Consumer medicine information

APO-Bicalutamide 50 mg Tablets

Bicalutamide

BRAND INFORMATION

Brand name

APO-Bicalutamide

Active ingredient

Bicalutamide

Schedule

S4

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using APO-Bicalutamide 50 mg Tablets.

What is in this leaflet


This leaflet answers some common questions about bicalutamide. It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you using this medicine against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine.
You may want to read it again.

What this medicine is used for


Bicalutamide is used in combination with other medicines called LHRH agonists to treat advanced prostate cancer and to prevent a side effect of LHRH agonists.

How it works


Bicalutamide is an anti-androgen medicine. Androgens such as testosterone are natural male sex hormones. In some types of prostate cancer, androgens may help the cancer cells to grow.
Bicalutamide interferes with some of the actions of these hormones.
Bicalutamide should only be taken by men.
Ask your doctor if you have any questions about why this medicine has been prescribed for you.
Your doctor may have prescribed this medicine for another reason.
This medicine is available only with a doctor's prescription.
This medicine is not addictive.
This medicine must not be used in children.

Before you take this medicine

When you must not take it


Do not take this medicine if you have an allergy to:
  • bicalutamide
  • any of the ingredients listed at the end of this leaflet
  • lactose

Some of the symptoms of an allergic reaction may include:
  • cough, shortness of breath
  • wheezing or difficulty breathing
  • swelling of the face, lips, tongue, throat or other parts of the body
  • rash, itching or hives on the skin
  • fainting or hayfever-like symptoms.

Do not take this medicine if you are taking cisapride, terfenadine or astemizole
Do not take this medicine if you are female.
Women are not treated with this medicine, as it could cause major defects in unborn children if taken by pregnant women, or harm to infants if taken when breastfeeding.
Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering.
If it has expired or is damaged, return it to your pharmacist for disposal.
If you are not sure whether you should start taking this medicine, talk to your doctor.

Before you start to take it


Tell your doctor if you have allergies to any other medicines, foods, preservatives or dyes.
Tell your doctor if you have or have had any of the following medical conditions:
  • liver problems
  • diabetes
  • heart conditions, including heart rhythm problems (arrhythmia)

Tell your doctor if you are planning to start a family, as this medicine may affect your fertility.
If you have not told your doctor about any of the above, tell them before you start taking this medicine.

Taking other medicines


Tell your doctor and pharmacist if you are taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop.
Some medicines may interact with bicalutamide. These include:
  • cisapride
  • terfenadine, astemizole
  • medicines used to prevent blood clots, especially warfarin
  • cimetidine, used for stomach problems
  • ketoconazole, used to treat fungal infections
  • midazolam or carbamazepine, used for treating seizures
  • cyclosporin, used after organ transplants
  • statins used to treat high cholesterol (e.g. simvastatin, atorvastatin, pravastatin, rosuvastatin, simvastatin)
  • calcium channel blockers used to treat high blood pressure (e.g. felodipine, nifedipine, amlodipine)
  • quinidine, used to treat certain heart problems
  • some medicines used to treat viral infections (e.g. ritonavir, saquinavir)
  • other medicines which interfere with the liver's CYP450 enzyme system

If you are taking any of these you may need a different dose or you may need to take different medicines.
Other medicines not listed above may also interact with bicalutamide.

How to take this medicine


Follow carefully all directions given to you by your doctor or pharmacist.
They may differ to the information contained in this leaflet.

How much to take


The usual dose is one tablet taken each day. This dose may be reduced if you have severe liver problems.

How to take it


Swallow your tablet whole with a full glass of water.

When to take it


Take this medicine at about the same time each day.
Taking it at the same time each day will have the best effect and will also help you remember when to take it. It does not matter if you take it with or without food.

How long to take it for


Continue taking your medicine for as long as your doctor tells you. Make sure you have enough to last over weekends and holidays.

If you forget to take it


If it is almost time to take your next dose (i.e. less than 12 hours to the next dose), skip the missed dose and take your next dose at the usual time.
Otherwise take it as soon as you remember and then go back to taking your medicine as you would normally.
Do not take a double dose to make up for missed doses.
This may increase the chance of unwanted side effects.
If you have trouble remembering to take your medicine, ask your pharmacist for some hints.

If you take too much (overdose)


Immediately telephone your doctor or the Poisons Information Centre (telephone 13 11 26) for advice or go to the Emergency Department at your nearest hospital if you think that you or anyone else may have taken too much of this medicine. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.

While you are taking this medicine

Things you must do


Tell any other doctors, dentists and pharmacists who are treating you that you take this medicine.
If you are about to be started on any new medicine, tell your doctor that you are taking this medicine.
You will need to take another prostate cancer medicine (an LHRH agonist) whilst you are taking bicalutamide. The two medicines need to work together to have an effect.
Keep all your doctor’s appointments, as your doctor may do tests to make sure the medicine is working and to prevent side effects.

Things you must not do


Do not give this medicine to anyone else, even if they have the same condition as you.
Do not take your medicine to treat any other complaint unless your doctor or pharmacist tells you to.
Do not stop taking your medicine, or change the dosage, without first checking with your doctor.

Things to be careful of


Be careful when driving or operating machinery until you know how this medicine affects you. Some people may feel sleepy, dizzy or weak when taking this medicine.

Side effects


Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking bicalutamide.
All medicines can have side effects. Sometimes they are serious but most of the time they are not.
Do not be alarmed by the following lists of side effects. You may not experience any of them.
Tell your doctor or pharmacist if you notice any of the following:

  • hot flushes or sweating
  • breast tenderness or swelling
  • mild rash, itching or dry skin
  • increased hairiness, or loss of hair
  • stomach upsets, such as pain, indigestion, nausea, vomiting, diarrhoea, constipation, wind
  • dry mouth
  • loss of appetite, weight changes
  • depression
  • unusual tiredness, weakness, problems sleeping, feeling sleepy
  • dizziness or light-headedness
  • headache
  • chills
  • pelvic pain
  • decrease in your sexual drive, inability to get or maintain an erection

Tell your doctor as soon as possible if you notice any of the following:
  • frequent urination (including at night) blood in the urine
  • becoming out of breath and dizzy when exercising, looking pale (anaemia)
  • excessive thirst with weight loss, passing large amounts of urine, sweet smelling breath

The above list includes serious side effects that may need medical attention.
If you experience any of the following, stop taking your medicine and contact your doctor immediately or go to the Emergency department at your nearest hospital:
  • chest pain, with or without a feeling of tightness radiating to the shoulders back, neck jaw or arms, with sweating, chills, nausea, vomiting and paleness
  • yellowing of the skin or eyes, and dark coloured urine (jaundice)
  • cough, shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue, or other parts of the body; rash, itching or hives on the skin; fainting; hayfever-like symptoms (signs of an allergic reaction)
  • serious breathlessness or sudden worsening of breathlessness, possibly with a cough or fever

The above list includes very serious side effects and you may need urgent medical attention or hospitalisation.
Other side effects not listed above may occur in some patients.

Storage and disposal

Storage


Keep your medicine in its original packaging until it is time to take it.
If you take your medicine out of its pack it may not keep well.
Keep your medicine in a cool dry place where the temperature will stay below 25°C.
Do not store your medicine, or any other medicine, in the bathroom or near a sink. Do not leave it on a window sill or in the car.
Heat and dampness can destroy some medicines.
Keep this medicine where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal


If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any medicine left over.

Product description

What it looks like


White to off white, round, biconvex, film coated tablets debossed "B50" on one side and plain on other side. Available in blister packs of 28 tablets. AUST R 194683

Ingredients


Each tablet contains 50 mg of bicalutamide as the active ingredient.
It also contains the following:
  • lactose monohydrate
  • sodium starch glycollate type A
  • povidone
  • magnesium stearate
  • hypromellose
  • macrogol 400
  • titanium dioxide

This medicine does not contain gluten, sucrose, tartrazine or any other azo dyes.

Sponsor


Arrotex Pharmaceuticals Pty Ltd
15 – 17 Chapel Street
Cremorne VIC 3121
www.arrotex.com.au
This leaflet was prepared in January 2024.

BRAND INFORMATION

Brand name

APO-Bicalutamide

Active ingredient

Bicalutamide

Schedule

S4

 

1 Name of Medicine

Bicalutamide.

2 Qualitative and Quantitative Composition

Each tablet contains 50 mg bicalutamide as the active ingredient.
Excipients with known effect. Contains lactose.
For the full list of excipients see Section 6.1 List of Excipients.

3 Pharmaceutical Form

White to off white, round, biconvex, film coated tablets debossed "B50" on one side and plain on other side.

4 Clinical Particulars

4.9 Overdose

Symptoms. There is no human experience of overdosage.
Treatment. There is no specific antidote; treatment should be symptomatic. Dialysis may not be helpful, since bicalutamide is highly protein bound and is not recovered unchanged in the urine. General supportive care, including frequent monitoring of vital signs, is indicated.
For information on the management of overdose, contact the Poisons Information Centre on 131126 (Australia).

5 Pharmacological Properties

5.3 Preclinical Safety Data

Genotoxicity. Bicalutamide was inactive in in vitro tests for gene mutation and in in vitro and in vivo tests for clastogenicity.
Carcinogenicity. Two year oral carcinogenicity studies were conducted in male and female rats and mice at doses of 5, 15 or 75 mg/kg/day of bicalutamide. A variety of tumour target organ effects were identified and were attributed to the antiandrogenicity of bicalutamide, namely, testicular benign interstitial (Leydig) cell tumours in male rats at all dose levels and uterine adenocarcinoma in female rats at 75 mg/kg/day (at these dose levels plasma (R)-bicalutamide concentrations were less than human therapeutic concentrations after the maximum recommended clinical dose of 150 mg). There is no evidence of Leydig cell hyperplasia in patients; uterine tumours are not relevant to the indicated patient population.
A small increase in the incidence of hepatocellular carcinoma in male mice given 75 mg/kg/day of bicalutamide (approximately 2 times human therapeutic concentrations after the maximum recommended clinical dose of 150 mg) and an increased incidence of benign thyroid follicular cell adenomas in rats given 5 mg/kg/day (less than the human therapeutic concentrations after the maximum recommended clinical dose of 150 mg) and above were recorded. These neoplastic changes were progressions of non-neoplastic changes related to hepatic enzyme induction observed in animal toxicity studies. Enzyme induction has not been observed following bicalutamide administration in man.

6 Pharmaceutical Particulars

6.7 Physicochemical Properties

Bicalutamide is a fine white to off white powder. At 37°C it is practically insoluble in water (4.6 mg/L), acid (4.6 mg/L at pH 1) and alkali (3.7 mg/L at pH 8). In organic solvents it is slightly soluble in ethanol, sparingly soluble in methanol and freely soluble in acetone and tetrahydrofuran.
Chemical structure.
https://stagingapi.mims.com/au/public/v2/images/fullchemgif/CSBICALU.gif Chemical name: (RS)-4'-cyano-α', α', α',-trifluoro-3-(4-fluorophenylsulphonyl)-2- hydroxy-2-methylpropiono-m-toluidide.
Molecular formula: C18H14F4N2O4S.
Molecular weight: 430.38.
CAS number. 90357-06-5.

7 Medicine Schedule (Poisons Standard)

S4 - Prescription Only Medicine.

Summary Table of Changes

https://stagingapi.mims.com/au/public/v2/images/fulltablegif/APOBICST.gif

References

1. Prostate Cancer Trialists' Collaborative Group. Maximum androgen blockade in advanced prostate cancer: an overview of 22 randomised trials with 3283 deaths in 5710 patients. Lancet 1995; 346: 265-269.