Nilutamide (Nilandron® , Anandron)

How to Take Nilutamide

Nilutamide is given as a tablet, with or without food, preferably at the same time each day.

It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.

Nilutamide can cause an intolerance of alcohol including facial flushing, malaise and low blood pressure. You should avoid consuming alcoholic beverages while taking this medication.

The blood levels of this medication can be affected by certain foods and medications, so they should be avoided. These include: rifampin, fluconazole, fluoxetine, fluvoxamine, voriconazole. Be sure to tell your healthcare provider about all medications and supplements you take.

Storage and Handling

Store this medication at room temperature, in the original container. If you prefer to use a pillbox, discuss this with your oncology pharmacist. Ask your oncology team where to return any unused medication for disposal. Do not flush down the toilet or throw in the trash.

Where do I get this medication?

Nilutamide is available through retail and mail order pharmacies. Your oncology team will work with your prescription drug plan to identify an in-network retail/mail order pharmacy for medication distribution.

Insurance Information

This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Co-pay assistance offered through private third party foundations, may also be available. Your care team can help you find these resources, if they are available.

Possible Side Effects of Nilutamide

There are a number of things you can do to manage the side effects of Nilutamide. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:

Pneumonitis

You may develop inflammation of the lungs (called pneumonitis) while taking this medication. Let your oncology care team know right away if you have any new or worsening symptoms, including shortness of breath, cough, pain, or fever. If you have a hard time breathing, call 911 or go to the nearest emergency room.

Hot Flashes

There are a few things you can do to help with hot flashes. Several medications have been shown to help with symptoms, such as clonidine (a blood pressure medication), low doses of certain antidepressants (such as venlafaxine and fluoxetine), and gabapentin. Talk to your care team about these medications to see if they are right for you.

Non-medical recommendations are to:

• Keep well-hydrated with eight glasses of water daily.
• Drink ice water or place an ice pack at the beginning of a hot flash.
• Wear cotton or lightweight, breathable clothes and dress in layers so you can change as needed.
• Exercise.
• Try practicing meditation or relaxation exercises to help with stress, which can be a trigger.
• Avoid triggers such as warm rooms, spicy foods, caffeine, and alcohol.

Vision Changes

Nilutamide can affect how your eyes adapt when going from a lighted area to a dark area. This can range from a few seconds to a few minutes. Be careful driving at night or through tunnels and consider wearing tinted glasses/sunglasses to help with this side effect. This medication can also cause other vision changes or changes in color vision. Report any changes to your provider.

Weakening of the Bones (Osteoporosis)

Men who take hormone therapy for long periods of time are at risk for bone thinning (osteoporosis). You may be told to take calcium and vitamin D supplements to help prevent bone loss. Weight bearing exercise and a diet rich in calcium and vitamin D can also help protect your bone health. You may have a bone density scan (DEXA scan) to check your bone health. If your provider thinks that you are at high risk of developing osteoporosis, they may recommend additional treatment with a type of medication called a bisphosphonate to help strengthen the bones.

Breast Tenderness or Increase in Breast Tissue

An increase in breast tissue (gynecomastia) or breast tenderness may develop. Your care team can suggest medications to relieve the tenderness. In rare cases, radiation can be given to relieve severe tenderness.

Less common, but important side effects can include:

• Liver Toxicity: This medication can cause liver toxicity, which your oncology care team may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown, or you have pain in your abdomen, as these can be signs of liver toxicity.

Sexual and Reproductive Changes

This drug can affect your reproductive system, resulting in sperm production becoming irregular or stopping permanently. In addition, you may experience erectile dysfunction or a decreased desire for sex during treatment. Talk to your urologist about options for treating erectile dysfunction.