Lanbica (Bicalutamide)

Bicalutamide is used in the antiandrogen pathway to treat prostate cancer.

• Advanced prostate cancer: reduces tumor growth when combined with hormonal therapy.
• Metastatic castration‑resistant prostate cancer: improves overall survival as part of combination regimens.
• Locally advanced prostate cancer: used as neoadjuvant therapy before surgery or radiation.

• Bicalutamide acts as a competitive antagonist at the androgen receptor, binding to the ligand‑binding domain and preventing dihydrotestosterone and testosterone from activating the receptor. By blocking androgen‑mediated signaling in prostate cells, it inhibits tumor proliferation and induces apoptosis, especially when used with luteinizing hormone‑releasing hormone analogues that suppress testicular androgen production.

Bicalutamide may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Hot flashes: transient episodes of increased body temperature.
• Gynecomastia: development of breast tissue in males.
• Decreased libido: reduced sexual desire.
• Gastrointestinal upset: nausea, abdominal discomfort.
• Fatigue: feeling of tiredness.
• Elevated liver enzymes: mild hepatic enzyme increase.

Serious or Rare Side Effects

• Severe liver injury: hepatitis or hepatic failure.
• Pulmonary embolism: blood clot in lung arteries.
• Allergic reactions: including anaphylaxis.
• Interstitial lung disease: inflammation of lung tissue.
• Severe skin reactions: such as Stevens‑Johnson syndrome.
• Adrenal insufficiency: impaired adrenal hormone production.

Before prescribing Bicalutamide, several safety considerations should be reviewed.

• Assess liver function: obtain baseline hepatic enzymes and monitor regularly.
• Monitor cardiovascular risk: evaluate history of thromboembolic events.
• Counsel on hormonal effects: inform patients about possible gynecomastia and breast pain.
• Avoid use in severe hepatic impairment: contraindicated in patients with marked liver dysfunction.
• Store at ambient temperature: keep in the original pack, protect from moisture and light.

Bicalutamide can interact with several medicines, affecting its efficacy or safety.

Major Interactions (Avoid)

• Strong CYP3A4 inducers (e.g., rifampin): may markedly reduce bicalutamide plasma levels.
• Strong CYP3A4 inhibitors (e.g., ketoconazole): can increase exposure and risk of toxicity.
• Warfarin: concurrent use may enhance anticoagulant effect and increase bleeding risk.

Moderate Interactions (Monitor Closely)

• Anticoagulants (e.g., apixaban, rivaroxaban): may require dose adjustment.
• Statins (e.g., simvastatin, atorvastatin): increased statin concentrations may occur.
• Glucocorticoids: may affect liver enzyme activity and alter bicalutamide metabolism.
• Digoxin: potential for altered serum concentrations, requiring monitoring.