Bicalutamide (Casodex) for Prostate: Dosage, Side Effects & More

Bicalutamide is a medication for prostate cancer treatment, well-known by its brand name, Casodex. 

If you wonder “is casodex chemotherapy”, Casodex is a type of hormone therapy known as anti-androgen to treat prostate cancer, which is different from a chemo.

This article will cover what Bicalutamide (Casodex) is, its uses, potential side effects and how to reduce them, interactions to be mindful of, and answer common FAQs about the drug.

How Bicalutamide Works For Prostate Cancer

Bicalutamide Drug Class

Bicalutamide belongs to a class of medications known as antiandrogens. It blocks the effects of androgens, such as testosterone, within the body and targets the androgen hormone receptors responsible for the growth of prostate cancer cells.

This medication plays an important role in the treatment of prostate cancer. Bicalutamide is primarily used when the cancer has become resistant to initial treatments or has already spread to other parts of the body.

Standard Bicalutamide Dosage: 50mg/day

Bicalutamide is typically prescribed in the form of oral tablets. The standard dosage consists of 50 mg tablets, and it is typically taken once a day. 

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Bicalutamide (Casodex) Side Effects

Like many medications, Bicalutamide can have side effects. It’s important to note that not everyone will experience these side effects, and their severity can vary from person to person. 

Here are some common side effects associated with Bicalutamide:

1) Breast Swelling and Tenderness

Some people may experience breast swelling and tenderness, which can be uncomfortable. This occurs due to the antiandrogenic effects of Bicalutamide on the body’s hormonal balance.

2) Hot Flashes

Hot flashes, similar to those experienced during menopause, can occur. These sudden sensations of warmth and flushing of the skin can be managed with lifestyle adjustments.

3) Fatigue

Bicalutamide may cause fatigue or weakness. It’s advisable to maintain a regular exercise routine and a healthy diet to combat this side effect.

4) Nausea and Vomiting

Nausea and vomiting are possible side effects of Bicalutamide (Casodex), although they are relatively rare. If these symptoms occur, you should report them to your healthcare provider.

5) Constipation

Some people may experience constipation while taking Bicalutamide. Staying hydrated and consuming fiber-rich foods can help alleviate this issue.

6) Liver Function Abnormalities

In rare cases, Bicalutamide can affect liver function, leading to elevated liver enzymes. Regular monitoring of liver function is typically recommended during treatment.

7) Skin Rash

Skin rashes, while not very common, have been reported. If you notice a rash, inform your healthcare provider for guidance on managing it.

8) Muscle Weakness

Weakness in the muscles may occur in some people. Engaging in regular physical activity can help maintain muscle strength.

It’s important to report any side effects to your healthcare provider promptly, as they can provide guidance on managing them or adjusting your treatment if necessary.

How to Reduce Bicalutamide’s Side Effects

Here are some strategies to help reduce the impact of Bicalutamide’s side effects:

1) Stay Hydrated

Adequate hydration is essential. Drinking plenty of water can help alleviate constipation, a common side effect, and assist your body in flushing out toxins. Be sure to maintain a healthy fluid intake.

2) Regular Exercise

Engaging in light to moderate exercise can combat fatigue and muscle weakness, two side effects that may accompany Bicalutamide treatment. 

Consult your healthcare provider for exercise recommendations tailored to your condition and energy levels.

3) Maintain a Healthy Diet

A balanced diet can contribute significantly to your overall well-being. Incorporate plenty of fruits, vegetables, and whole grains into your meals. 

Consider consulting a registered dietitian who can provide dietary guidance specific to your needs.

4) Open Communication

If you find that side effects are becoming bothersome or severe, don’t hesitate to consult your healthcare provider. 

They are your best resource for managing these challenges. Your healthcare team may recommend adjusting your medication, prescribing additional medications to alleviate specific symptoms, or providing guidance on coping strategies.

5) Take Your Medication As Prescribed

Consistency in following your healthcare provider’s instructions regarding dosage and timing is crucial. It ensures the effectiveness of your treatment and minimizes the risk of side effects. 

Always consult your healthcare team before making any changes to your medication regimen.

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Drug Interactions with Bicalutamide

It’s essential to be aware of potential drug interactions, medical conditions where Bicalutamide is contraindicated, and foods, supplements, and herbs to avoid while taking this medication:

Bicalutamide may interact with medications such as

  • Acenocoumarol
  • Cobimetinib
  • Domperidone
  • Methotrexate
  • Warfarin
  • Midazolam

Always inform your healthcare provider about all the medications you are taking to avoid potentially harmful interactions.

Other precautions

Hormone Therapy

If you are undergoing hormone therapy for prostate cancer, Bicalutamide may be part of your treatment plan. 

Discuss the potential side effects and interactions with your healthcare team, and ensure all members of your healthcare team are aware of your complete treatment regimen.

Liver Impairment

Bicalutamide can affect liver function, so it should be used cautiously in those with pre-existing liver conditions.


Bicalutamide may cause breast swelling and tenderness. Discuss this potential side effect with your healthcare provider if it becomes problematic or uncomfortable.


Bicalutamide can impact fertility. If you plan to have children in the future, consult your healthcare provider for guidance on preserving fertility options before starting treatment.

Bicalutamide and Dental Treatment

Inform your dentist that you are taking Bicalutamide before any dental procedures, as it can affect how certain anesthetics work. 

Over-The-Counter Medicines

Even over-the-counter medicines and supplements can interact with Bicalutamide. Always check with your healthcare provider or pharmacist before taking any new medications or supplements while on Bicalutamide to prevent potential interactions.


Is Bicalutamide a form of chemotherapy?

No, Bicalutamide is not a form of chemotherapy – it is an antiandrogen medication. Chemotherapy primarily targets rapidly dividing cells, while Bicalutamide specifically focuses on the androgen pathway.

Does Bicalutamide shrink prostate cancer?

Bicalutamide helps slow the progression of prostate cancer by inhibiting the growth of cancer cells fueled by androgens, but it may not always “shrink” the tumor in all cases. 

Its primary goal is to control the disease’s advancement and provide relief from symptoms associated with prostate cancer.

How long can you be on Bicalutamide?

Some people may take the drug for several months, while others may use it for an extended period as part of their ongoing cancer management. 

The duration of Bicalutamide treatment varies depending on several factors, including the stage and progression of prostate cancer. Your healthcare provider will determine the appropriate treatment plan for you. 

It’s essential to follow your healthcare provider’s recommendations and attend regular follow-up appointments to assess treatment effectiveness.

How does Bicalutamide make you feel?

Bicalutamide can have various effects, and how it makes you feel can vary. Some common experiences include sudden sensations of warmth and flushing, as well as breast swelling and tenderness. The medication can also make you feel tired and fatigued.

While some people may not notice significant changes in how they feel, others may find these side effects somewhat uncomfortable. 

What is the success rate of Bicalutamide?

The success of Bicalutamide in treating prostate cancer depends on several factors, including the stage of cancer, the aggressiveness of the disease, overall health, and the individual’s response to the medication. 

Bicalutamide is often used in combination with other treatments, such as hormone therapy or radiation therapy, to maximize its effectiveness. 

Your healthcare provider will assess your specific situation and tailor your treatment plan accordingly. 

Regular monitoring and follow-up appointments are essential to evaluate treatment progress and adjust the approach as needed.


Bicalutamide, sold under the brand name Casodex, plays a vital role in the treatment of prostate cancer.  

If you or a loved one are undergoing treatment for prostate cancer, consult your healthcare provider for personalized guidance on the use of Bicalutamide and its potential benefits in your specific case.

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  1. Kolvenbag, Geert JCM, George RP Blackledge, and Karen Gotting‐Smith. “Bicalutamide (Casodex®) in the treatment of prostate cancer: history of clinical development.” The Prostate 34.1 (1998): 61-72.
  2. Fradet, Yves. “Bicalutamide (Casodex®) in the treatment of prostate cancer.” Expert review of anticancer therapy 4.1 (2004): 37-48.
  3. Iversen, Peter, et al. “Casodex (bicalutamide) 150-mg monotherapy compared with castration in patients with previously untreated nonmetastatic prostate cancer: results from two multicenter randomized trials at a median follow-up of 4 years.” Urology 51.3 (1998): 389-396.
  4. Blackledge, G. R. P., I. D. Cockshott, and B. J. A. Furr. “Casodex™(bicalutamide): overview of a new antiandrogen developed for the treatment of prostate cancer.” European urology 31.Suppl. 2 (1997): 30-39.

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