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Casodex (Bicalutamide) Buyer and Patient Handbook in South Africa

What is Casodex?

Casodex is a 50 mg oral tablet containing the anti-androgen bicalutamide, used in the treatment of Prostate Cancer. It belongs to the class of non-steroidal anti-androgens and is approved by the South African Health Products Regulatory Authority (SAHPRA) and the FDA. The medication is supplied as a single-strength pill for once-daily use.

Who Should Use Casodex?

• Men diagnosed with locally advanced or metastatic prostate Cancer
• Patients already receiving luteinising-hormone-releasing hormone (LHRH) therapy or orchiectomy
• Individuals for whom a non-steroidal anti-androgen is indicated as part of a combination regimen

How Does It Work?

Casodex blocks the androgen receptor, preventing testosterone and other male hormones from stimulating prostate-cancer cells. Think of the receptor as a lock; Casodex acts as a key that fits but does not turn, stopping the hormone from “unlocking” cancer growth. The drug does not have significant abuse potential, but it should be used only as directed.

Why Choose Casodex?

For patients who need a reliable anti-androgen, Casodex offers a well-studied safety profile and convenient once-daily dosing. Generic versions of bicalutamide are bioequivalent and may provide cost savings, while the branded product ensures consistent quality and availability through major South African pharmacies.

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

• 50 mg tablet taken once daily, usually in the evening.

How to Take

1. Swallow the tablet whole with a glass of water.
2. Can be taken with or without food; maintain the same routine each day.
3. Do not crush or chew the tablet.

Missed Dose

• If you realise a dose is missed within 12 hours, take it immediately.
• If it is later than 12 hours, skip the missed dose and resume your regular schedule. Do not double-dose.

Overdose

• Call emergency services (112) or go to the nearest hospital if you think you have taken more than the prescribed amount.
• Provide details of the amount taken and the time of ingestion.

Special Populations

• Elderly: No dose adjustment needed, but monitor liver function.
• Children: Not approved for use in paediatric patients.
• Renal or hepatic impairment: Use with caution; dose reduction may be required based on clinical assessment.

Lifestyle & Diet

• No major food interactions, but avoid excessive grapefruit products as they may affect drug metabolism.
• Limit alcohol to moderate amounts; heavy drinking can worsen liver side-effects.

Precautions and Warnings

• Monitor liver enzymes regularly; elevation may require temporary discontinuation.
• Report any signs of jaundice, dark urine, or persistent nausea.
• Do not start Hormone Therapy without discussing fertility preservation if future conception is a concern.

Drug Interactions

Potential Side Effects

Common Side Effects

• Hot Flashes
• Breast tenderness or enlargement
• Nausea

Less Common Side Effects

• Diarrhoea
• Skin rash
• Decreased libido

Serious Side Effects

• Liver toxicity (jaundice, severe Fatigue) - seek medical help immediately.
• Severe allergic reaction (swelling, difficulty breathing) - call emergency services.

Who Should Avoid This Medication?

• Patients with a known hypersensitivity to bicalutamide or any tablet excipients.
• Individuals with severe liver disease (e.g., cirrhosis).
• Women and children, as the product is not indicated for these groups.

Storage Instructions

• Keep the bottle tightly closed at room temperature (15-30 °C).
• Store away from direct sunlight and moisture.
• Keep out of reach of children and pets.

Casodex Alternatives

Frequently Asked Questions

How long should I stay on Casodex?

Treatment duration varies; many patients remain on therapy for several years as part of long-term cancer management. Your healthcare team will review progress regularly.

Can I take Casodex with my blood pressure medication?

Most antihypertensives do not interact with bicalutamide, but always confirm with your prescriber or pharmacist.

Will Casodex affect my sexual performance?

It may reduce libido and cause erectile changes in some men; discuss any concerns with your clinician for possible supportive measures.

Is it safe to travel while taking Casodex?

Yes, the tablet is stable at normal cabin temperatures. Carry it in its original packaging and keep it with you in hand luggage.

What should I do if I experience persistent fatigue?

Report the symptom to your healthcare provider; fatigue can be related to disease, therapy, or other factors that may need evaluation.

Can I consume grapefruit juice while on Casodex?

Occasional grapefruit is unlikely to cause problems, but large quantities may increase drug levels; moderation is advisable.

Does Casodex interfere with vaccinations?

No evidence suggests interference, but inform the vaccinating clinician that you are on anti-androgen therapy.

Are there any over-the-counter supplements I should avoid?

Herbal products that affect liver enzymes (e.g., St John’s wort) could alter bicalutamide metabolism; discuss any supplements with your pharmacist.

How quickly will I notice an effect?

Casodex works by blocking hormone signals; clinical benefits are usually assessed over weeks to months, not immediate symptom relief.

What if I forget to take a dose for several days?

Resume therapy only after consulting your healthcare team, as a sudden gap may affect treatment effectiveness.

Glossary

• Anti-androgen: A substance that blocks the action of male hormones at the receptor level.
• LHRH therapy: Treatment that reduces testosterone production by suppressing the pituitary gland.
• CYP3A4: An enzyme in the liver that metabolises many drugs; inhibitors can raise drug concentrations.

Disclaimer

The information provided here is for general educational purposes only and does not replace professional medical advice. Off-label use should be discussed with a qualified healthcare provider. Readers are responsible for verifying any treatment decisions with their own clinician. Our service offers information on medication availability and price comparison in South Africa, but we do not dispense drugs directly. Always consult a qualified health professional before starting or changing any medication regimen.