Flucinom

Flucinom - Precautions | Use | Overdose | Effects

Flucinom, its active substance flutamide, belongs to the group of anti-androgens - drugs that block the action of male sex hormones (androgens). It is used to treat certain types of prostate cancer alone or in combination with other drugs that are administered as an injection (e.g. leuprolide, triptorelin, and histrelin).

Precautions

Do not take Flucinom if:

  • You are hypersensitive to this drug or other drug ingredients
  • You have unusual reactions to the drug (e.g. sneezing)

Be especially careful if:

  • If you have liver problems. In one study, which was performed on 34 patients, three patients experienced liver damage, and one patient experienced a fatal hepatic necrosis. This study shows that the incidence of liver damage in patients taking this drug is probably greater than it was initially thought. Therefore, it is recommended that liver function tests be carried out every two weeks during the first two months of the treatment with this drug, in order to detect liver damage and prevent complications in a timely manner.1 Why it induces liver injury is unknown but it is believed to be linked to dysfunction of mitochondria.2 If you notice symptoms of liver damage (e.g. loss of appetite, pain in the upper right part of the abdomen or discoloration of urine or skin), contact a physician immediately.
  • Cases of flutamide-induced methemoglobinemia (the phenomenon where erythrocytes have a higher concentration of methemoglobin which is detrimental to the body and can be fatal), have also been reported. This occurs because this medicine has a chemical similarity to the anilides (chemical compounds that lead to increased concentrations of methemoglobin in the blood).3 For this reason, you should regularly control the level of methemoglobin in the blood. It seems that methemoglobinemia occurs much less frequently than liver damage, because in one study, 45 patients received 250 mg of this drug three times a day and no change in the concentration of methemoglobin in the blood was observed.4 If you notice symptoms of methemoglobinemia (the most characteristic symptom of methemoglobinemia is a change in skin color to pale, gray or even blue), contact your doctor immediately.
  • If taken in large doses, this drug can have adverse effects on the heart. Extra precaution is therefore required in patients with heart disease.

How to use

Flucinom exists in the form of tablets at a dose of 250 mg. The usual daily dose is 750 mg (divided into three doses).

Swallow the tablet whole with 8 fl. oz. of plain water immediately after a meal.

Overdose

Symptoms of Flucinom overdose include:

  • Slowed movements
  • Slowed thinking
  • Changes in skin color (sign of methemoglobinemia)
  • Loss of coordination of muscle movements (ataxia)

Interactions

Flucinom should not be taken simultaneously with the following medicines:

  • Immunomodulators (leflunomide and teriflunomide) - these drugs are hepatotoxic just like Flucinom, and therefore they must not be applied simultaneously.
  • Lomitapid and mipomersen - drugs used to lower blood lipid levels. Given that these drugs are hepatotoxic, combination with Flucinom is not recommended.
  • Local anesthetics, such as: prilocaine. This medicine may cause methemoglobinemia just like Flucinom, and simultaneous use is not recommended.

Tell your doctor about all other medicines you are taking.

Adverse effects

In addition to the above mentioned side effects on the liver and methemoglobinemia, Flucinom may also cause the following side effects:

  • Gynecomastia and galactorrhoea (breast enlargement and the occurrence of breast milk)
  • Insomnia and fatigue
  • Blurred vision
  • Chest pain
  • Depression
  • Swelling of the feet
  • High blood pressure

Overall, Flucinom is well tolerated and rarely causes serious side effects.

Reference

  1. NCBI link 1
  2. NCBI link 2
  3. NCBI link 3
  4. NCBI link 4

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