Why is this medication prescribed?

Estramustine is a medication primarily prescribed to treat prostate cancer. It is a combination of estradiol (an estrogen hormone) and nitrogen mustard, a chemotherapy drug. Estradiol works by suppressing the production of testosterone, which can stimulate the growth of prostate cancer cells. Nitrogen mustard is a type of alkylating agent that damages the DNA of cancer cells, preventing them from multiplying.

Estramustine is typically used when prostate cancer has spread to other parts of the body and is not responsive to other treatments. It can also be used in combination with other medications or therapies as part of a comprehensive treatment plan.

How should this medicine be used?

The dosage and administration of Estramustine can vary depending on factors such as the patient’s overall health, the severity of the cancer, and other treatments being used. It is usually taken orally in the form of capsules. It’s important to follow the dosage instructions provided by a healthcare professional and not to exceed the prescribed amount.

Common dosing schedules might involve taking the medication multiple times a day with or without food. It’s crucial to take Estramustine exactly as prescribed, at the same times each day, to maintain consistent levels of the drug in the body.

Since Estramustine is a chemotherapy medication, it can cause side effects such as nausea, vomiting, diarrhea, loss of appetite, fatigue, and changes in blood counts. Patients should report any severe or persistent side effects to their healthcare provider.

As with any medication, it’s essential for patients to discuss potential benefits and risks with their healthcare provider before starting Estramustine and to follow their instructions closely throughout the course of treatment.

Other uses for this medicine

In addition to its primary use in treating prostate cancer, Estramustine may also be prescribed for other conditions, although such uses are less common and typically off-label. Some off-label uses might include the treatment of breast cancer, endometrial cancer, or certain types of lymphoma. However, the efficacy and safety of Estramustine for these conditions may not be well-established, and its use should be guided by a healthcare professional’s recommendation.

What special precautions should I follow?

Special precautions should be observed when using Estramustine, including:

• Pregnancy and breastfeeding: Estramustine should not be used during pregnancy, as it can harm the unborn baby. It is also not recommended for use while breastfeeding, as it may pass into breast milk and harm the nursing infant.
• Pre-existing medical conditions: Individuals with certain medical conditions such as liver disease, cardiovascular disease, or a history of blood clots should use Estramustine with caution or avoid it altogether. It’s crucial to discuss any existing medical conditions with a healthcare provider before starting treatment.
• Blood clotting disorders: Estramustine can increase the risk of blood clots, so it should be used cautiously in individuals with a history of blood clots or clotting disorders.
• Monitoring: Regular monitoring of blood counts and liver function may be necessary during treatment with Estramustine to check for any potential side effects or complications.
• Interactions with other medications: Estramustine can interact with other medications, including blood thinners, certain antibiotics, and medications that affect liver function. Patients should inform their healthcare provider about all medications, supplements, and herbal products they are taking before starting Estramustine.
• Allergic reactions: Individuals with a known allergy to estradiol, nitrogen mustard, or any other ingredients in Estramustine should not use this medication.
• Driving and operating machinery: Estramustine may cause dizziness or drowsiness in some individuals. It’s important to avoid driving or operating machinery until you know how Estramustine affects you.

As always, it’s essential to follow your healthcare provider’s instructions closely and to report any unusual symptoms or side effects while taking Estramustine. They can provide guidance on the safest and most effective use of the medication based on your individual circumstances.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Estramustine. However, it’s essential to maintain a balanced and nutritious diet to support overall health and well-being during cancer treatment. Your healthcare provider may recommend dietary modifications based on your individual needs and any side effects you experience.

What should I do if I forget a dose?

If you forget to take a dose of Estramustine at the scheduled time, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you’re unsure about what to do, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Estramustine, like many medications, can cause side effects, ranging from mild to severe. Not everyone will experience these side effects, and their severity can vary from person to person. Common side effects of Estramustine may include:

• Nausea and vomiting: These are among the most common side effects of Estramustine. Your healthcare provider may prescribe medications to help manage these symptoms.
• Diarrhea or constipation: Changes in bowel habits are possible while taking Estramustine.
• Loss of appetite: Some individuals may experience a decreased desire to eat while on this medication.
• Fatigue: Feeling tired or lacking energy is a common side effect of many chemotherapy medications, including Estramustine.
• Fluid retention: Estramustine may cause fluid retention, leading to swelling in the legs, ankles, or other parts of the body.
• Hot flashes: Some men may experience hot flashes while taking Estramustine, similar to those experienced by women during menopause.
• Breast enlargement or tenderness: This side effect is due to the estrogen component of Estramustine and may occur in some men.
• Changes in liver function tests: Estramustine can affect liver function, leading to changes in liver enzyme levels detected in blood tests.
• Decreased libido: Some individuals may experience a decrease in sexual desire while taking Estramustine.
• Bone marrow suppression: Estramustine may decrease the production of blood cells in the bone marrow, leading to an increased risk of anemia, thrombocytopenia (low platelet count), and leukopenia (low white blood cell count).
• Increased risk of blood clots: Estramustine can increase the risk of blood clots, particularly in individuals with pre-existing clotting disorders or a history of blood clots.

It’s essential to report any side effects you experience while taking Estramustine to your healthcare provider. They can provide guidance on managing side effects and may adjust your treatment plan if necessary. In some cases, they may recommend additional medications or supportive care measures to help alleviate symptoms. If you experience severe or persistent side effects, seek medical attention promptly.

What should I know about storage and disposal of this medication?

Storage and Disposal:

• Storage: Store Estramustine capsules at room temperature away from light and moisture. Keep them out of reach of children and pets. Do not store medication in the bathroom, as moisture and heat can degrade the medication.
• Disposal: Dispose of unused or expired Estramustine capsules properly according to local regulations. Do not flush them down the toilet or pour them down the drain unless instructed to do so. Instead, consult your healthcare provider or pharmacist for guidance on proper disposal methods, such as using a drug take-back program or a medication disposal pouch.

In case of emergency/overdose

In case of an overdose of Estramustine, seek emergency medical attention or contact a poison control center immediately. Symptoms of an overdose may include severe nausea, vomiting, diarrhea, dizziness, confusion, difficulty breathing, or unconsciousness. It’s essential to take the medication exactly as prescribed to avoid the risk of overdose.

What other information should I know?

• Inform all healthcare providers involved in your care that you are taking Estramustine, including your doctors, dentists, and pharmacists.
• Attend all scheduled appointments for monitoring and blood tests as recommended by your healthcare provider.
• Avoid grapefruit and grapefruit juice while taking Estramustine, as they may interact with the medication and increase the risk of side effects.
• Use effective contraception to prevent pregnancy while taking Estramustine, as it can harm the unborn baby.
• If you plan to undergo surgery or dental procedures, inform your healthcare provider that you are taking Estramustine.
• Keep a list of all medications you are taking, including prescription drugs, over-the-counter medications, supplements, and herbal products, and share it with your healthcare provider to prevent potential drug interactions.

Following these guidelines can help ensure the safe and effective use of Estramustine and minimize the risk of complications. If you have any questions or concerns about your medication, don’t hesitate to consult your healthcare provider or pharmacist for guidance.