flutamide: clinical use

Prescribing considerations

• Assess hepatic function before initiation and weigh benefit against risk in pre-existing liver impairment.
• Use cautiously in renal impairment, cardiovascular disease, fluid-retention states and patients at risk of QT prolongation.
• Consider fracture risk and bone health during androgen-deprivation treatment.
• Advise contraception and prompt reporting of hepatic or respiratory symptoms.

Contraindications and cautions

• Hypersensitivity to flutamide or any product component.
• The lactose-containing selected product is unsuitable for certain rare hereditary disorders of galactose metabolism or absorption.

Monitoring

• Check liver function before treatment, periodically during treatment and whenever hepatic symptoms develop.
• Assess promptly for dyspnoea or other evidence of interstitial pneumonitis.
• Consider ECG and interacting medicines when QT-risk factors are present.
• Monitor bone mineral density in patients at risk of osteoporosis or fracture.
• Monitor prothrombin time closely with oral anticoagulants.

Clinical pharmacology

Flutamide is rapidly metabolised to active 2-hydroxyflutamide. The parent compound and active metabolite are highly protein-bound, with metabolites eliminated mainly in urine.

Formulation and product differences

• The selected product is an uncoated, immediate-release oral tablet.
• It contains lactose monohydrate and is supplied in blister packaging.
• Store below 25°C in the original dry, light-protective packaging.

Tablet

Route: Oral

Strengths: 250 mg