Nilutamide Medication: Uses, Dosage, and Side Effects Explained

Summary of Key Points

Nilutamide is a medication used to treat advanced prostate cancer, particularly in cases where the cancer is hormone-sensitive or resistant to other treatments. It works by blocking male hormones (androgens) that fuel the growth of prostate cancer cells. Nilutamide is typically prescribed alongside other treatments, such as surgery or hormone therapy. Always consult your healthcare provider before starting or adjusting your Nilutamide dosage.

Names of Medication

US Brand Name: Nilandron

Generic Name: Nilutamide

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, Nilutamide is the generic name.

Pharmacologic Category

Antiandrogen, Nonsteroidal

Other medications in this category include:

1. Bicalutamide (Casodex)
2. Flutamide (Eulexin)
3. Enzalutamide (Xtandi)

Nilutamide Dosage

Nilutamide is used to treat various types of prostate cancer. Dosage may vary depending on the specific condition. Always follow your doctor’s instructions and consult them before making any changes to your dose. Our telemedicine providers are available to guide you through your treatment plan.

Prostate Cancer (Advanced, Metastatic, or Hormone-Sensitive)

Initial Dose: 300 mg once daily for 30 days.

Maintenance Dose: 150 mg once daily thereafter.

Castration-Resistant Prostate Cancer

Initial Dose: 300 mg once daily for 30 days.

Maintenance Dose: 150 mg once daily thereafter.

Non-Metastatic or Recurrent Prostate Cancer

Initial Dose: 300 mg once daily for 30 days.

Maintenance Dose: 150 mg once daily thereafter.

Androgen-Dependent or Stage D Prostate Cancer

Initial Dose: 300 mg once daily for 30 days.

Maintenance Dose: 150 mg once daily thereafter.

It is essential to take Nilutamide exactly as prescribed. If you have any questions about your dosage, schedule a telemedicine appointment with one of our providers.

Dosage Forms and Strengths

Tablet: 150 mg

Administration Instructions for Nilutamide

Nilutamide is taken orally, usually once a day. It can be taken with or without food. Swallow the tablet whole with a full glass of water. Try to take it at the same time each day to maintain consistent medication levels in your body. If you miss a dose, take it as soon as you remember, unless it’s close to the time of your next dose. Do not double up on doses to make up for a missed one.

Nilutamide Side Effects and Adverse Reactions

Like all medications, Nilutamide can cause side effects. It’s important to be aware of these and contact your healthcare provider if you experience any severe or persistent symptoms. Side effects can range from mild to serious.

Common Side Effects (affecting 1 in 10 patients):

1. Hot flashes: A sudden sensation of warmth, often over the face, neck, and chest.
2. Nausea: A feeling of sickness or discomfort in the stomach.
3. Vision changes: Difficulty adjusting to light or seeing in the dark.

Less Common Side Effects (affecting 1 in 100 patients):

1. Liver problems: Symptoms may include yellowing of the skin or eyes, dark urine, or abdominal pain.
2. Breathing difficulties: Shortness of breath or a persistent cough.

Serious Side Effects (rare but require immediate medical attention):

1. Severe allergic reactions: Rash, itching, swelling, severe dizziness, or trouble breathing.
2. Lung inflammation: Persistent cough, chest pain, or difficulty breathing.

If you experience any side effects, especially serious ones, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers to discuss your symptoms and treatment options.

Contraindications for Nilutamide

A contraindication is a specific situation where a medication should not be used because it may be harmful. For Nilutamide, there are several conditions where its use is not recommended, as it could lead to serious complications.

1. Severe Liver Disease: Nilutamide is processed by the liver. If you have severe liver disease, your body may not break down the medication properly, increasing the risk of side effects or toxicity.
2. Respiratory Disorders: Nilutamide can cause interstitial lung disease, a serious lung condition. If you have respiratory problems, such as chronic obstructive pulmonary disease (COPD) or asthma, Nilutamide could worsen your condition.
3. Hypersensitivity to Nilutamide: If you’ve had an allergic reaction to Nilutamide in the past, taking it again could lead to severe allergic reactions, including anaphylaxis, which can be life-threatening.

Always inform your healthcare provider about your full medical history before starting Nilutamide. If you have any of the conditions listed above, your provider may recommend an alternative treatment. If you are unsure whether Nilutamide is safe for you, schedule a telemedicine consultation with one of our providers today.

Drug-to-Drug Interactions with Nilutamide

Nilutamide can interact with other medications, increasing the risk of side effects or reducing treatment effectiveness. Be sure to tell your healthcare provider about all the medications you are taking, including over-the-counter drugs, supplements, and herbal products. Some medications that may interact with Nilutamide include:

1. Warfarin (Coumadin): Nilutamide can increase the effects of blood thinners like warfarin, raising the risk of bleeding.
2. Theophylline (Elixophyllin, Theo-24): Nilutamide may increase the levels of theophylline in your blood, which could lead to toxicity.
3. Phenytoin (Dilantin): Nilutamide may affect how your body processes phenytoin, increasing the risk of side effects.
4. Midazolam (Versed): Nilutamide can enhance the effects of sedative medications like midazolam, leading to excessive drowsiness or respiratory depression.

To avoid dangerous interactions, always consult your healthcare provider before starting or stopping any medication. If you need advice on managing your medications, our telemedicine team is here to help.

Nilutamide in Pregnancy

Is it safe to take Nilutamide during pregnancy?

Nilutamide is not recommended for use during pregnancy. It is classified as a Category X medication, meaning it can cause harm to an unborn baby. Since Nilutamide is primarily prescribed to men with prostate cancer, its use in women, particularly during pregnancy, is inappropriate. If you are pregnant or planning to become pregnant, it is essential to consult your healthcare provider to explore safer alternatives.

Nilutamide while Breastfeeding

Is it safe to take Nilutamide while breastfeeding?

Nilutamide is not advised for use while breastfeeding. Although it is rarely prescribed to women, if you are breastfeeding and taking Nilutamide for any reason, it is crucial to either discontinue breastfeeding or discuss alternative treatments with your healthcare provider. The effects of Nilutamide on breast milk and nursing infants have not been thoroughly studied, but there is a potential risk of harm.

Estimated Cost of Nilutamide Medication

The cost of a 30-day supply of Nilutamide without insurance typically ranges from $500 to $800, depending on the pharmacy and location. However, using a GoodRx coupon may reduce the price to approximately $300 to $500. Prices can vary, so it’s a good idea to check with your local pharmacy or use an online tool like GoodRx to find the most affordable option in your area.

Possible Alternatives to Nilutamide

If Nilutamide is not suitable for you, or if you are considering other treatment options, several alternatives are available depending on the type and stage of prostate cancer. Always consult your healthcare provider before making any changes to your treatment plan. Below are some potential alternatives:

1. Prostate Cancer: Alternatives may include surgery (prostatectomy), radiation therapy, or other hormone therapies such as bicalutamide (Casodex) or flutamide.
2. Metastatic Prostate Cancer: Chemotherapy (e.g., docetaxel) or newer hormonal agents like abiraterone (Zytiga) or enzalutamide (Xtandi) may be considered.
3. Hormone-Sensitive Prostate Cancer: Androgen deprivation therapy (ADT) using medications like leuprolide (Lupron) or goserelin (Zoladex) may help reduce testosterone levels.
4. Castration-Resistant Prostate Cancer: Newer medications such as enzalutamide (Xtandi) or abiraterone (Zytiga) are often used when cancer no longer responds to traditional hormone therapy.
5. Advanced Prostate Cancer: Treatment options may include a combination of hormone therapy, chemotherapy, and radiation therapy. Immunotherapy (e.g., sipuleucel-T) may also be an option.
6. Non-Metastatic Prostate Cancer: Depending on the stage and aggressiveness of the cancer, active surveillance, surgery, or radiation therapy may be considered.
7. Recurrent Prostate Cancer: Treatment may involve additional hormone therapy, radiation, or chemotherapy, depending on the location and extent of the recurrence.
8. Androgen-Dependent Prostate Cancer: Hormone therapy, such as leuprolide (Lupron) or bicalutamide (Casodex), may be used to lower testosterone levels.
9. Stage D Prostate Cancer: This advanced stage may be treated with a combination of hormone therapy, chemotherapy, and possibly radiation therapy.

For more information on alternative treatments or to discuss your specific case, schedule a telemedicine appointment with one of our healthcare providers today.

Recent Updates on Nilutamide Research

Recent studies on Nilutamide have focused on its role in combination therapies for advanced prostate cancer. Some research suggests that when Nilutamide is used alongside other hormone therapies, it may improve outcomes in patients with castration-resistant prostate cancer. Ongoing clinical trials are also investigating the use of Nilutamide in combination with newer agents like enzalutamide (Xtandi) and abiraterone (Zytiga) to determine whether these combinations can further delay cancer progression.

While Nilutamide remains a valuable treatment option for certain patients, newer medications are being developed that may offer fewer side effects and improved effectiveness. If you would like to learn more about the latest treatment options or determine if Nilutamide is right for you, consider speaking with one of our healthcare providers through a telemedicine consultation.

James Kingsley

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