonly occurring as a side effect of antiandrogen therapy.
Hepatotoxicity
Liver injury caused by a drug, manifested by elevated liver enzymes or clinical jaundice.
Prostate-Specific Antigen (PSA)
A protein produced by prostate cells; blood levels are used to monitor prostate cancer activity.

Medical Disclaimer

This article provides educational information about bicalutamide and is not a substitute for professional medical advice. Treatment decisions, including use for unapproved indications, must be made under the guidance of a qualified healthcare provider. The content is intended for informational purposes and does not constitute medical recommendations. Always consult a physician before starting, stopping, or changing any medication regimen.

Information for Bicalutamide is sourced from established medical standards and updated frequently. It is provided for general guidance and should be confirmed with a healthcare professional before use.
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