Understanding Casodex 50 mg for Prostate Cancer Treatment

Casodex 50 mg is a medication that is commonly prescribed for the treatment of advanced prostate cancer in adult males, including the elderly. This article provides an overview of Casodex, its composition, therapeutic indications, and important dosage instructions.


Casodex 50 mg contains the active ingredient Bicalutamide (INN) at a strength of 50 mg per tablet. It’s essential to know the composition of any medication you’re taking, and in this case, the active ingredient is Bicalutamide. Additionally, each tablet contains 61 mg of lactose monohydrate.

Pharmaceutical Form

These tablets are film-coated and appear white. They are designed for oral administration and come in a convenient tablet form.

Therapeutic Indications

Casodex is primarily used in the treatment of advanced prostate cancer. It is often prescribed in combination with luteinizing-hormone releasing hormone (LHRH) analogue therapy or surgical castration. The key therapeutic indication is to suppress the growth of prostate cancer cells, as androgens (male hormones) can fuel the growth of such tumors.

Dosage and Administration

  • For adult males, including elderly patients, the standard dosage is one tablet of Casodex 50 mg (50 mg of Bicalutamide) taken once a day.
  • Treatment with Casodex should begin at least 3 days before starting LHRH analogue therapy or concurrently with surgical castration.

It’s vital to follow the recommended dosage and administration instructions provided by your healthcare provider. In the case of children, Casodex is contraindicated, meaning it should not be used.

Special Considerations

Renal Impairment: Patients with renal impairment generally do not need a dosage adjustment.

Hepatic Impairment: For those with mild hepatic impairment, no dosage adjustment is usually necessary. However, patients with moderate to severe hepatic impairment might experience increased accumulation of Casodex and should be closely monitored. Severe hepatic changes are rare but should be taken seriously.


Casodex is contraindicated in females, children, and in patients who have shown hypersensitivity reactions to the active substance or any of the excipients in the product. It’s essential to rule out these contraindications before starting the treatment.

Precautions for Use

  • Casodex should be used with caution in patients with moderate to severe hepatic impairment.
  • Periodic liver function testing is advisable.
  • A reduction in glucose tolerance has been observed in males receiving LHRH agonists, so monitoring blood glucose is recommended.
  • Casodex inhibits cytochrome P450 (CYP 3A4), which should be taken into consideration when co-administered with drugs primarily metabolized by CYP 3A4.
  • Patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption should not use this medicine.
  • Antiandrogen therapy may affect sperm morphology, so adequate contraception is advised during and for 130 days after Casodex therapy.
  • Casodex may potentiate the effects of coumarin anticoagulants, leading to increased Prothrombin Time (PT) and International Normalized Ratio (INR). Close monitoring and dosage adjustment should be considered when using these drugs concurrently.

These precautions are essential to ensure that the treatment remains effective while minimizing potential side effects and complications.

Interaction with Other Medications

It’s crucial to consider potential drug interactions:

  • There is no evidence of pharmacodynamic or pharmacokinetic interactions between Casodex and LHRH analogues.
  • Casodex can affect the activity of cytochrome P450 (CYP 3A4), which may interact with certain drugs.
  • In vitro studies have shown that bicalutamide can displace coumarin anticoagulants, affecting blood clotting.
  • Given these interactions, it’s vital to consult your healthcare provider and make them aware of all the medications you’re taking.

Fertility, Pregnancy, and Lactation

  • Bicalutamide is contraindicated during pregnancy and breastfeeding.
  • Reversible impairment of male fertility has been observed in animal studies, but this is usually not a concern in humans.

Undesirable Effects

Common side effects associated with Casodex may include:

  • Blood and Lymphatic System Disorders: Anemia.
  • Metabolism and Nutrition Disorders: Decreased appetite.
  • Psychiatric Disorders: Decreased libido, depression.
  • Nervous System Disorders: Dizziness, somnolence.
  • Cardiac Disorders: Myocardial infarction, cardiac failure.
  • Vascular Disorders: Hot flush.
  • Respiratory Disorders: Interstitial lung disease.
  • Gastrointestinal Disorders: Abdominal pain, constipation, nausea.
  • Hepato-Biliary Disorders: Hepatotoxicity, jaundice, raised transaminases.
  • Skin and Subcutaneous Tissue Disorders: Alopecia, hirsutism, dry skin, pruritus, rash.
  • Reproductive System and Breast Disorders: Gynecomastia, breast tenderness.
  • General Disorders and Administration Site Conditions: Asthenia, edema, chest pain.

These side effects are categorized by their frequency of occurrence. Most side effects are common and expected, but it’s essential to report any unusual or severe side effects to your healthcare provider.


There is no specific antidote for Casodex overdose. General supportive care is indicated. Dialysis is not likely to be helpful due to the medication’s characteristics.

Pharmacological Properties

Casodex is a non-steroidal antiandrogen with a specific mechanism of action. It inhibits the androgen stimulus, thereby slowing the growth of prostate tumors. It is metabolized in the liver and excreted via urine and bile. The predominantly active enantiomer accounts for 99% of the total circulating enantiomers.


Casodex 50 mg plays a crucial role in the management of advanced prostate cancer. It’s essential to follow the prescribed dosage and precautions for its safe and effective use. Always consult your healthcare provider for any concerns or questions related to this medication. Your specialist will guide you through the treatment and monitoring process.