Drogenil

Action

Exerts potent antiandrogenic activity at cellular level by inhibiting androgen uptake or nuclear binding of androgen

Availability

Capsules: 125 mg

Indications and dosages

➣ Metastatic prostate cancer

Adults: 250 mg P.O. t.i.d. q 8 hours, given with luteinizing hormone-releasing hormone (LHRH) analog. Total daily dosage is 750 mg.

Off-label uses

• Benign prostatic hypertrophy

Contraindications

• Hypersensitivity to drug

• Severe hepatic impairment

• Sleep apnea

• Women

Precautions

None

Administration

• Be aware that leuprolide acetate is the most common LHRH analog given with flutamide.

Adverse reactions

CNS: drowsiness, confusion, depression, anxiety, nervousness, paresthesia

CV: peripheral edema, hypertension

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, anorexia, dry mouth

GU: erectile dysfunction, loss of libido, gynecomastia, hot flashes

Hematologic: anemia, leukopenia, thrombocytopenia

Hepatic: hepatitis

Skin: rash, photosensitivity

Interactions

Drug-drug. Warfarin: increased prothrombin time

Drug-diagnostic tests. Alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatine kinase: increased levels

Hemoglobin, platelets, white blood cells: decreased levels

Drug-herbs. Chaparral, comfrey, eucalyptus, germander, pennyroyal, skullcap, valerian: increased risk of hepatotoxicity

Drug-behaviors. Sun exposure: increased risk of photosensitivity

Patient monitoring

• Monitor CBC and liver function tests.

See Watch for bleeding tendency and signs and symptoms of hepatic damage (jaundice, vomiting, dark yellow or brown urine).

• Monitor blood pressure.

Patient teaching

See Instruct patient to immediately report unusual bleeding or bruising.

• Tell patient to avoid activities that can cause injury. Advise him to use soft toothbrush and electric razor to avoid gum and skin injury.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• Instruct patient to minimize GI upset by eating frequent, small servings of healthy food.

• Tell patient he'll undergo regular blood testing during therapy.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.