Care During Chemotherapy and Beyond
Generic Name: Nilutamide
(ni LOO ta mide)
Drug type: Nilutamide is a hormone therapy. It is classified
as an "anti-androgen." It may be given in combination with "LHRH agonist," another
type of hormone therapy. (For more detail, see "How this drug works" section below).
What This Drug Is Used For:
- Nilutamide therapy is for men with advanced prostate cancer at stage D2, when there
is evidence of metastases (cancer spread) to other areas of the body.
- Anti-androgen medications are usually given in conjunction with LHRH agonists or
after orchiectomy (surgical removal of the testicles).
Note: If a drug has been approved for one use, physicians may elect
to use this same drug for other problems if they believe it may be helpful.
How This Drug Is Given:
- Nilutamide is a tablet, taken by mouth. It is taken once a day.
- It should be taken at the same time each day, with or without food.
- In some cases (e.g. spinal cord metastasis), nilutamide will be started approximately
5-7 days before you receive the LHRH agonist. This is done to block the "flare"
or surge of testosterone that occurs after LHRH agonist is given.
- The amount of this medicine you receive depends on many factors. Your doctor
will determine your dose and schedule.
Important things to remember about the side effects of nilutamide:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and will go away after treatment is complete.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the
effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for
patients taking nilutamide:
- Hot flashes (see sexuality)
- Swelling of the breasts (gynecomastia) (see sexuality)
- Breast pain (see sexuality)
- Loss of interest in sex (decreased libido) (see sexuality)
- Nipple discharge (galactorrhea) (see sexuality)
- Inability to obtain or sustain an erection (impotence) (see sexuality)
- This medication may make it harder for your eyes to adapt to the dark. This usually
occurs when passing from a lighted area to one that is dark.
The following are less common side effects (occurring in 10-29%) for patients
- Headaches, dizziness, pain, weakness and swelling are all noted infrequently
- Poor appetite
- Increases in blood tests measuring liver function. These return to normal
once treatment is discontinued.
- Trouble sleeping (insomnia)
A rare side effect occurring in less than 2% of patients is cough, shortness of
breath and irritation of the lung (pneumonitis). If seen usually would occur
within the first 3 months of treatment.
Not all side effects are listed above, some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your
health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you
should experience any of the following symptoms:
- Shortness of breath, chest or jaw pain or discomfort
- Fever of 100.4° F (38° C), chills (possible signs of infection)
- Urinary retention, inability to urinate
The following symptoms require medical attention, but are not emergency situations.
Contact your health care provider within 24 hours of noticing any of the
- Constipation unrelieved by the use of laxatives
- Nausea (interferes with ability to eat and unrelieved with prescribed medications)
- Vomiting (vomiting more than 4-5 times in a 24-hour period)
- Dizziness or lightheadedness, feeling faint
- Persistent headache
- Any changes in eyesight
- Cough and/or shortness of breath
- Swelling of the feet or ankles
- Yellowing of the skin or eyes, abdominal pain, loss of appetite, flu-like symptoms
Always inform your health care provider if you experience any unusual symptoms.
- Before starting nilutamide treatment, make sure you tell your doctor about any other
medications you are taking (including prescription, over-the-counter, vitamins,
herbal remedies, etc.). Do not take aspirin, or products containing aspirin
unless your doctor specifically permits this.
- Anti-androgens are usually given to men. However, if nilutamide is given to
a woman, conceiving a child (getting pregnant) should be avoided. Pregnancy
category C (use in pregnancy only when benefit to the mother outweighs risk to the
- Anti-androgens are usually given to men. However, if nilutamide is given to
a woman, she should not breast feed.
- Do not stop taking this medication unless your healthcare provider tells you to.
Take the medication exactly as directed.
- If you are experiencing hot flashes, wear light clothing, staying in a cool environment,
and putting cool cloths on your head may reduce symptoms. Consult you health care
provider if these worsen, or become intolerable.
- This medication may make it harder for your eyes to adapt to the dark. Be careful
of driving an automobile at nighttime. This may resolve when you discontinue the
medication. Wearing tinted glasses, or sunglasses may help.
- Keep your bowels moving. Your health care provider may prescribe a stool softener
to help prevent constipation that may be caused by this medicine.
- Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your
fluid intake, and maintain good nutrition. This will decrease your chances of being
constipated, and prevent dehydration.
- Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and
eat small, frequent meals.
- This medication may cause a severe reaction if you drink alcoholic beverages. Therefore,
drinking alcohol should be avoided. You should discuss this with your doctor.
- If you experience symptoms or side effects, especially if severe, be sure to discuss
them with your health care team. They can prescribe medications and/or offer
other suggestions that are effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your health care professional while you are taking
nilutamide, to monitor side effects and check your response to therapy. Periodic
blood work to monitor your complete blood count (CBC) as well as the function of
other organs (such as your kidneys and liver) may also be ordered by your doctor.
How This Drug Works:
Growth of prostate cancer may be stimulated by male hormones (androgens, primary
testosterone) circulating in the body. Reducing the amount of these hormones
in a man with prostate cancer can help fight the disease. This is often referred
to as "hormone therapy."
Hormones are chemical substances that are produced by glands in the body, which
enter the bloodstream and cause effects in other tissues. For example, the
hormone testosterone, made in the testicles and is responsible for male characteristics
such as deepening voice and increased body hair. The use of hormone therapy
to treat cancer is based on the observation that receptors for specific hormones
that are needed for cell growth are on the surface of some tumor cells. Hormone
therapy can work by stopping the production of a certain hormone, blocking hormone
receptors, or substituting chemically similar agents for the active hormone, which
cannot be used by the tumor cell. Different types of hormone therapies are categorized
by their function and/or the type of hormone that is affected.
Nilutamide is categorized as an antiandrogen. Antiandrogens are substances
that block the effects of testosterone. Cancer of the prostate depends on the male
hormone testosterone for its growth. If the amount of testosterone is reduced
it is possible to slow down or shrink the cancer. Nilutamide is usually given
immediately after orchiectomy (surgical removal of the testicles).
Antiandrogens are usually given with LHRH agonists (leutenizing hormone - releasing
hormone). LHRH agonists work by telling the pituitary gland located in the
brain to stop producing leutinizing hormone, which (in men) stimulates the testicles
to release testosterone and (in women) stimulates the ovaries to release estrogen.
The drug does not have a direct effect on the cancer, only on the testicles or ovaries.
The resulting lack of testosterone (in men) and estrogen (in women) interferes with
stimulating cell growth in testosterone or estrogen dependent cancer cells.
- Examples of LHRH agonists are: goserelin acetate (Zoladex® ), leuprolide acetate (EligardTM,Lupron® ,ViadurTM ), triptorelin
pamoate (TrelstarTM )
Note: We strongly encourage you to talk with your health
care professional about your specific medical condition and treatments. The information
contained in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org