Estramustine - Oral

Estramustine is used to treat cancer of the prostate gland.

Take Estramustine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Take it on an empty stomach, at least 1 hour before or 2 hours after a meal. Try to take it at the same time each day.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of treatment depending on your response to the medication.

Estramustine must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Do not take Estramustine if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine, estradiol, or other similar type of medicines known as nitrogen mustards.

Alert your doctor if you have the following conditions:

• current blood clotting disorders e.g. thrombophlebitis (inflammation of the vein caused by a blood clot)
• severe heart disease
• peptic ulcer (open sores in the lining of the stomach, small intestine, or lower food pipe)
• severe liver disease

as Estramustine may not be suitable for you.

Men should not father a child while being treated with this medicine. Men must use proven birth control methods during Estramustine therapy. You may wish to discuss reliable methods of birth control with your doctor.

Inform your doctor if you have the following conditions:

• history of thrombophlebitis or other blood clotting disorders
• cerebrovascular disease (disease of the blood vessels supplying the brain)
• heart problems e.g. coronary artery disease (narrowing of the blood vessels of the heart), heart failure (weakness and inability of the heart to pump blood)
• high blood pressure
• epilepsy (fits or seizures)
• high calcium level in the blood
• diabetes
• mild to moderate liver disease
• kidney disease

Estramustine is not indicated for use in women.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. liver function, blood calcium or sugar levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
• Regular monitoring for signs of allergic reaction may also be needed.

Estramustine may cause any of the following side effects: headache, diarrhoea, upset stomach, nausea, tiredness, enlarged breasts, breast pain or discomfort, and difficulty sleeping.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• signs and symptoms of allergic reactions e.g. rashes, breathlessness, swelling of the eyes, face, throat, and lips
• signs and symptoms of heart problems e.g. chest pain, tightness or pressure, pain that may spread to the arms, jaw, neck, shoulder or back, shortness of breath, lightheadedness
• signs and symptoms of blood clots e.g. chest pain, coughing up blood, swelling and tenderness in your leg accompanied by redness and warmth
• yellowing of the skin or eyes, abdominal pain, dark coloured urine
• swelling of the ankles, feet or hands, unusual rapid weight gain

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• certain medicines for depression
• medicines for high blood pressure
• medicines containing calcium, magnesium or aluminium e.g. antacids (medicines that neutralise stomach acids)

This list does not include all medicines that may interact with Estramustine.

Avoid vaccinations with live vaccines during treatment with this medicine. Alert your doctor if you have been recently vaccinated or if you are planning to get vaccinated.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Do not take Estramustine with dairy products such as milk, cheese, yoghurt, or ice cream. Dairy products may reduce the effectiveness of this medicine when taken at the same time. Take Estramustine at least 1 hour before or 2 hours after you have taken any dairy products.

Store in the refrigerator, between 2-8°C, away from the reach of children.

Available products of Estramustine may vary with its storage requirements. Ask your doctor or pharmacist on how to properly store this medicine.

Medicines must not be used past the expiry date.

As this is a cancer medicine, always return any unused or expired capsules to the clinic, hospital, or pharmacy for disposal. Do not throw it away in the household waste.