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Estramustine (Generic Name)

UPMC Content 2

About This Drug

Estramustine is used to treat prostate cancer. This drug is given by mouth.

Possible Side Effects (More Common)

  • Loose bowel movements (diarrhea) that may last for a few days
  • Trouble catching your breath
  • Trouble breathing when lying flat
  • Ankle swelling
  • Breast pain and/or tenderness
  • Changes in sexual function

Possible Side Effects (Less Common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets.  This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Mild nausea and throwing up (vomiting). Drugs are available to lessen these side effects.
  • Thinning hair. You may notice your hair thinning several days after getting this drug. Usually hair loss is temporary; your hair should grow back when treatment is completed.
  • Skin and tissue irritation
  • Raised, red rash on your arms, legs, back, or chest
  • Dry skin
  • Headache
  • Feeling very drowsy
  • Watery eyes
  • Trouble sleeping
  • Decreased appetite
  • Rectal gas
  • Pain or cramping in the groin or leg, especially the calf
  • Chest pain
  • Peeling of skin on fingertips
  • Night sweats
  • Fever
  • This drug may weaken the heart and decrease heart function. Your heart function will be checked as needed.

Allergic Reactions

Allergic reactions including anaphylaxis are rare but may happen in some patients. Signs of allergic reactions to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way.  If this happens, do not take another dose of this drug.  You should get urgent medical treatment.

Treating Side Effects

  • Ask your doctor or nurse about medicine to help stop or lessen nausea and throwing up (vomiting).
  • Drink 6-8 cups of fluids every day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated( lack water in the body due to losing too much fluid)
  • If you get a rash, do not put anything on the rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
  • Be careful when cooking, walking, and handling sharp objects and hot liquids.

Food and Drug Interactions

  • Take estramustine one hour before a meal or two hours after a meal on an empty stomach.  Avoid taking estramustine with milk, milk products, foods high in calcium, or antacids.
  • This drug may interact with other medicines. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.
  • Missed dose: if you miss a dose, take it as soon as you remember.  Do not take it if it is close (within 12 hours) to your next dose.  Just take the next dose at your regular time.  Do not take more than 1 dose at a time.

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Easy bruising or bleeding
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
  • Blurred vision or other changes in eyesight
  • Pain when passing urine; blood in urine
  • Pain in your lower back or side
  • Confusion or agitation
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause.  If you have any of these symptoms for 2 minutes, call 911. 
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin.

Call your doctor or nurse as soon as possible if any of these symptoms happen:

  • Change in hearing, ringing in the ears
  • Decreased urine
  • Unusual thirst or passing urine often
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea that is not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Heavy menstrual period that lasts longer than normal
  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Headache that does not go away
  • Painful, red, or swollen areas on your hands or feet.
  • No bowel movement for 3 days or you feel uncomfortable
  • Extreme weakness that interferes with normal activities

Sexual Problems and Reproductive Concerns

  • Estramustine is not indicated for use in women.
  • This drug may temporarily or permanently affect your ability to have children. This cannot be determined before your treatment. In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. 
  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment for male patients with partners of childbearing potential.

Revised July 2014