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Nilutamide (Nilandron®, Anandron®)
Last Modified: January 8, 2016
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, with or without food, preferably at the same time each day.
Nilutamide can cause an intolerance of alcohol including facial flushing, malaise and low blood pressure. You should avoid consuming alcoholic beverages while taking this medication.
Storage and Handling
Store this medication at room temperature, in the original container. If you prefer to use a pillbox, discuss this with your oncology pharmacist. Ask your oncology team where to return any unused medication for disposal. Do not flush down the toilet or throw in the trash.
Where do I get this medication?
Nilutamide is available through retail and mail order pharmacies. Your oncology team will work with your prescription drug plan to identify an in-network retail/mail order pharmacy for medication distribution.
This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Co-pay assistance offered through private third party foundations, may also be available. Your care team can help you find these resources, if they are available.
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:
Nausea and/or Vomiting
Talk to your doctor or nurse so they can prescribe medications to help you manage nausea and vomiting. 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.
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.
There are a few things you can do to help with hot flashes. Several medications have been shown to help with symptoms, including clonidine (a blood pressure medication), low doses of certain antidepressants (such as venlafaxine and Prozac), and gabapentin. Non-medical recommendations include:
- Keep well-hydrated with eight glasses of water daily.
- Drink ice water or apply an ice pack at the onset of a hot flash.
- Wear cotton or lightweight, breathable fabrics and dress in layers so you can adjust as needed.
- Exercise on a regular basis.
- Try practicing meditation or relaxation exercises to manage stress, which can be a trigger.
- Avoid triggers such as warm rooms, spicy foods, caffeinated beverages, and alcohol.
Weakening of the Bones (Osteoporosis)
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. Weight bearing exercise and a healthy diet rich in calcium and vitamin D can also help protect your bone health. 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.
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.
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. A stool softener once or twice a day may prevent constipation. If you do not have a bowel movement for 2-3 days, you should contact your healthcare team for suggestions to relieve the constipation.
Decrease in Appetite
Nutrition is an important part of your care. Cancer treatment can affect your appetite and, in some cases, the side effects of treatment can make eating difficult. Ask your nurse about nutritional counseling services at your treatment center to help with food choices.
- 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 find that food has no taste at all. You may dislike foods or beverages that you liked before receiving cancer treatment. These symptoms can last for several months or longer after treatment ends.
- 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. Sometimes cold food has less of an odor.
- Add extra flavor to meat or fish by marinating it in sweet juices, sweet and sour sauce or dressings. Use seasonings like basil, oregano or rosemary to add flavor. Bacon, ham and onion can add flavor to vegetables.
Nilutamide can impact how your vision adapts when going from a lighted area to a dark area. This can range from a few seconds to a few minutes. Exercise caution when driving at night or through tunnels and consider wearing tinted glasses/sunglasses to manage this side effect. This medication can also cause other vision changes or changes in color vision. Report any vision changes to your healthcare provider.
This medication can cause liver toxicity, which your healthcare provider may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown, or you develop pain in your abdomen, as these can be signs of liver toxicity.
Patients can develop an inflammation of the lungs (called interstitial pneumonitis) while taking this medication. You may have a chest x-ray and pulmonary function tests prior to starting this therapy. Notify your healthcare provider right away if you develop any new or worsening symptoms, including shortness of breath, trouble breathing, chest pain, cough or fever.
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.