Adult Dosing

Palliative treatment of metastatic or progressive cancer of the prostate

• Recommended dose: 14 mg/kg of body weight PO divided tid-qid
• Alt: 10-16 mg/kg/day PO divided tid-qid
• Dose should be taken 1 hour before or 2 hours after meals

Note:

• Avoid using dairy products and calcium-rich foods or drugs, simultaneously with estramustine

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Palliative treatment of metastatic and progressive cancer of prostate

• Hypersensitivity to any of the ingredients of the product
• Hypersensitivity to estradiol
• Hypersensitivity to nitrogen mustards
• Active thromboembolism

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined; use with caution

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined; use with caution

• Increased risk of thrombosis, including fatal and nonfatal MI has been reported in men receiving estramustine for prostatic cancer. Use estramustine cautiously in patients with a history of thrombophlebitis, thromboembolic disorders, and in cerebral vascular or coronary artery disease
• Closely monitor diabetic patients, as glucose tolerance may decrease while receiving estramustine
• Hypertension has been reported with the use of estramustine. Monitor blood pressure periodically while on treatment.
• Worsening of preexisting or incipient peripheral edema, and congestive heart disease, has occurred in some patients receiving this therapy. Conditions such as epilepsy, migraine, or renal dysfunction require careful observation
• Use estramustine cautiously in patients with metabolic bone diseases associated with hypercalcemia, and in patients with renal impairment
• Risk for hypocalcemia may increase in patients with prostate cancer and osteoblastic metastases; closely monitor calcium levels in such patients
• Allergic reactions and angioedema have been reported with estramustine
• Estramustine may affect endocrine and liver function tests, and depress testosterone levels
• Hepatic enzyme and bilirubin abnormalities have been reported in patients receiving estramustine. Perform such tests during therapy and repeat after the drug has been withdrawn for two months

Cautions: Use cautiously in

• Renal impairment
• Hepatic impairment
• Thromboembolic disorders
• CAD
• Metabolic bone diseases associated with hypercalcemia
• Cardiovascular disorder

Pregnancy Category:D

Breastfeeding: Safety unknown

• CV: MI, CHF, edema, stroke
• CNS: Cerebrovascular accident
• GI: Nausea, diarrhea, minor gastrointestinal upset, anorexia, flatulence
• GU: Breast tenderness, breast enlargement
• HEMA: Thrombophlebitis
• DERM: Pruritus, dry skin, easy bruising
• RESP: Pulmonary emboli, dyspnea
• REPRODUCTIVE: libido changes
• MUSC: Leg cramps
• LABTESTS: Leukopenia, bilirubin, SGOT, LDH, abnormal LFTs
• MISC: Lethargy alone, emotional lability, insomnia

• Nitrogen mustard; undergoes conversion to active compounds; interferes with DNA replication and RNA transcription, ultimately disrupts protein synthesis
• Metabolized by liver; CYP450: Unknown
• Excreted in bile, feces and urine
• Half-life: 20 hrs

US Trade Name(s)

• Emcyt

US Availability

Emcyt

• CAPS: 140 mg

Canadian Trade Name(s)

• Emcyt

Canadian Availability

Emcyt

• CAPS: 140 mg

UK Trade Name(s)

• Estracyt

UK Availability

Estracyt

• CAPS: 140 mg

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Hematology/Oncology

Antineoplastics

Alkylating Agents

Pricing data from www.DrugStore.com in U.S.A.

• Emcyt 140 MG CAPS [Bottle] (PFIZER U.S.)
  150 mg = $1009.97
  450 mg = $2931.81

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

Drug Name: Emcyt 140 MG Oral Capsule

Ingredient(s): Estramustine

Imprint: PHARMACIA;AND;UPJOHN;EMCYT;140MG

Color(s): White

Shape: Capsule

Size (mm): 19.00

Score: 1

Inactive Ingredient(s): magnesium stearate / silicon dioxide / sodium lauryl sulfate / talc / titanium dioxide

Drug Label Author:
Pharmacia and Upjohn Company

DEA Schedule:
Non-Scheduled