Pronounced: nye-LOO-tah-mide
Classification: Anti-Androgen
About Nilutamide
Most prostate cancers need supplies of the male hormone testosterone to grow. Testosterone is an androgen (hormone) produced by the testes and adrenal glands. The production of testosterone can be stopped by surgically removing the testicles or through medication therapy. Anti-androgen medications (also called nonsteroidal anti-androgens) work 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.
How to Take Nilutamide
Nilutamide is given as a tablet, taken once a day, preferably at the same time each day.
Possible Side Effects of Nilutamide
There are a number of things you can do to manage the side effects of Nilutamide. 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:
Hot Flashes
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 all-natural fiber clothes, 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, nicotiene and alcohol.
Sexual and Reproductive Changes
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.
Breast Tenderness or Increase in Breast Tissue
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.
Nausea and/or Vomiting
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.
Constipation
There are several things you can do to prevent or relieve constipation. Include fiber in your diet (fruits and vegetables), drink 8-10 glasses of non-alcoholic fluids a day and keep active. Your doctor or nurse can also recommend medications to relieve constipation. A stool softener once or twice a day may prevent constipation.
Decrease in Appetite
Visit OncoLink's section on Nutrition for tips on dealing with this side effect. Ask your nurse about nutritional counseling services.
- Try to eat five or six small meals or snacks throughout the day, instead of 3 larger meals.
- If you are not eating enough, nutritional supplements may help.
- You may experience a metallic taste or dislike foods or beverages that you liked before receiving chemotherapy. These symptoms can last up to several months.
- Avoid any food that you think smells or tastes bad. If red meat is a problem, eat chicken, turkey, eggs, dairy products and fish without a strong smell.
- Flavor meat or fish by marinating it in sweet juices, sweet and sour sauce or dressings. Use seasonings like basil, oregano or rosemary. Bacon, ham and onion can also add flavor to vegetables.
Muscle or Joint Pain/Aches and Headache
Your doctor or nurse can recommend medication and other strategies to relive pain. Also view OncoLink's page on pain management.
Visual Changes
Nilutamide can make it more difficult for your eyes to refocus when in dark or poorly lit areas. Patients should use caution operating a vehicle at night and may need to use a night light for safety. In addition, nilutamide can affect how color is seen. Colored objects may appear unnaturally colored and colorless objects may appear tinged with color (called chromatopsia).
Other Side Effects
Some less common side effects that have been reported include: dry skin, testicular atrophy, liver changes, reproductive changes and loss of body hair.
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