What is this medication?

ESTRAMUSTINE (ES tra MUS teen) is a chemotherapy drug. It slows the growth of cancer cells. This medicine is used to treat prostate cancer.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Emcyt

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

•blood disorders

•diabetes

•heart disease

•infection (especially a virus infection such as chickenpox, cold sores, or herpes)

•kidney disease

•migraine

•seizures

•an unusual or allergic reaction to estramustine, estrogens, other chemotherapy, other medicines, foods, dyes, or preservatives

•pregnant or trying to get pregnant

•breast-feeding

How should I use this medication?

Take this medicine by mouth with a glass of water. Take this medicine on an empty stomach, at least 1 hour before or 2 hours after food. Do not take with food. Do not take with milk or other calcium-rich food or drink. Follow the directions on the prescription label. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on your doctor's advice.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medicine with any of the following medications:

•nalidixic acid

This medicine may also interact with the following medications:

•calcium supplements

•medicines to increase blood counts like filgrastim, pegfilgrastim, sargramostim

•vaccines

Talk to your doctor or health care professional before taking any of these medicines:

•acetaminophen

•aspirin

•ibuprofen

•ketoprofen

•naproxen

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your doctor for checks on your progress. This drug may make you feel generally unwell. This is not uncommon, as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your doctor tells you to stop.

In some cases, you may be given additional medicines to help with side effects. Follow all directions for their use.

Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.

This medicine may increase your risk to bruise or bleed. Call your doctor or health care professional if you notice any unusual bleeding.

Be careful brushing and flossing your teeth or using a toothpick because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving this medicine.

Avoid taking products that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your doctor. These medicines may hide a fever.

Both men and women must use effective birth control methods to prevent pregnancy while taking this medicine. Do not become pregnant while taking this medicine. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Women, do not breast-feed an infant while taking this medicine.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care professional as soon as possible:

•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

•signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine

•signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine

•breathing problems

•changes in vision

•chest pain

•high blood pressure

•pain, swelling, warmth in the leg

•swelling of the ankles, feet, hands

•trouble with balance, talking, walking

•vomiting

•weight gain

•yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

•breast enlargement in both males and females

•change in sex drive or performance

•diarrhea

•dry skin

•loss of appetite

•nausea

•stomach upset

•trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children.

Store in the refrigerator between 2 and 8 degrees C (36 and 46 degrees F). Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.