Estramustine

Estramustine is a prescription medication used for palliative treatment of metastatic and/or progressive prostate carcinoma.

• Estramustine is available under the following different brand names: Emcyt

Common side effects of Estramustine include:

• nausea
• vomiting
• loss of appetite
• diarrhea
• upset stomach
• weakness
• tiredness
• male breast swelling or tenderness
• flushing
• headache
• leg cramps
• decreased sexual interest
• impotence
• elevated blood pressure

Serious side effects of Estramustine include:

• cardiac arrest
• congestive heart failure
• pulmonary emboli
• thrombosis

Rare side effects of Estramustine include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, coordination loss, unsteady, very stiff muscles, high fever, profuse sweating, or tremors
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, light-headedness, or passing out

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and geriatric dosage

Capsule

• 140 mg

Prostate Carcinoma

Adult and geriatric dosage

• 14 mg/kg divided every 6-8 hours orally
• Treat for 30-90 days to determine benefits of continued therapy; continue treatment as long as favorable response lasts

Dosage Considerations – Should be Given as Follows:

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, healthcare provider, or pharmacist first.

• Estramustine has severe interactions with no other drugs
• Estramustine has serious interactions with the following drugs:
  • deferiprone
  • palifermin
  • ropeginterferon alfa 2b
• Estramustine has moderate interactions with the following drugs:
  • acalabrutinib
  • calcium acetate
  • calcium carbonate
  • calcium chloride
  • calcium citrate
  • calcium gluconate
  • food
  • hydroxyurea
  • ofatumumab SC
  • siponimod
  • trastuzumab
  • trastuzumab deruxtecan
• Estramustine has minor interactions with no other drugs

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, health questions, or concerns.

Contraindications

• Hypersensitivity to estradiol or nitrogen mustard
• Active thrombophlebitis or thromboembolic disorder, except when tumor mass is the cause of thromboembolic phenomenon and benefits of therapy outweigh risk

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Estramustine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Estramustine?”

Cautions

• Increased risk of thrombosis, including fatal and non-fatal myocardial infarction
• Liver dysfunction, metabolic bone disease associated with hypercalcemia, renal insufficiency
• History of thromoboembolic phenomenon especially associated with estrogen therapy
• Decreased glucose tolerance-monitor diabetics
• Risk of HTN-monitor blood pressure periodically
• May cause fluid retention with exacerbation of congestive heart failure (CHF), peripheral edema, or conditions influenced by fluid retention, such as epilepsy, migraine, renal dysfunction
• May cause gynecomastia and impotence
• Allergic reactions, including angioedema of airway has been reported
• Avoid becoming pregnant

Pregnancy and Lactation

• Do not use in pregnancy
• Lactation
  • Not intended for use in women