Eulexin (flutamide) is a nonsteroidal antiandrogen medication indicated for the treatment of metastatic prostate carcinoma in combination with a luteinizing hormone-releasing hormone (LHRH) agonist. It functions by competitively inhibiting androgen uptake and binding to androgen receptors in target tissues, thereby impeding the growth-stimulating effects of testosterone on prostate cancer cells. This oral therapeutic agent is a cornerstone of combined androgen blockade therapy, offering a targeted mechanism to suppress tumor progression and manage advanced disease. Its clinical use is supported by extensive oncological research and established treatment protocols for hormone-sensitive prostate malignancies.

Features

• Active ingredient: Flutamide 125 mg or 250 mg
• Pharmaceutical form: Film-coated tablets
• Mechanism: Competitive antagonist at androgen receptor sites
• Administration: Oral route with high bioavailability
• Metabolism: Hepatic conversion to active hydroxylated derivatives
• Excretion: Primarily renal elimination of metabolites
• Prescription status: Schedule-controlled medication

Benefits

• Effectively reduces tumor growth by blocking androgen receptor signaling
• Delays disease progression in metastatic prostate cancer when combined with LHRH agonists
• Helps maintain quality of life by controlling cancer-related symptoms
• Provides oral administration convenience compared to injectable alternatives
• Demonstrates predictable pharmacokinetics for consistent dosing regimens
• Supported by decades of clinical evidence in oncological practice

Common use

Eulexin is primarily prescribed as part of combined androgen blockade therapy for patients with metastatic prostate cancer (stage D2). It is administered concomitantly with an LHRH agonist such as leuprolide or goserelin to achieve complete androgen suppression. The medication is typically initiated upon diagnosis of metastatic disease and continued throughout treatment unless disease progression or intolerable toxicity occurs. Clinical guidelines recommend its use in hormone-sensitive prostate cancer cases where comprehensive androgen deprivation is medically indicated.

Dosage and direction

The standard 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 simultaneously with an LHRH agonist, with the first dose of flutamide preceding the first LHRH agonist dose by 24 hours to prevent disease flare. Tablets should be swallowed whole with water, with or without food, though consistent administration relative to meals is recommended for stable pharmacokinetics. Treatment duration continues until disease progression or unacceptable toxicity, as determined by ongoing oncological assessment.

Precautions

Regular monitoring of liver function tests (ALT, AST, bilirubin) is mandatory, particularly during the first four months of therapy, due to risk of hepatotoxicity. Patients should be advised to report any symptoms suggesting liver injury, including nausea, vomiting, abdominal pain, fatigue, anorexia, “flu-like” symptoms, dark urine, or jaundice. Blood counts should be monitored periodically as anemia may occur. Caution is advised in patients with glucose-6-phosphate dehydrogenase deficiency due to risk of methemoglobinemia, hemolytic anemia, and cholestatic jaundice. Patients should avoid alcohol consumption during therapy due to potential additive hepatic effects.

Contraindications

Eulexin is contraindicated in patients with known hypersensitivity to flutamide or any component of the formulation. It must not be administered to patients with severe hepatic impairment (Child-Pugh Class C). The medication is contraindicated in women, particularly during pregnancy or breastfeeding, due to potential teratogenic effects and lack of established safety profile. It should not be used in pediatric patients as safety and effectiveness have not been established in this population.

Possible side effects

Common adverse reactions (≥10%) include hot flashes (61%), loss of libido (36%), impotence (33%), diarrhea (12%), nausea and vomiting (11%), and gynecomastia (9%). Less frequent but clinically significant effects include hepatic toxicity (elevated transaminases in 6-8%, clinical hepatitis in 1-2%), hematological changes (anemia, leukopenia), cardiovascular effects (hypertension, edema), and dermatological reactions (rash, photosensitivity). Rare but serious adverse events include liver failure, methemoglobinemia, and thrombocytopenia. Most side effects are dose-dependent and may require dosage adjustment or discontinuation.

Drug interaction

Eulexin demonstrates significant interactions with warfarin and other vitamin K antagonists, potentiating anticoagulant effect and requiring frequent INR monitoring and warfarin dose reduction. Concurrent use with other hepatotoxic agents (including acetaminophen, statins, and certain antifungals) may increase risk of liver injury. It may alter metabolism of drugs processed by CYP1A2, CYP2C19, and CYP3A4 enzymes. Concomitant administration with LHRH agonists represents a therapeutic synergy rather than adverse interaction. Caution is advised with medications that prolong QT interval due to potential additive effects.

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 androgen blockade, so patients should be counseled on adherence strategies and the importance of maintaining the 8-hour dosing interval when possible.

Overdose

There is limited experience with Eulexin overdose. Symptoms may include exaggerated pharmacological effects (increased hot flashes, gastrointestinal distress) and signs of hepatotoxicity. In case of suspected overdose, gastric lavage or activated charcoal administration may be considered if presentation is early. Supportive care should be instituted with particular attention to monitoring liver function and providing symptomatic treatment. There is no specific antidote for flutamide overdose. Dialysis is unlikely to be effective due to high protein binding and extensive metabolism.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in the original container with the lid tightly closed. Protect from light and moisture. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Do not transfer tablets to other containers as this may affect stability. Proper disposal of unused medication should follow local regulations for pharmaceutical waste.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Treatment decisions must be made by qualified healthcare professionals based on individual patient characteristics and current clinical guidelines. The prescribing physician should be consulted for specific recommendations tailored to the patient’s condition. Actual product characteristics and prescribing information may vary by region and manufacturer.

Reviews

Clinical studies demonstrate that Eulexin in combination with LHRH agonists significantly improves progression-free survival and overall response rates compared to monotherapy in metastatic prostate cancer. The combination shows particular efficacy in patients with minimal disease burden. Many oncologists report satisfactory tolerance profiles, though hepatic monitoring remains crucial. Patient-reported outcomes indicate effective symptom control despite expected androgen deprivation effects. Long-term follow-up data support its role in comprehensive prostate cancer management protocols.