Estramustine adverse effects

ESTRAMUSTINE H2 RECEPTOR BLOCKERS-CIMETIDINE t adverse effects of alkylating agent, e.g. myelosuppression Additive toxicity Monitor more closely monitor FBC regularly... 

CIMETIDINE BUSULFAN, CARMUSTINE, CHLORAMBUCIL CYCLOPHOSPHAMIDE, ESTRAMUSTINE, IFOS-FAMIDE, LOMUSTINE, THIOTEPA, TREOSULFAN T adverse effects of cytotoxic, e.g. myelosuppression Additive toxicity. Possible minor inhibition of cyclophosphamide metabolism via CYP2C9 Monitor more closely monitor FBC regularly. Avoid co-administration of cimetidine with cyclophosphamide... 

Gynecomastia severe enough to necessitate withdrawal of therapy was the main adverse effect of estramustine 560 mg/day for more than 1 year in prostatic carcinoma (15). 

In 57 patients with advanced prostate cancer resistant to first-line hormonal therapy treated with estramustine and clodronate, the main adverse effect was nausea (33). Therapeutic efficacy was small. Reasons for premature withdrawal of clodronate in one study included refusal to continue treatment (five patients) and progressive disease of the bone (four patients) (34). One patient refused to take clodronate from the start seven discontinued clodronate after a median of 13 (range 0.2-23) months because of adverse events. In five patients the cause was nausea, combined with vomiting in four and diarrhea in one. After 0.9, 1.0, and 1.3 months the dosage of clodronate was reduced to 800mg/day in three patients (one had nausea, another dyspepsia, and a third had uncharacteristic sensations in the skeleton). 

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