Eulexin

Eulexin (flutamide) is a nonsteroidal antiandrogen medication indicated for use in combination therapy for the management of metastatic prostate carcinoma. It functions by competitively inhibiting androgen uptake and binding at the cellular level, thereby impeding the growth stimulation of prostate cancer cells that are hormone-responsive. When administered alongside a luteinizing hormone-releasing hormone (LHRH) agonist, Eulexin provides a comprehensive androgen blockade, targeting both testicular and adrenal androgen sources. This dual approach is a cornerstone of advanced prostate cancer treatment protocols, offering a mechanism to control disease progression and manage symptoms in appropriate patient populations.

Features

• Active ingredient: Flutamide 125 mg per capsule
• Pharmaceutical form: Oral capsules
• Mechanism: Nonsteroidal antiandrogen; competitive inhibitor of androgen binding to receptors
• Administration: For oral use, typically in a divided dose regimen
• Manufacturer: Various pharmaceutical companies under license
• Availability: Prescription-only medication

Benefits

• Provides effective suppression of androgen-stimulated tumor growth in metastatic prostate cancer
• Works synergistically with LHRH agonists to achieve complete androgen blockade
• Helps reduce tumor-related symptoms including pain and urinary obstruction
• May delay disease progression when used in appropriate combination therapy
• Contributes to improved quality of life through symptom management
• Offers oral administration convenience compared to some other hormonal therapies

Common use

Eulexin is primarily used in combination with a luteinizing hormone-releasing hormone (LHRH) agonist for the treatment of metastatic prostate carcinoma (stage D2). This combination therapy approach is designed to achieve maximal androgen blockade by addressing both testicular and adrenal androgen sources. The medication is typically initiated concurrently with or shortly before beginning LHRH agonist therapy to prevent the initial testosterone surge that can occur with LHRH agonists alone. Treatment is generally continued until disease progression is evident or until side effects necessitate discontinuation. The combination therapy has demonstrated efficacy in delaying disease progression and managing cancer-related symptoms in hormone-responsive prostate cancer.

Dosage and direction

The recommended adult dosage is 250 mg (two 125 mg capsules) administered orally three times daily at approximately eight-hour intervals, for a total daily dose of 750 mg. Eulexin should be initiated concurrently with an LHRH agonist, with the first dose typically administered 24 hours before or simultaneously with the first LHRH agonist dose. Administration with food is not required but may help minimize gastrointestinal discomfort. Dosage adjustments may be necessary in patients with hepatic impairment, though specific guidelines are limited and require careful clinical monitoring. Treatment duration should be individualized based on therapeutic response and tolerability, typically continuing until disease progression or unacceptable toxicity occurs.

Precautions

Regular monitoring of liver function tests is essential, particularly during the first four months of therapy, as hepatotoxicity has been reported. Patients should be advised to report any symptoms suggesting liver dysfunction, including nausea, vomiting, abdominal pain, fatigue, anorexia, flu-like symptoms, dark urine, or jaundice. Periodic measurement of prostate-specific antigen (PSA) levels is recommended to monitor treatment response. Blood counts should be monitored periodically due to potential hematological effects. Patients with glucose-6-phosphate dehydrogenase deficiency should be monitored for possible hemolytic anemia. Caution is advised in patients with pre-existing hepatic impairment, as drug elimination may be affected.

Contraindications

Eulexin is contraindicated in patients with known hypersensitivity to flutamide or any component of the formulation. It should not be used in patients with severe hepatic impairment (Child-Pugh Class C). The medication is contraindicated in women, particularly during pregnancy, due to potential teratogenic effects and lack of indication for use in female patients. It should not be administered to pediatric patients as safety and effectiveness have not been established in this population. Concurrent use with terfenadine, astemizole, or cisapride is contraindicated due to potential QT prolongation risks.

Possible side effects

Common adverse reactions (≥10%): Hot flashes (61%), loss of libido (36%), impotence (33%), diarrhea (12%), nausea/vomiting (10%), gynecomastia (9-38%) Less frequent reactions (1-10%): Hepatic enzyme elevations, anemia, leukopenia, thrombocytopenia, edema, hypertension, rash, pruritus, photosensitivity Rare but serious reactions (<1%): Clinical hepatitis, hepatic necrosis, cholestatic jaundice, hepatic encephalopathy, hemolytic anemia, methemoglobinemia, pulmonary toxicity Other reported effects: Dizziness, insomnia, anxiety, confusion, blurred vision, breast tenderness, galactorrhea, tumor flare

Drug interaction

Eulexin may interact with warfarin and other coumarin derivatives, potentially increasing anticoagulant effect and requiring close monitoring of prothrombin time. Concurrent use with medications that prolong QT interval (e.g., certain antiarrhythmics, antipsychotics, antibiotics) may increase arrhythmia risk. The metabolism of flutamide may be affected by CYP1A2 inhibitors (e.g., fluvoxamine) or inducers (e.g., smoking), potentially altering drug levels. Eulexin may interfere with laboratory tests for testosterone and other androgen measurements. Concomitant use with other hepatotoxic drugs may increase the risk of liver injury.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed administration. Consistent dosing is important for maintaining stable drug levels and optimal androgen blockade. Healthcare providers should be consulted if multiple doses are missed or if there is uncertainty about proper dosing resumption.

Overdose

There is limited experience with Eulexin overdose. Symptoms may include exaggerated pharmacological effects such as nausea, vomiting, diarrhea, and dizziness. Hepatic toxicity may be exacerbated in cases of significant overdose. There is no specific antidote for flutamide overdose. Management should include supportive measures and symptomatic treatment. Gastric lavage may be considered if ingestion was recent. Liver function should be monitored closely, and appropriate supportive care provided based on clinical manifestations. Hemodialysis is unlikely to be effective due to high protein binding.

Storage

Store at controlled room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Protect from light and moisture. Keep the container tightly closed. Do not freeze. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Properly dispose of any unused medication according to local regulations, preferably through medication take-back programs.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Treatment decisions should be made by qualified healthcare professionals based on individual patient circumstances. The prescribing physician should be consulted for complete prescribing information, including boxed warnings. Dosage may need adjustment based on individual patient factors, and regular monitoring is essential during therapy. Patients should report any adverse effects to their healthcare provider promptly.

Reviews

Clinical studies have demonstrated that Eulexin in combination with LHRH agonists provides effective androgen suppression in metastatic prostate cancer. The combination has shown statistically significant improvements in progression-free survival compared to monotherapy in some patient populations. Many clinicians report satisfactory disease control and symptom management with appropriate patient selection. However, the hepatic toxicity profile requires careful consideration and monitoring. Patient experiences vary, with some reporting manageable side effects while others discontinue due to gastrointestinal intolerance or hepatic concerns. Overall, Eulexin remains an important component of combination hormonal therapy for advanced prostate cancer when used appropriately with necessary monitoring protocols.