ESTRAMUSTINE

COMMON BRAND NAME(S): Emcyt

GENERIC NAME(S): ESTRAMUSTINE PHOSPHATE SODIUM

Description: Estramustine is a cancer medicine that interferes with the growth and spread of cancer cells in the body. This medication is thought to work by increasing estrogens, which interfere with prostate cancer, and by slowing/stopping the growth of cancer cells.

Uses

Indications:

This medication is used to treat some types of metastatic or progressive prostate cancer.

Contraindication:

Should not be used in patients with known severe allergic reactions to the drug and active thrombophlebitis or thromboembolic disorders.

How to use estramustine

Dosage: Take this medication by mouth on an empty stomach, either 1 hour before or 2 hours after a meal, usually 3-4 times a day or as directed by your doctor.

Take this medication with a full glass of water (8 ounces or 240 milliliters) unless your doctor directs you otherwise.
Take this medication regularly in order to get the most benefit from it.
Take this medication 3 hours before or after taking any products containing magnesium, aluminum, or calcium. Some examples include quinapril, didanosine, vitamins/minerals, and antacids. Dairy products (e.g., milk, yogurt), calcium-enriched juice, sucralfate, bismuth subsalicylate, iron, and zinc are also included. These products bind with estramustine, preventing its full absorption.
Do not increase your dose or take this medication more often than prescribed. Your condition will not improve any faster, and the risk of serious side effects may be increased.
Since this drug can be absorbed through the skin and lungs, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the capsules.

Warnings

Increased risk of thrombosis including myocardial infarction in men receive estrogen for prostate cancer.
Glucose tolerance: Tolerance may be decreased; therefore, diabetic patients should be carefully observed.
High Blood Pressure: Patients taking this drug must monitor blood pressure regularly.

Side Effects

If any of the following side effects occur while taking estramustine, check with your doctor or nurse as soon as possible:

More common

Swelling of feet or lower legs

Some of the side effects that can occur with estramustine may not need medical attention.:

More common

Breast tenderness or enlargement
decreased interest in sex
diarrhea
nausea

Less common

Trouble in sleeping
Vomiting

Precautions

Precautions

General:

If you will be having surgery or will be confined to a chair or bed for a long time (e.g., a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking this drug because of the increased risk for blood clots.

Estramustine may be poorly metabolized in patients with liver problems and should be administered with caution.

Medical History: Before using this medication, tell your doctor or pharmacist if you had: history of stroke or other blood clots (e.g., in the legs, eyes, lungs), bone disease (e.g., bone metastases, high calcium levels), high cholesterol or triglyceride (blood fat) levels, depression, diabetes, severe headaches (e.g., migraine), heart disease (e.g., angina, heart attack, heart failure), high blood pressure, kidney disease, liver disease, seizure, long periods of sitting or lying down (e.g., immobility such as being bedridden), stroke, thyroid problems.
Smoking: Estrogens combined with smoking further increase your risk for stroke, blood clots, high blood pressure, and heart attacks.
Diabetes: If you have diabetes, estramustine may worsen control of blood glucose levels. Monitor your blood glucose levels regularly and inform your doctor of the results.
Eye problems: If you are nearsighted or wear contact lenses, you may develop vision problems or trouble wearing your contact lenses.
Skin problems: This drug may cause a patchy darkening of the skin on the face (melasma). Sunlight may worsen this darkening.
Sperm production: This medication may affect the production of sperm. Use a reliable form of birth control while on this medication. Consult your doctor.

Pregnancy Risk: Category X. Not for use in pregnancy.

This medication is not usually used in women.

Interactions

This drug should not be used with the following medications because very serious interactions may occur: aromatase inhibitors (e.g., anastrozole, exemestane), troleandomycin, tranexamic acid.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: corticosteroids (e.g., prednisolone), ospemifene, tamoxifen, medication for low thyroid (hypothyroidism).
Certain drugs can affect the estrogen levels in your system. Drugs that may cause this effect include: azole antifungals (e.g., itraconazole, ketoconazole), many antibiotics (e.g., cephalosporins, chloramphenicol, macrolides, penicillins, tetracyclines, sulfas), aprepitant, bexarotene, bosentan, dapsone, griseofulvin, certain HIV protease inhibitors (e.g., nelfinavir, ritonavir), modafinil, nevirapine, rifamycins (e.g., rifampin), many seizure medications (e.g., barbiturates, carbamazepine, phenytoin, primidone, topiramate), St John’s wort.

Overdose & Brands

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately.

Notes

Do not share this medication with others.

Laboratory tests (e.g., blood pressure, liver function tests, calcium levels) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store the U.S. product in the refrigerator between 36-46 degrees F (2-8 degrees C) away from light and moisture. Do not store in the bathroom.

Store the Canadian product between 36-77 degrees F (2-25 degrees C) away from light and moisture. Do not store in the bathroom.

Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Brands

There are no brands containing this molecule.