Description
Estramustine belongs to the general group of medicines called antineoplastics. It is used to treat some cases of prostate cancer.
Estramustine is a combination of two medicines, an estrogen and mechlorethamine. The way that estramustine works against cancer is not completely understood. However, it seems to interfere with the growth of cancer cells, which are eventually destroyed.
Estramustine is available only with your doctor's prescription.
This product is available in the following dosage forms:
- Capsule
Before Using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Geriatric
Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of estramustine in the elderly with use in other age groups.
Breastfeeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amifampridine
- Bupropion
- Cosyntropin
- Donepezil
- Somatrogon-ghla
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Levothyroxine
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.
- Dairy Food
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Asthma or
- Epilepsy or
- Mental depression (or history of) or
- Migraine headaches or
- Kidney disease—Fluid retention sometimes caused by estramustine may worsen these conditions
- Blood clots (or history of) or
- Stroke (or history of) or
- Recent heart attack or stroke—May be worsened because of blood vessel problems caused by estramustine
- Chickenpox (including recent exposure) or
- Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body
- Diabetes mellitus (sugar diabetes)—Estramustine may change the amount of antidiabetic medicine needed
- Gallbladder disease (or history of)—May be worsened by estramustine
- Heart or blood vessel disease—Estramustine can cause circulation problems
- Jaundice or hepatitis (or history of) or other liver disease—Effects, including liver problems, may be increased
- Stomach ulcer—May be aggravated by estramustine
Proper Use
Use this medicine only as directed by your doctor. Do not use more or less of it, and do not use it more often than your doctor ordered. The exact amount of medicine you need has been carefully worked out. Taking too much may increase the chance of side effects, while taking too little may not improve your condition.
Do not take estramustine within 1 hour before or 2 hours after meals or after the time you take milk, milk formulas, or other dairy products, since they may keep the medicine from working properly.
This medicine commonly causes nausea and sometimes causes vomiting. However, it may have to be taken for several weeks to months to be effective. Even if you begin to feel ill, do not stop using this medicine without first checking with your doctor. Ask your health care professional for ways to lessen these effects.
If you vomit shortly after taking a dose of estramustine, check with your doctor. You will be told whether to take the dose again or to wait until the next scheduled dose.
Dosing
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
Missed Dose
If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage
Store in the refrigerator. Do not freeze.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Precautions
It is very important that your doctor check your progress at regular visits to make sure that the medicine is working properly and does not cause unwanted effects.
While you are being treated with estramustine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Estramustine may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have recently taken oral polio vaccine. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
- Black, tarry stools
- blood in urine or stools
- cough or hoarseness
- fever or chills
- headaches (severe or sudden)
- loss of coordination (sudden)
- lower back or side pain
- painful or difficult urination
- pains in chest, groin, or leg (especially calf of leg)
- pinpoint red spots on skin
- shortness of breath (sudden, for no apparent reason)
- slurred speech (sudden)
- unusual bleeding or bruising
- vision changes (sudden)
- weakness or numbness in arm or leg
Check with your doctor as soon as possible if any of the following side effects occur:
More common
- Swelling of feet or lower legs
Rare
- Skin rash or fever
- unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
- Breast tenderness or enlargement
- decreased interest in sex
- diarrhea
- nausea
Less common
- Trouble in sleeping
- vomiting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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