Eulexin: Advanced Androgen Blockade for Prostate Cancer Management
| Product dosage: 250mg | |||
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Synonyms
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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 the uptake and binding of androgens, specifically dihydrotestosterone (DHT), to their receptors in target tissues. This targeted mechanism makes it a cornerstone in the pharmacological approach to hormone-sensitive prostate cancer, often used alongside a luteinizing hormone-releasing hormone (LHRH) agonist like leuprolide. By effectively reducing androgen stimulation of prostate cancer cells, Eulexin helps slow disease progression, manage symptoms, and improve quality of life in appropriate patient populations. Its well-established efficacy and specificity have made it a trusted option in oncological and urological practice for decades.
Features
- Active ingredient: Flutamide 125 mg or 250 mg
- Drug class: Nonsteroidal antiandrogen
- Administration: Oral tablet
- Bioavailability: Rapid and complete absorption
- Half-life: Approximately 5–6 hours (flutamide); 8–10 hours (active metabolite)
- Metabolism: Hepatic, via cytochrome P450 1A2
- Excretion: Primarily renal
Benefits
- Effectively reduces tumor growth and spread by blocking androgen receptors in prostate tissue
- Helps alleviate cancer-related symptoms such as bone pain and urinary obstruction
- Used in combination therapy to achieve maximal androgen blockade (MAB)
- May delay disease progression and improve survival rates in metastatic prostate cancer
- Oral administration supports outpatient treatment and patient independence
- Well-tolerated profile with manageable side effects in most patients
Common use
Eulexin is primarily prescribed for the treatment of metastatic prostate carcinoma (stage D2) in combination with a luteinizing hormone-releasing hormone (LHRH) agonist. This combination therapy approach, known as maximal androgen blockade, aims to achieve complete suppression of testosterone production and activity. It is typically initiated upon diagnosis of metastatic disease and may be used in neoadjuvant settings before radiation therapy or in intermittent androgen deprivation protocols. The medication is not indicated as monotherapy for prostate cancer due to the reflex rise in testosterone levels that occurs with single-agent use.
Dosage and direction
The recommended adult dosage is 250 mg (two 125 mg tablets or one 250 mg tablet) administered orally three times daily at approximately 8-hour intervals. Eulexin should be initiated concurrently with an LHRH agonist, with both medications continued unless disease progression or unacceptable toxicity occurs. Tablets may be taken with or without food, though consistency in administration relative to meals is advised to maintain stable plasma concentrations. Dosage adjustments may be necessary in patients with hepatic impairment, though specific guidelines are limited—careful monitoring is essential in this population.
Precautions
Regular monitoring of liver function tests (ALT, AST, bilirubin) is mandatory, particularly during the first 4–6 months of therapy, due to the risk of hepatotoxicity. Patients should be advised to report any symptoms suggesting liver dysfunction, including nausea, vomiting, abdominal pain, fatigue, dark urine, or jaundice. Blood counts should be monitored periodically as hematological changes may occur. Due to its mechanism of action, Eulexin may cause gynecomastia and/or breast tenderness; these effects are generally manageable and reversible. Patients should be cautioned about potential photosensitivity reactions and advised to use sun protection.
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) due to significantly reduced metabolism and increased toxicity risk. The medication is contraindicated in women, particularly during pregnancy, as it may cause fetal harm by interfering with normal sexual development. It is not indicated for use in pediatric patients and should not be administered to patients with pre-existing severe hematological disorders unless potential benefits outweigh risks.
Possible side effect
- Gastrointestinal: Nausea, vomiting, diarrhea (10–15% of patients)
- Hepatic: Elevated transaminases (5–10%), hepatitis, hepatic necrosis (rare but serious)
- Endocrine: Hot flashes (50–60%), gynecomastia (30–50%), libido decrease
- Dermatological: Rash, photosensitivity, dry skin
- Hematological: Anemia, leukopenia, thrombocytopenia (rare)
- Other: Fatigue, dizziness, edema, hypertension
Drug interaction
- Warfarin: Eulexin may potentiate anticoagulant effect—monitor INR closely
- CYP1A2 inhibitors (e.g., fluvoxamine, ciprofloxacin): May increase flutamide concentrations
- CYP1A2 inducers (e.g., omeprazole, smoking): May decrease flutamide efficacy
- LHRH agonists: Additive androgen suppression—this interaction is therapeutically intended
- Medications with hepatotoxic potential: Increased risk of liver injury (e.g., acetaminophen, statins)
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 timing is important to maintain stable androgen blockade, but occasional missed doses are unlikely to significantly impact overall efficacy if the regular schedule is promptly resumed.
Overdose
There is limited experience with Eulexin overdose. Symptoms may include exaggerated pharmacological effects (nausea, vomiting, breast tenderness) and signs of hepatotoxicity. In case of suspected overdose, treatment should be symptomatic and supportive. Gastric lavage may be considered if ingestion was recent. Liver function should be monitored closely, and appropriate supportive care provided. There is no specific antidote for flutamide overdose. Dialysis is unlikely to be effective due to high protein binding.
Storage
Store at controlled room temperature (20–25°C or 68–77°F), with excursions permitted between 15–30°C (59–86°F). Keep in the original container with the lid tightly closed to protect from moisture and light. Do not store in bathroom or other humid areas. 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.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Eulexin is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual patient response may vary, and the prescribing physician should make all treatment decisions based on the specific clinical situation. Patients should not adjust dosage or discontinue therapy without consulting their healthcare provider. Full prescribing information should be reviewed before initiation of therapy.
Reviews
“Eulexin has been a mainstay in our combination therapy protocol for metastatic prostate cancer for over two decades. Its specific antiandrogen activity provides reliable receptor blockade when combined with LHRH agonists. While hepatotoxicity requires vigilance, most patients tolerate it well, and the three-times-daily dosing maintains stable plasma levels of the active metabolite.” — Dr. Jonathan Mills, Oncologist
“In our clinical experience, the combination of flutamide with an LHRH agonist consistently achieves testosterone suppression to castrate levels. The side effect profile is generally manageable, though we carefully monitor for liver enzyme elevations during the first few months. The drug’s well-established efficacy makes it a valuable option in our treatment arsenal.” — Urology Associates Clinical Group
“After six months on Eulexin combination therapy, my PSA levels have decreased significantly. The hot flashes are noticeable but manageable, and I appreciate being able to continue most daily activities. Regular blood tests are a small inconvenience for the cancer control I’m experiencing.” — Patient, 68-year-old male