Flutamide

Flutamide is a hormonal therapy drug used to treat prostate cancer. It can be given alone or with other types of treatment. It is best to read this information with our general information about hormonal therapies and the type of cancer you have.

Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.

This information is correct at time of publishing. But sometimes the types of cancer this treatment is used for, or treatment side effects, may change between revision dates.

You can talk to your cancer team if you want more detailed information about this treatment. Or visit the electronic Medicines Compendium (eMC) website, which has patient information leaflets (PIL) for individual drugs.

Flutamide may be given:

• on its own or with other hormonal therapies
• for a few weeks when taking hormonal drugs called LHRH agonists to prevent any symptoms getting worse because of a temporary rise in testosterone (called tumour flare)
• with other treatments such as surgery (radical prostatectomy) or radiotherapy
• to treat prostate cancer that has spread to other parts of your body (advanced or metastatic prostate cancer). 

Your doctor or nurse will explain why you are having flutamide and how long you will have it for.

Flutamide comes as tablets you can take at home. You take it every 8 hours (3 times a day). 

Always take the tablets exactly as explained. This is important to make sure they work as well as possible for you. 

Remember the following:

• Take the tablets with a glass of water, preferably after food.
• Try to take them at the same times every day.  
• Do not chew or crush the tablets. If you do, there is a risk you might overdose because this medicine will be absorbed into your body too quickly. 
• Tell your doctor if you have difficulty swallowing tablets. If you find them difficult to swallow whole, you can break the tablet along the score line. You should not divide tablets into smaller doses. 

• If you forget to take your tablets, take the missed dose as soon as possible, unless it is almost time for your next tablet. If this happens, skip the missed tablet and take the next tablet on time. If a full day has passed, let your doctor or nurse know. Do not take a double dose unless your doctor tells you to.

Other things to remember about your tablets:

• Keep them in the original package and at room temperature, away from heat and direct sunlight.
• Keep them safe and out of sight and reach of children.
• If you are sick just after taking the tablets, contact your healthcare team. Do not take another dose.
• Get a new prescription before you run out of tablets, and make sure you have plenty for holidays.
• If your treatment is stopped, return any unused tablets to the pharmacist. 

Your nurse or pharmacist may also give you other medicines to take home. Take all your medicines exactly as they have been explained to you. Do not stop taking any of your medicines unless your doctor tells you to.

Hot flushes are a common side effect of this treatment. During a flush, your neck and face may feel warm. If you have white skin, your skin may look red. If you have black or brown skin, your skin colour may deepen. Flushes can last up to 5 minutes. You might also have sweats or feel anxious or irritable during a flush. 

Here are some things you can do to reduce the effects of hot flushes:

• Wear natural fabrics, such as cotton.
• Wear layers so you can remove clothes as needed. 
• Use cotton sheets and layers of bedding you can remove. 
• Try cooling pads or pillows to keep you cool.
• Keep rooms cool or use a fan.
• Have cold drinks and avoid caffeine and alcohol. 

You might have fewer hot flushes as your body adjusts to this treatment. You could try therapies to help you cope with hot flushes, such as:

• talking therapies like cognitive behaviour therapy (CBT)
• controlled breathing exercises
• yoga
• acupuncture. 

If they do not improve, talk to your doctor. Certain drugs can help to improve hot flushes. 

Flushes usually stop a few months after treatment ends. But some people continue to have them.

This treatment may cause swelling and tenderness of your breast tissue. This is called gynaecomastia. You may also notice a small amount of fluid leaking from your nipples. Your doctor can give you advice on preventing and treating this.

This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is normal for you, or having watery or loose stools. You may also have stomach cramps. If you have a stoma, it may be more active than usual. 

If you are passing loose stools 3 or more times a day and this is not normal for you, contact the hospital as soon as possible on the 24-hour number. Follow the advice they give you about:

• taking anti-diarrhoea medicines 
• drinking enough fluids to keep you hydrated and to replace lost salts and minerals
• any changes to your diet that might help. 

They might also ask you for a specimen of your stool to check for infection.

It is common to lose your sex drive and have erection difficulties with hormonal therapy. Hormonal therapy may also make your penis shorter and your testicles smaller. 

Your doctor can prescribe drugs and treatments to help with erection difficulties. These will not increase your sex drive. But they might work, even with a low sex drive. 

Things can improve a few months after you stop taking the drug. But it depends on how long you take hormonal therapy, and what other treatments you have had. Some people continue to have problems after treatment ends.

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, may give you more energy.

Flutamide may also cause problems with falling or staying asleep. Your doctor or specialist nurse may be able to give you some help and advice with these side effects.

If you feel sleepy, do not drive or operate machinery.

This treatment may affect how your liver works. You will have blood tests to check how well your liver is working.

Flutamide may give you a bigger appetite and you might eat more than usual. Eating healthily and being active can help you keep to a healthy weight. Your doctor, nurse or a dietitian can give you more advice.

Talk to your doctor or nurse about how much alcohol is safe to drink while you are taking flutamide. Let them know if you need help or advice on staying within safe levels.

Some medicines can affect how this treatment works or be harmful while you are having it. Always tell your cancer doctor, nurse or pharmacist about any drugs you are taking or planning to take, such as: 

• medicines you have been prescribed
• medicines you buy in a shop, pharmacy or online
• vitamins or supplements 
• herbal drugs and complementary or homeopathic therapies
• recreational drugs – for example, cannabis.

Cancer and some cancer treatments can increase the risk of a blood clot. Contact the hospital straight away on the 24-hour number if you have any of these symptoms during or after treatment:

• throbbing pain or swelling in a leg or arm
• reddening of the skin in the area – if you have black or brown skin, this can be harder to notice, but the skin might become darker
• suddenly feeling breathless or coughing.

Always call 999 if you have:

• chest pain
• difficulty breathing.

A blood clot is serious, but it can be treated with drugs called anticoagulants. These thin the blood. Your doctor, nurse or pharmacist can give you more information about preventing and treating blood clots.

Your doctor, nurse or pharmacist will advise you not to make someone pregnant while having this treatment. The drug may harm the developing baby. It is important to use effective contraception during treatment and for a while after it finishes.

Some drugs can affect whether you can make someone pregnant.

There may be ways to preserve your fertility. If you are worried about this, it is important to talk with your doctor before you start treatment.

If you need medical treatment for any reason other than cancer, always tell the healthcare professional that you are having cancer treatment. Give them the contact details for your cancer doctor or cancer team so they can ask for advice.

If you have appointments with a dentist, always tell them you are having cancer treatment. Talk to your cancer team before you have any dental treatment.