In patients with advanced prostate cancer treated with bicalutamide in combination with an LHRH analog, the most frequent adverse reaction was hot flashes (53%).
In the multicenter, double-blind, controlled clinical trial comparing bicalutamide 50 mg once daily with flutamide 250 mg three times a day, each in combination with an LHRH analog, the following adverse reactions with an incidence of 5% or greater, regardless of causality, have been reported.
Table 1 Incidence of Adverse Reactions (≥ 5% in Either Treatment Group) Regardless of Causality
Body System Adverse Reaction
| Treatment Group Number of Patients (%)
|
| Bicalutamide Plus LHRH Analog (n=401)
| Flutamide Plus LHRH Analog (n=407)
|
Body as a Whole
|
|
|
Pain (General)
| 142 (35)
| 127 (31)
|
Back Pain
| 102 (25)
| 105 (26)
|
Asthenia
| 89 (22)
| 87 (21)
|
Pelvic Pain
| 85 (21)
| 70 (17)
|
Infection
| 71(18)
| 57 (14)
|
Abdominal Pain
| 46 (11)
| 46 (11)
|
Chest Pain
| 34 (8)
| 34 (8)
|
Headache
| 29 (7)
| 27 (7)
|
Flu Syndrome
| 28 (7)
| 30 (7)
|
Cardiovascular
|
|
|
Hot Flashes
| 211 (53)
| 217 (53)
|
Hypertension
| 34 (8)
| 29 (7)
|
Digestive
|
|
|
Constipation
| 87 (22)
| 69 (17)
|
Nausea
| 62 (15)
| 58 (14)
|
Diarrhea
| 49 (12)
| 107 (26)
|
| Increased Liver Enzyme Test Increased liver enzyme test includes increases in AST, ALT or both.
| 30 (7)
| 46 (11)
|
Dyspepsia
| 30 (7)
| 23 (6)
|
Flatulence
| 26 (6)
| 22 (5)
|
Anorexia
| 25 (6)
| 29 (7)
|
Vomiting
| 24 (6)
| 32 (8)
|
Hemic and Lymphatic
|
|
|
| Anemia Anemia includes anemia, hypochronic-and iron deficiency anemia.
| 45 (11)
| 53 (13)
|
Metabolic and Nutritional
|
|
|
Peripheral Edema
| 53 (13)
| 42 (10)
|
Weight Loss
| 30 (7)
| 39 (10)
|
Hyperglycemia
| 26 (6)
| 27 (7)
|
Alkaline Phosphatase Increased
| 22 (5)
| 24 (6)
|
Weight Gain
| 22 (5)
| 18 (4)
|
Musculoskeletal
|
|
|
Bone Pain
| 37 (9)
| 43 (11)
|
Myasthenia
| 27 (7)
| 19 (5)
|
Arthritis
| 21 (5)
| 29 (7)
|
Pathological Fracture
| 17 (4)
| 32 (8)
|
Nervous System
|
|
|
Dizziness
| 41 (10)
| 35 (9)
|
Paresthesia
| 31 (8)
| 40 (10)
|
Insomnia
| 27 (7)
| 39 (10)
|
Anxiety
| 20 (5)
| 9 (2)
|
Depression
| 16 (4)
| 33 (8)
|
Respiratory System
|
|
|
Dyspnea
| 51 (13)
| 32 (8)
|
Cough Increased
| 33 (8)
| 24 (6)
|
Pharyngitis
| 32 (8)
| 23 (6)
|
Bronchitis
| 24 (6)
| 22 (3)
|
Pneumonia
| 18 (4)
| 19 (5)
|
Rhinitis
| 15 (4)
| 22 (5)
|
Skin and Appendages
|
|
|
Rash
| 35 (9)
| 30 (7)
|
Sweating
| 25 (6)
| 20 (5)
|
Urogenital
|
|
|
Nocturia
| 49 (12)
| 55 (14)
|
Hematuria
| 48 (12)
| 26 (6)
|
Urinary Tract Infection
| 35 (9)
| 36 (9)
|
Gynecomastia
| 36 (9)
| 30 (7)
|
Impotence
| 27 (7)
| 35 (9)
|
Breast Pain
| 23 (6)
| 15 (4)
|
Urinary Frequency
| 23 (6)
| 29 (7)
|
Urinary Retention
| 20 (5)
| 14 (3)
|
Urinary Impaired
| 19 (5)
| 15 (4)
|
Urinary Incontinence
| 15 (4)
| 32 (8)
|
Other adverse reactions (greater than or equal to 2%, but less than 5%) reported in the bicalutamide-LHRH analog treatment group are listed below by body system and are in order of decreasing frequency within each body system regardless of causality.
Body as a Whole: Neoplasm; Neck Pain; Fever; Chills; Sepsis; Hernia; Cyst
Cardiovascular: Angina Pectoris; Congestive Heart Failure; Myocardial Infarct; Heart Arrest; Coronary Artery Disorder; Syncope
Digestive: Melena; Rectal Hemorrhage; Dry Mouth; Dysphagia; Gastrointestinal Disorder; Periodontal Abscess; Gastrointestinal Carcinoma
Metabolic and Nutritional: Edema; BUN Increased; Creatinine Increased; Dehydration; Gout; Hypercholesteremia
Musculoskeletal: Myalgia; Leg Cramps
Nervous: Hypertonia; Confusion; Somnolence; Libido Decreased; Neuropathy; Nervousness
Respiratory: Lung Disorder; Asthma; Epistaxis; Sinusitis
Skin and Appendages: Dry Skin; Alopecia; Pruritus; Herpes Zoster; Skin Carcinoma; Skin Disorder
Special Senses: Cataract specified
Urogenital: Dysuria; Urinary Urgency; Hydronephrosis; Urinary Tract Disorder
Abnormal Laboratory Test Values:
Laboratory abnormalities including elevated AST, ALT, bilirubin, BUN, and creatinine and decreased hemoglobin and white cell count have been reported in both bicalutamide-LHRH analog treated and flutamide-LHRH analog treated patients.