Estramustine

Estramustine is used to treat metastatic or progressive prostate cancer.

Estramustine may also be used for reasons not mentioned in this medication guide.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Take estramustine on an empty stomach, at least 1 hour before or 2 hours after a meal.

Take estramustine with water, not with milk or other dairy products.

Estramustine doses are based on weight (especially in children and teenagers). Your dose needs may change if you gain or lose weight.

It may take up to 90 days before you receive the full benefit of taking estramustine. Your doctor will determine how long to treat you.

You may need frequent blood tests. Your blood pressure will also need to be checked often.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using estramustine.

Store in the refrigerator, do not freeze.

You should not use estramustine if you have a blood clot, swelling of a vein caused by a blood clot, or if you have ever had an allergic reaction to estradiol or nitrogen mustard.

You should not use estramustine if you are allergic to estradiol or nitrogen mustard.

You may not be able to use this medicine if you have a blood clot or swelling of a vein caused by a blood clot.

Tell your doctor if you have ever had:

• a blood clot, stroke, or heart attack;
• diabetes;
• high blood pressure (hypertension);
• heart disease or coronary artery disease (atherosclerosis);
• congestive heart failure;
• migraine headaches;
• epilepsy or other seizure disorder;
• low or high levels of calcium in your blood;
• liver disease;
• kidney disease; or
• a bone disorder such as osteoporosis or Paget's disease.

If a man fathers a baby while using estramustine, the baby may have birth defects. Use condoms to prevent pregnancy during your treatment. Ask your doctor how long you should continue using condoms after you stop taking estramustine.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Estramustine may cause serious side effects. Stop using estramustine and call your doctor right away if you have:

• heart problems--shortness of breath (even with mild exertion), swelling, rapid weight gain, chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
• signs of a stroke--sudden numbness or weakness (especially on one side of the body), severe headache, slurred speech, balance problems;
• signs of a blood clot in the lung--chest pain, sudden cough, wheezing, rapid breathing, coughing up blood; or
• signs of a blood clot deep in the body--swelling, warmth, or redness in an arm or leg.

Common side effects of estramustine may include:

• breast swelling or tenderness;
• impotence;
• nausea, diarrhea, upset stomach;
• swelling, trouble breathing;
• leg cramps; or
• abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Prostate Cancer:

14 mg/kg/day orally in 3 or 4 divided dosesDuration of Therapy: Continue therapy as long as there is a favorable patient response; some patients have been maintained on therapy for more than 3 years.Comments: -Patients should receive this drug for 30 to 90 days before the treating physician determines the possible benefits of continued therapy.-Most patients have been treated at 10 to 16 mg/kg/day.Use: Palliative treatment of patients with metastatic and/or progressive carcinoma of the prostate.

Take the medicine as soon as possible, but skip the missed dose if it is close to the time for your next dose. Do not take two doses at once.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Do not take estramustine with milk, milk products, calcium supplements, or calcium-rich foods such as ice cream, yogurt, broccoli, and others.

Avoid using antacids or vitamin/mineral supplements that contain calcium. Calcium can make it harder for your body to absorb estramustine.

Other drugs may affect estramustine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all the medicines you are currently taking and any medicine you start or stop using.