My experience with Bicalutamide was not great…

Anecdotal First Hand Experience

I had such high hopes for Bicalutamide that I switched doctors primarily to give it a try, because my prior doctor was unwilling. There are no clinical guidelines for safety, so I came up with my own:

• 1x 50mg
• Wait 48 hours for any adverse reaction
• 1x 50mg
• Wait 48 hours for any adverse reaction
• 1x 50mg every day
• Liver/Cholesterol labs after 30 days

I was looking out for any signs of liver toxicity: swelling or tenderness of the liver or signs of hepatitis.

Something I wasn’t looking out for so much were other more common side effects:

1. Bicalutamide Side Effects

https://medlineplus.gov/druginfo/meds/a697047.html

• hot flashes or flushing
• bone, back, or pelvic pain
• muscle weakness
• muscle or joint pain
• headache
• shortness of breath
• increased blood pressure
• swelling of the hands, feet, ankles, or lower legs
• cough
• constipation
• nausea
• vomiting
• abdominal pain
• diarrhea
• gas
• change in weight (loss or gain)
• loss of appetite
• dizziness
• pain, burning, or tingling in the hands or feet
• difficulty sleeping
• feeling of uneasiness or dread
• rash
• sweating
• inability to get or keep an erection
• need to urinate frequently during the night
• bloody urine
• painful or difficult urination
• frequent and urgent need to urinate
• difficulty emptying bladder
• painful or swollen breasts

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• yellowing of the skin or eyes
• pain in the upper right part of the stomach
• extreme tiredness
• unusual bleeding or bruising
• lack of energy
• upset stomach
• loss of appetite
• flu-like symptoms
• dull or sharp side pain
• chest pain

The bold items above are side effects I experienced. In addition the deal breaker side effects I experienced were:

• heart palpitations (“big” beats, skipped beats)
• pounding in ears
• ringing in ears
• lowered blood pressure
• sudden drops in blood pressure, such as while trying to sleep
• waking up suddenly gasping for breath with an adrenaline rush
• body aching all over the day after a dose

I’m fairly confident if I continued taking Bicalutamide regularly it could actually kill me. I realize most people taking Bicalutamide don’t have such serious side effects, and honestly I’m surprised my reaction was so extreme. I really expected it to be compatible with my physiology and was expecting no problems.

It has taken me 1 week and a total of 5x 50mg doses to call it quits on Bicalutamide. I was getting some great breast development and I think I could attribute some of that to Bicalutamide. I’m actually writing this after a very bad night of not being able to sleep and crossing my fingers my liver will process the Bicalutamide over the next 5 days without me having to go to the hospital during this spike in Coronavirus cases.

My chest is very uncomfortable and my breathing is shallow and slightly labored with body aches all over and some tenderness in the upper right stomach area. I have been feeling like I am sick every day I have taken a dose (checked temperature – no fever, and passed in roughly 24 hours each time), but it seemed so unlikely I would have any dramatic reaction that I just figured my body would adjust or it might be in my head. Unfortunately the pattern was consistent with each dose.

On Spironolactone I had zombie brain and the low blood pressure and diuretic effect was a deal breaker. I was wearing a hat for a couple of hours the day I tried Spironolactone and the impression on my forehead was still there over 12 hours later, and the skin above my knees became “pruned”. Clearly my body is not so great dealing with diuretics and my dose was only 50mg.

On Finasteride I was so stimulated that I was doing 500 calorie cardio workouts every day and still couldn’t sleep from insomnia, so I had to quit it. It was also acting like Adderall to my ADHD brain so strongly that I skipped Ritalin while on it (even though I am not a fan of the Adderall-like effect).

On Bicalutamide along with all the dangerous side effects I experienced, I was also extremely horny. One day I had sex twice, 8 hours apart; then masturbated another 3 times within the same 24 hour window.

Apparently I just don’t tolerate antiandrogens very well. Thankfully I don’t especially need antiandrogens based on my serum Testosterone / DHT levels; however, I’ve noticed additional useful effects while on them despite low serum androgen levels; such as increased breast development and better fat distribution.

I plan to give Dutasteride a try in a week or two and see how it treats me… assuming I bounce back from the tail of Bicalutamide without any serious consequences. The main thing I’ve been trying to reduce is DHT to help with hair recovery; but also on Finasteride my facial fat filled in very well along with restarting breast development.

Summary

I am by no means trying to dissuade anyone from giving Bicalutamide a try… or Spironolactone, or Finasteride. Unfortunately I am very neurologically hypersensitive, and by that I’m not talking about brain, but actually neurological function on various medications throughout my body. For example on SNRI medication I had such extreme and constant pain all over my body, I just held myself while shivering with pain until it wore off. That happened from a single dose.

On Bicalutamide I have some similar constant pain all over my body, but the level is not nearly as bad as it was on Cymbalta (SNRI); which ironically is found to help with chronic pain. I am just not wired typically for some reason. This is not to say my pain threshold is low – it’s actually very high. I have stitched myself up and pulled my own teeth in a pinch, and things that cause most people intolerable pain I am often insensitive to. I just react strangely to certain types of medications. At this point I feel fairly confident liver metabolism is related to my pain reaction to certain medications.

I hope this post about my own experiences helps others know what to look out for and perhaps gradually increase their Bicalutamide dosage safely while looking out for adverse effects to avoid a more serious medical situation that may be life threatening. There are few formal recorded cases of mortality on Bicalutamide; however, that may not reflect cases that are not monitored or filed formally which may have correlation with Bicalutamide.

Update 48 Hours from Final Dose

Palpitations are gone, which is great. I was able to sleep last night. Urine color is good, but still discomfort in upper right quadrant which may indicate swelling. Slight discomfort when applying pressure to upper right quadrant, but not painful. Still unspecific pain in abdomen / upper right quadrant / right side. Nausea is much worse unfortunately, but bowel movements are daily and on schedule. Excretion of Bicalutamide is 60/40 for feces/urine. Overall indication is not any major hepatic impairment, so it’s just a matter of riding out the tail of Bicalutamide for another 72 hours.

Update 2 Weeks from Final Dose

Still kicking! I recovered fully in about a week from the side effects. I did start Dutasteride recently and other than feeling more tired than usual from it, I seem to be tolerating it better than Bicalutamide. I believe Dutasteride has also helped with breast development by helping prevent signaling of DHT generated from DHEA directly in localized tissues (theory based on self observations and correspondingly typical DHT levels for serum testosterone; 3.3 ng/dl; so impact should be minimal and is instead noticeable for development of certain tissues)