ESTRAMUSTINE

It is an antineoplastic agent. It is a chemical compound of oestradiol and nitrogen mustard. It is effective in the treatment of advanced prostatic carcinoma.

Indications

Carcinoma of the prostate, especially in cases unresponsive to, or relapsing after, treatment by conventional oestrogens (stilboestrol, polyoestradiol phosphate etc.) or by orchidectomy.

Dosage

Adult and the elderly patients : The recommended daily dose for Estramustine cap is 14mg per kg of body weight (i.e., one 140mg capsule for each 10 kg or 22 lb of body weight), given in 3 or 4 divided doses. Children : Estramustine should not be administered to children.

Contra-Indications

The use of Estramustine is contraindicated in patients with peptic ulceration, or those with severe liver dysfuction or myocardial insufficiency, use in children & in patients hypersensitive to oestradiol or nitrogen mustard.

Special Precautions

Use with caution in patients with moderate to severe bone marrow depression, thrombophlebitis, thrombosis, thromboembolic disorders, cardiovascular disease,coronary artery disease and congestive heart failure. Caution should also be exercised in patients with diabetes, hypertension, epilepsy, hepatic and renal impairment and disease associated with hypercalcaemia. Blood counts, liver function tests and serum calcium in hypercalcaemia should be performed at regular intervals. Patients with prost

Side Effects

The most common adverse effects include gynoecomastia and impotence, nausea/vomiting and fluid retention/oedema. The most serious reactions are thromboembolism, ischaemic heart disease, congestive heart failure and rarely, angioneurotic oedema.

Drug Interactions

Milk, milk products or drug containing calcium may impair the absorption of Estramustine and should not be taken simultaneously with Estramustine. An interaction between Estramustine and ACE-inhibitors, possibly leading to an increased risk of angioneurotic oedema cannot be excluded.