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Care During Chemotherapy and Beyond

Nilutamide

(ni LOO ta mide)

Trade Name: Nilandron® , Anandron®

Chemocare.com uses generic names in all descriptions of drugs. Nilandron is the trade name for nilutamide. Anandron is another name for nilutamide. In some cases, health care professionals may use the trade name nilandron or other names anandron when referring to the generic drug name nilutamide.

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 Nilutamide 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 Nilutamide 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. 

Side Effects:

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 receiving nilutamide:

  • Headaches, dizziness, pain, weakness and swelling are all noted infrequently
  • Nausea
  • Poor appetite
  • Constipation
  • Diarrhea
  • Increases in blood tests measuring liver function.  These return to normal once treatment is discontinued.
  • Trouble sleeping (insomnia)
  • Headache

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 following:

  • 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.

Precautions:

  • 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 fetus).
  • Anti-androgens are usually given to men.  However, if nilutamide is given to a woman, she should not breast feed.

Self-Care Tips:

  • 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 Nilutamide 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.

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