Most prostate cancers need supplies of the male hormone testosterone to grow. Testosterone is an androgen (hormone) produced by the testes and adrenal glands. Flutamide works by blocking testosterone receptors on the prostate cells, and therefore preventing testosterone from attaching to the receptors on the surface of the prostate cancer cells. Without testosterone, the cancer cells may either grow more slowly, or stop growing altogether.
Flutamide is given as a capsule, taken three times a day (spaced every 8 hours). For patients who cannot swallow pills, the capsule can be opened and its contents mixed with food, such as applesauce or pudding.
There are a number of things you can do to manage the side effects of Flutamide. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:
Take anti-nausea medications as prescribed. If you continue to have nausea or vomiting, notify your doctor or nurse so they can help you manage this side effect. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try antacids, (e.g. milk of magnesia, calcium tablets such as Tums), saltines, or ginger ale to lessen symptoms. Read the Nausea & Vomiting Tip Sheet for more suggestions.
Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.
Most men find that hot flashes decrease after a period of time on the medication. There are a few things you can do to help with hot flashes. Several medications have been studied, including some low doses of antidepressants (such as venlafaxine and Paxil), and certain hormone therapies (medroxyprogesterone acetate and cyproterone acetate). Non-medical recommendations include: keeping well-hydrated with eight glasses of water daily, wearing cotton or lightweight, breathable fabrics, dressing in layers, exercising on a regular basis (generally walking exercise is best), practicing relaxation exercises, and avoiding triggers such as warm rooms, spicy foods, caffeinated beverages, nicotine and alcohol.
This drug can affect your reproductive system, resulting in sperm production becoming irregular or stopping permanently. In addition, you may experience erectile dysfunction or a decreased desire for sex during treatment. Talk to your urologist about options for treating erectile dysfunction.
Exposure of an unborn child to this medication could cause birth defects, so you should not father a child while on this medication. Effective birth control is necessary during treatment, even if you believe your sperm is affected. You may want to consider sperm banking if you may wish to have a child in the future. Discuss these options with your oncology team. See OncoLink's section on sexuality for helpful tips for dealing with these side effects.
An increase in breast tissue (gynecomastia) or breast tenderness may develop. Your healthcare team can suggest medications to relieve the tenderness. In rare cases, radiation can be given to relieve severe tenderness.
Men who take hormone therapy for extended periods of time are at risk for bone thinning (osteoporosis). You may be advised to take calcium and vitamin D supplements to help prevent bone loss. You may have a bone density scan (DEXA scan) to assess your bone health. If your physician determines that you are at high risk of developing osteoporosis, they may recommend additional treatment with a type of medication called a bisphosphonate to help strengthen the bones. Learn more about bone health after cancer therapy.
Flutamide can cause an increase in liver function tests that resolves when the medication is stopped. This medication can make your urine appear blue/green or orange in color.