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yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK548158_"><span class="title" itemprop="name">Nilutamide</span></h1><p class="fm-aai"><a href="#_NBK548158_pubdet_">Publication Details</a></p></div></div><div class="body-content whole_rhythm" itemprop="text"><div id="Nilutamide.OVERVIEW"><h2 id="_Nilutamide_OVERVIEW_">OVERVIEW</h2><div id="Nilutamide.Introduction"><h3>Introduction</h3><p>Nilutamide is a first generation, oral nonsteroidal antiandrogen similar in structure to flutamide that is used in the therapy of prostate cancer. Nilutamide is associated with a low rate of serum aminotransferase elevations during therapy and with rare instances of clinically apparent, acute liver injury.</p></div><div id="Nilutamide.Background"><h3>Background</h3><p>Nilutamide (nye loo' ta mide) is an anilide nonsteroidal antiandrogen that blocks the binding of endogenous androgens to intracellular androgen receptors blocking their effects. Nilutamide has been shown to be effective in reducing pain and disease progression in metastatic prostate cancer when administered in conjunction with orchiectomy or other antiandrogen agents such as luteinizing hormone releasing hormone (LHRH) agonists. Nilutamide was approved for use in the United States in 1996. Current indications are limited to the therapy of metastatic prostate cancer in combination with orchiectomy. Nilutamide is available generically and under the trade name Nilandron in 150 mg tablets, and the typically recommended dose is 300 mg daily starting at the time of orchiectomy with reduction of the dose to 150 mg daily one month later. Nilutamide is not approved for nor recommended for use in hyperandrogenic states such as hirsutism or acne. Common side effects include dizziness, impaired vision, fatigue, nausea, anorexia and weight loss. An uncommon but potentially serious adverse event is interstitial pneumonitis that occurs in approximately 2% of treated patients and that can progress to respiratory failure and death.</p></div><div id="Nilutamide.Hepatotoxicity"><h3>Hepatotoxicity</h3><p>In large registration clinical trials, ALT elevations occurred in 8% (range 2% to 33%) of patients during nilutamide therapy. The elevations were usually mild, asymptomatic and transient, requiring drug discontinuation in only 1% of treated patients. In rare instances, clinically apparent acute liver injury has occurred during nilutamide therapy, but the number of published cases are few, and the agent appears to be less hepatotoxic than flutamide. Nevertheless, fatal cases have been reported (Case 1). In reported cases, the latency to onset averaged 2 to 4 months and the clinical pattern of enzyme elevations was typically hepatocellular, thus largely resembling flutamide induced liver injury. Signs of hypersensitivity and autoimmunity were not common.</p><p>Likelihood score: C (probable cause of clinically apparent liver injury).</p></div><div id="Nilutamide.Mechanism_of_Injury"><h3>Mechanism of Injury</h3><p>The mechanism of nilutamide hepatotoxicity is unknown, but toxic metabolites of the agent may induce oxidative stress or interfere with mitochondrial function.</p></div><div id="Nilutamide.Outcome_and_Management"><h3>Outcome and Management</h3><p>The mild ALT elevations during nilutamide therapy are usually self-limiting even with continuation of the medication. The rare instances of clinically apparent liver injury are usually self-limiting, but several fatal instances have been reported. Monitoring of liver tests is recommended before starting treatment and at regular intervals thereafter, particularly during the first 4 months of treatment and therapy stopped if symptoms, jaundice or marked serum aminotransferase elevations arise. Rechallenge should be avoided. Patients with nilutamide hepatotoxicity should probably not receive flutamide and be given bicalutamide with caution.</p><p>Drug Class: <a href="/books/n/livertox/AntineoplasticAgents/?report=reader">Antineoplastic Agents</a>, <a href="/books/n/livertox/Anti-androgens/?report=reader">Antiandrogens</a></p></div></div><div id="Nilutamide.CASE_REPORTS"><h2 id="_Nilutamide_CASE_REPORTS_">CASE REPORTS</h2><div id="Nilutamide.Case_1_Acute_liver_failure_fr"><h3>Case 1. Acute liver failure from nilutamide therapy.(<a class="bibr" href="#Nilutamide.REF.1" rid="Nilutamide.REF.1">1</a>)</h3><p>A 65 year old man with prostate cancer developed jaundice 8 weeks after starting nilutamide for prostate cancer. Nilutamide was stopped promptly, but he continued to worsen and developed mental confusion and was admitted to a hospital. On examination, he was markedly jaundiced and had stage 2 hepatic encephalopathy (asterixis and confusion). His past medical history was negative for liver disease and he had no risk factors for viral hepatitis and rarely drank alcohol. He had been diagnosed with prostate cancer and underwent orchiectomy 3 months previously and was treated postoperatively for 3 weeks with norfloxacin and prednisolone. Liver tests were reported to be normal before he was started on nilutamide (150 mg/day) and leuprolide (an LHRH analog: 3.75 mg intramuscularly each month). At the time that nilutamide was stopped 8 weeks later, serum bilirubin was 7.5 mg/dL, and it rose rapidly thereafter (Table). Tests for hepatitis A, B and C, EBV and CMV as well as for autoantibodies were negative. Abdominal ultrasound showed no evidence of biliary disease. He developed progressive mental obtundation, coagulopathy and, not being a candidate for emergency liver transplantation, died 16 days after onset of jaundice. Post mortem liver biopsy showed massive necrosis with minimal fibrosis.</p><div id="Nilutamide.Key_Points"><h4>Key Points</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figNilutamideTc"><a href="/books/NBK548158/table/Nilutamide.Tc/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figNilutamideTc" rid-ob="figobNilutamideTc"><img class="small-thumb" src="/books/NBK548158/table/Nilutamide.Tc/?report=thumb" src-large="/books/NBK548158/table/Nilutamide.Tc/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="Nilutamide.Tc"><a href="/books/NBK548158/table/Nilutamide.Tc/?report=objectonly" target="object" rid-ob="figobNilutamideTc">Table</a></h4></div></div></div><div id="Nilutamide.Laboratory_Values"><h4>Laboratory Values</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figNilutamideTd"><a href="/books/NBK548158/table/Nilutamide.Td/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figNilutamideTd" rid-ob="figobNilutamideTd"><img class="small-thumb" src="/books/NBK548158/table/Nilutamide.Td/?report=thumb" src-large="/books/NBK548158/table/Nilutamide.Td/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="Nilutamide.Td"><a href="/books/NBK548158/table/Nilutamide.Td/?report=objectonly" target="object" rid-ob="figobNilutamideTd">Table</a></h4></div></div></div><div id="Nilutamide.Comment"><h4>Comment</h4><p>Despite stopping nilutamide when jaundice was first identified, this patient developed progressive hepatic failure and died within weeks of onset of liver injury. The latency (2 months), pattern of serum enzyme elevations (markedly hepatocellular), and lack of other obvious causes for liver injury (viral hepatitis, alcoholism, biliary disease, ischemia) points strongly to the role of nilutamide. The overall clinical characteristics of nilutamide hepatotoxicity resemble those of flutamide, but clinically apparent liver disease appears to be less common.</p></div></div><div id="Nilutamide.Case_2_Interstitial_pneumonit"><h3>Case 2. Interstitial pneumonitis and mild elevations in serum enzymes during nilutamide therapy.(<a class="bibr" href="#Nilutamide.REF.2" rid="Nilutamide.REF.2">2</a>)</h3><p>A 69 year old man with prostate cancer developed shortness of breath and liver enzyme abnormalities 2 months after starting the combination of nilutamide and an luteinizing hormone releasing hormone (LHRH) analog. He had noticed progressive shortness of breath over the previous 4 weeks and was found to have tachypnea and abnormal chest x-ray findings suggestive of interstitial pneumonitis. Nilutamide was stopped. At the same time, blood test results showed mild elevations in ALT and alkaline phosphatase in comparison to pretreatment values. However, serum bilirubin levels were normal (Table). There was no eosinophilia and no signs of chronic liver disease or hepatic decompensation. Tests for viral hepatitis and autoantibodies were negative. A lung biopsy showed interstitial pneumonitis. In follow up, serum enzyme levels fell to pretreatment levels. He recovered slowly from the pulmonary complication. Flutamide was started after all test results returned to normal and was continued with no apparent toxic effects.</p><div id="Nilutamide.Key_Points_1"><h4>Key Points</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figNilutamideTe"><a href="/books/NBK548158/table/Nilutamide.Te/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figNilutamideTe" rid-ob="figobNilutamideTe"><img class="small-thumb" src="/books/NBK548158/table/Nilutamide.Te/?report=thumb" src-large="/books/NBK548158/table/Nilutamide.Te/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="Nilutamide.Te"><a href="/books/NBK548158/table/Nilutamide.Te/?report=objectonly" target="object" rid-ob="figobNilutamideTe">Table</a></h4></div></div></div><div id="Nilutamide.Laboratory_Values_1"><h4>Laboratory Values</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figNilutamideTf"><a href="/books/NBK548158/table/Nilutamide.Tf/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figNilutamideTf" rid-ob="figobNilutamideTf"><img class="small-thumb" src="/books/NBK548158/table/Nilutamide.Tf/?report=thumb" src-large="/books/NBK548158/table/Nilutamide.Tf/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="Nilutamide.Tf"><a href="/books/NBK548158/table/Nilutamide.Tf/?report=objectonly" target="object" rid-ob="figobNilutamideTf">Table</a></h4></div></div></div><div id="Nilutamide.Comment_1"><h4>Comment</h4><p>Interstitial pneumonitis is an uncommon but well established complication of nilutamide therapy. Symptoms and signs reverse slowly and only partially after therapy is stopped. This patient was also found to have minor ALT elevations but not clinically apparent liver disease during therapy. In most situations, such minor ALT elevations can be monitored without dose modification. The fact that this patient tolerated flutamide therapy without subsequent evidence of liver injury does not indicate that there is no cross reactivity in instances of clinically apparent hepatotoxicity between these two agents. Switching therapy to flutamide is not recommended for patients with clinically apparent liver injury from nilutamide.</p></div></div></div><div id="Nilutamide.PRODUCT_INFORMATION"><h2 id="_Nilutamide_PRODUCT_INFORMATION_">PRODUCT INFORMATION</h2><p>
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<b>REPRESENTATIVE TRADE NAMES</b>
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</p><p>Nilutamide – Generic, Nilandron®</p><p>
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<b>DRUG CLASS</b>
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</p><p>Antineoplastic Agents</p><p>
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<a href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=nilutamide" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">COMPLETE LABELING</a>
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</p><p>Product labeling at DailyMed, National Library of Medicine, NIH</p></div><div id="Nilutamide.CHEMICAL_FORMULA_AND_STRUCTUR"><h2 id="_Nilutamide_CHEMICAL_FORMULA_AND_STRUCTUR_">CHEMICAL FORMULA AND STRUCTURE</h2><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figNilutamideTg"><a href="/books/NBK548158/table/Nilutamide.Tg/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figNilutamideTg" rid-ob="figobNilutamideTg"><img class="small-thumb" src="/books/NBK548158/table/Nilutamide.Tg/?report=thumb" src-large="/books/NBK548158/table/Nilutamide.Tg/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="Nilutamide.Tg"><a href="/books/NBK548158/table/Nilutamide.Tg/?report=objectonly" target="object" rid-ob="figobNilutamideTg">Table</a></h4></div></div></div><div id="Nilutamide.CITED_REFERENCES"><h2 id="_Nilutamide_CITED_REFERENCES_">CITED REFERENCES</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="Nilutamide.REF.1">Marty F, Godart D, Doermann F, Mérillon H. <span><span class="ref-journal">Gastroenterol Clin Biol. </span>1996;<span class="ref-vol">20</span>:710–1.</span> [Fatal fulminating hepatitis caused by nilutamide. A new case] French. [<a href="https://pubmed.ncbi.nlm.nih.gov/8977826" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8977826</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="Nilutamide.REF.2">Gomez JL, Dupont A, Cusan L, Tremblay M, Tremblay M, Labrie F. Simultaneous liver and lung toxicity related to the nonsteroidal antiandrogen nilutamide (Anandron): a case report. <span><span class="ref-journal">Am J Med. </span>1992;<span class="ref-vol">92</span>:563–6.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/1580304" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1580304</span></a>]</div></dd></dl></dl></div><div id="Nilutamide.ANNOTATED_BIBLIOGRAPHY"><h2 id="_Nilutamide_ANNOTATED_BIBLIOGRAPHY_">ANNOTATED BIBLIOGRAPHY</h2><p>References updated: 15 March 2023</p><p>Abbreviations: LHRH, luteinizing hormone releasing hormone; PSA, prostate-specific antigen.</p><ul class="first-line-outdent"><li><div class="bk_ref" id="Nilutamide.REF.zimmerman.1999">Zimmerman HJ. Hepatotoxic effects of oncotherapeutic and immunosuppressive agents. In, Zimmerman HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999, p. 699.<div><i>(Expert review of hepatotoxicity published in 1999, mentions that flutamide has led to instances of severe hepatic necrosis and fulminant hepatic failure).</i></div></div></li><li><div class="bk_ref" id="Nilutamide.REF.deleve.2013">DeLeve LD. Antiandrogens. Cancer chemotherapy. In, Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 3rd ed. Amsterdam: Elsevier, 2013, pp. 612-3.<div><i>(Textbook on drug induced liver injury mentions that nilutamide has been implicated in causing at least four cases of acute hepatitis, two of which were fatal).</i></div></div></li><li><div class="bk_ref" id="Nilutamide.REF.moy.2011">Moy B, Lee RJ, Smith M. Hormone therapy in prostate cancer. Natural products in cancer chemotherapy: hormones and related agents. In, Brunton LL, Chabner BA, Knollman BC, eds. Goodman & Gilman's the pharmacological basis of therapeutics. 12th ed. New York: McGraw-Hill, 2011, pp. 1763-9.<div><i>(Textbook of pharmacology and therapeutics; discusses the role of androgen receptor blockers in prostate cancer including bicalutamide, flutamide and nilutamide).</i></div></div></li><li><div class="bk_ref" id="Nilutamide.REF.hammel.1991.557">Hammel P, Ducreux M, Bismuth E, et al. <span><span class="ref-journal">Gastroenterol Clin Biol. </span>1991;<span class="ref-vol">15</span>:557.</span> [Nilutamide-induced acute hepatitis] French. [<a href="https://pubmed.ncbi.nlm.nih.gov/1916139" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1916139</span></a>]<div>
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<i>(68 year old man with prostate cancer developed itching and then jaundice 4 months after starting nilutamide [bilirubin 8.2 mg/dL, ALT 22 times and Alk P 2 times ULN, eosinophils 800/μL], biopsy showed submassive necrosis; rapid improvement upon stopping with ultimate full recovery).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.gomez.1992.563">Gomez JL, Dupont A, Cusan L, Tremblay M, Tremblay M, Labrie F. Simultaneous liver and lung toxicity related to the nonsteroidal antiandrogen nilutamide (Anandron): a case report. <span><span class="ref-journal">Am J Med. </span>1992;<span class="ref-vol">92</span>:563–6.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/1580304" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1580304</span></a>]<div>
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<i>(69 year old man with prostate cancer developed pulmonary toxicity [interstitial pneumonitis] 2 months after starting nilutamide with concurrent minor enzyme abnormalities [bilirubin 0.50 mg/dL, ALT 96 U/L, Alk P 150 U/L], which resolved rapidly with stopping: Case 2).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.pescatore.1993.499">Pescatore P, Hammel P, Durand F, et al. <span><span class="ref-journal">Gastroenterol Clin Biol. </span>1993;<span class="ref-vol">17</span>:499–501.</span> [Fatal fulminant hepatitis induced by nilutamide (Anandron)] French. [<a href="https://pubmed.ncbi.nlm.nih.gov/8243938" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8243938</span></a>]<div>
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<i>(69 year old man with prostate cancer underwent orchiectomy and developed jaundice 8 weeks after starting nilutamide [bilirubin 13.9 mg/dL, ALT 45 times ULN], with progressive liver failure and death within 2 weeks; autopsy showed massive necrosis).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.bertagna.1994.396">Bertagna C, De Géry A, Hucher M, François JP, Zanirato J. Efficacy of the combination of nilutamide plus orchidectomy in patients with metastatic prostatic cancer. A meta-analysis of seven randomized double-blind trials (1056 patients). <span><span class="ref-journal">Br J Urol. </span>1994;<span class="ref-vol">73</span>:396–402.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/8199827" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8199827</span></a>]<div>
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<i>(Review of 7 randomized clinical trials of nilutamide in 1191 patients with prostate cancer showed improved pain and objective evidence of disease but not survival compared to placebo; no mention of hepatotoxicity).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.marty.1996.710">Marty F, Godart D, Doermann F, Mérillon H. <span><span class="ref-journal">Gastroenterol Clin Biol. </span>1996;<span class="ref-vol">20</span>:710–1.</span> [Fatal fulminating hepatitis caused by nilutamide. A new case] French. [<a href="https://pubmed.ncbi.nlm.nih.gov/8977826" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8977826</span></a>]<div>
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<i>(65 year old man with prostate cancer developed jaundice 8 weeks after starting nilutamide [bilirubin 9.3 mg/dL, ALT 2360 U/L, Alk P 231 U/L], with rapid progression to liver failure and death 3 weeks later: Case 1).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.dijkman.1997.160">Dijkman GA, Janknegt RA, De Reijke TM, Debruyne FM. Long-term efficacy and safety of nilutamide plus castration in advanced prostate cancer, and the significance of early prostate specific antigen normalization. International Anandron Study Group. <span><span class="ref-journal">J Urol. </span>1997;<span class="ref-vol">158</span>:160–3.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/9186345" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9186345</span></a>]<div>
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<i>(Long term follow up of randomized clinical trials of nilutamide vs placebo after orchiectomy in 457 patients with prostate cancer; overall survival improved by 7 months, no new long term drug specific serious adverse event, no mention of hepatotoxicity).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.mcleod.1997.18">McLeod DG. Tolerability of nonsteroidal antiandrogens in the treatment of advanced prostate cancer. <span><span class="ref-journal">Oncologist. </span>1997;<span class="ref-vol">2</span>:18–27.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/10388026" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10388026</span></a>]<div>
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<i>(Overview of the safety and side effects of the nonsteroidal antiandrogens; ALT elevations occur in 2-33% receiving nilutamide compared to 4-62% with flutamide; 5 cases of clinically apparent hepatitis have been reported due to nilutamide, compared to more than 50 with flutamide).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.edouard.2003.1170">Edouard A, Robinel R, Rat C, Lombard F, Lorinet C, Escarmant P. <span><span class="ref-journal">Gastroenterol Clin Biol. </span>2003;<span class="ref-vol">27</span>:1170–1.</span> [Fatal fulminating hepatitis induced by nilutamide] French. [<a href="https://pubmed.ncbi.nlm.nih.gov/14770126" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14770126</span></a>]<div>
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<i>(67 year old man with prostate cancer developed jaundice 3 months after starting nilutamide [bilirubin 14.2 mg/dL, ALT 35 times and Alk P 1.5 times ULN, protime 42%], with progressive hepatic failure and death 4 weeks later).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.thole.2004.289">Thole Z, Manso G, Salgueiro E, Revuelta P, Hidalgo A. Hepatotoxicity induced by antiandrogens: a review of the literature. <span><span class="ref-journal">Urol Int. </span>2004;<span class="ref-vol">73</span>:289–95.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/15604569" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15604569</span></a>]<div>
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<i>(Systematic review of the literature from the Spanish pharmacovigilance group; 21 reports on hepatotoxicity of cyproterone, 46 flutamide, 4 nilutamide and only 1 bicalutamide; 6 cases of hepatocellular carcinoma linked to cyproterone therapy).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.russo.2004.1018">Russo MW, Galanko JA, Shrestha R, Fried MW, Watkins P. Liver transplantation for acute liver failure from drug-induced liver injury in the United States. <span><span class="ref-journal">Liver Transpl. </span>2004;<span class="ref-vol">10</span>:1018–23.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/15390328" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15390328</span></a>]<div>
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<i>(Among ~50,000 liver transplants done in the United States between 1990 and 2002, 270 [0.5%] were done for drug induced acute liver failure, but no case was attributed to an antiandrogen, perhaps because patients with prostate cancer would not be eligible for liver transplantation).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.manso.2006.253">Manso G, Thole Z, Salgueiro E, Revuelta P, Hidalgo A. Spontaneous reporting of hepatotoxicity associated with antiandrogens: data from the Spanish pharmacovigilance system. <span><span class="ref-journal">Pharmacoepidemiol Drug Saf. </span>2006;<span class="ref-vol">15</span>:253–9.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/16294367" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16294367</span></a>]<div>
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<i>(Analysis of spontaneous reporting to Spanish pharmacovigilance system found 88 cases of flutamide, 11 bicalutamide and 15 cyproterone hepatotoxicity, latency 3-6 months; 2 fatalities, both from flutamide; nilutamide not used in Spain).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.bj_rnsson.2006.33">Björnsson E, Olsson R. Suspected drug-induced liver fatalities reported to the WHO database. <span><span class="ref-journal">Dig Liver Dis. </span>2006;<span class="ref-vol">38</span>:33–8.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/16054882" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16054882</span></a>]<div>
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<i>(Survey of drug induced liver fatalities reported to WHO database between 1968-2003 revealed 4690 reports; flutamide ranked 11th with a total of 59 cases).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.chalasani.2008.1924">Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T, Serrano J, Yang H, Rochon J., Drug Induced Liver Injury Network (DILIN). Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. <span><span class="ref-journal">Gastroenterology. </span>2008;<span class="ref-vol">135</span>:1924–34.</span> [<a href="/pmc/articles/PMC3654244/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3654244</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/18955056" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18955056</span></a>]<div>
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<i>(Among 300 cases of drug induced liver disease in the US collected between 2004 and 2008, none were attributed to an antiandrogen).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.merwat.2009.910">Merwat SN, Kabbani W, Adler DG. Fulminant hepatic failure due to nilutamide hepatotoxicity. <span><span class="ref-journal">Dig Dis Sci. </span>2009;<span class="ref-vol">54</span>:910–3.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/18688719" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18688719</span></a>]<div>
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<i>(76 year old man with prostate cancer developed abdominal pain followed by jaundice 6 weeks after starting nilutamide [bilirubin 25.8 mg/dL, ALT 1793 U/L, Alk P 231 U/L, INR 1.7], followed by progressive hepatic and multiorgan failure and death).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.reuben.2010.2065">Reuben A, Koch DG, Lee WM., Acute Liver Failure Study Group. Drug-induced acute liver failure: results of a U.S. multicenter, prospective study. <span><span class="ref-journal">Hepatology. </span>2010;<span class="ref-vol">52</span>:2065–76.</span> [<a href="/pmc/articles/PMC3992250/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3992250</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20949552" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20949552</span></a>]<div>
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<i>(Among 1198 patients with acute liver failure enrolled in a US prospective study between 1998 and 2007, 133 were attributed to drug induced liver injury, but none were attributed to antiandrogen therapies).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.chalasani.2015.1340">Chalasani N, Bonkovsky HL, Fontana R, Lee W, Stolz A, Talwalkar J, Reddy KR, et al. United States Drug Induced Liver Injury Network. Features and outcomes of 899 patients with drug-induced liver injury: The DILIN Prospective Study. <span><span class="ref-journal">Gastroenterology. </span>2015;<span class="ref-vol">148</span>:1340–52.e7.</span> [<a href="/pmc/articles/PMC4446235/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4446235</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25754159" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25754159</span></a>]<div>
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<i>(Among 899 cases of drug induced liver injury enrolled in a US prospective study between 2004 and 2013, one case was attributed to bicalutamide, but none to nilutamide or other antiandrogens).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.crawford.2018.956">Crawford ED, Schellhammer PF, McLeod DG, Moul JW, Higano CS, Shore N, Denis L, et al. Androgen receptor targeted treatments of prostate cancer: 35 years of progress with antiandrogens. <span><span class="ref-journal">J Urol. </span>2018;<span class="ref-vol">200</span>:956–966.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/29730201" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29730201</span></a>]<div>
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<i>(Review of the development of antiandrogen therapies of prostate cancer starting with discovery of the androgen sensitive nature of prostate cancer, the effects of orchiectomy, followed by the development of androgen receptor antagonists, first generation agents flutamide and nilutamide, second generation agent bicalutamide and third generation agents enzalutamide, apalutamide and darolutamide that have more potent androgen receptor inhibition).</i>
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</div></div></li><li><div class="bk_ref" id="Nilutamide.REF.rashid.2019.108">Rashid M, Shamshavali K, Chhabra M. Efficacy and safety of nilutamide in patients with metastatic prostate cancer who underwent orchiectomy: a systematic review and metaanalysis. <span><span class="ref-journal">Curr Clin Pharmacol. </span>2019;<span class="ref-vol">14</span>:108–115.</span> [<a href="/pmc/articles/PMC7040499/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7040499</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30648519" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30648519</span></a>]<div>
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<i>(Systematic review identified 5 controlled trials of nilutamide in 1637 patients with prostate cancer, that showed improvements in both overall and progression free survival with nilutamide compared to placebo and adverse events included delayed adaption to darkness, blurred vision, alcohol intolerance, hot flashes, nausea, respiratory disorders and serum enzyme elevations).</i>
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</div></div></li></ul></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK548158_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Update: <span itemprop="dateModified">March 15, 2023</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div></div><h3>Publisher</h3><p><a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Nilutamide. [Updated 2023 Mar 15].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/livertox/Nilotinib/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/livertox/Nimesulide/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article><article data-type="table-wrap" id="figobNilutamideTc"><div id="Nilutamide.Tc" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548158/table/Nilutamide.Tc/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Nilutamide.Tc_lrgtbl__"><table><tbody><tr><th id="hd_b_Nilutamide.Tc_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medication:</th><td headers="hd_b_Nilutamide.Tc_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nilutamide, 150 mg daily for 8 weeks</td></tr><tr><th id="hd_b_Nilutamide.Tc_1_1_2_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pattern:</th><td headers="hd_b_Nilutamide.Tc_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hepatocellular</td></tr><tr><th id="hd_b_Nilutamide.Tc_1_1_3_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Severity:</th><td headers="hd_b_Nilutamide.Tc_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5+ (acute liver failure and death)</td></tr><tr><th id="hd_b_Nilutamide.Tc_1_1_4_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Latency:</th><td headers="hd_b_Nilutamide.Tc_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8 weeks</td></tr><tr><th id="hd_b_Nilutamide.Tc_1_1_5_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Recovery:</th><td headers="hd_b_Nilutamide.Tc_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr><tr><th id="hd_b_Nilutamide.Tc_1_1_6_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other medications:</th><td headers="hd_b_Nilutamide.Tc_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Leuprolide. Prednisolone and norfloxacin 2 months previously</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobNilutamideTd"><div id="Nilutamide.Td" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548158/table/Nilutamide.Td/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Nilutamide.Td_lrgtbl__"><table><thead><tr><th id="hd_h_Nilutamide.Td_1_1_1_1" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Time After<br />Starting</th><th id="hd_h_Nilutamide.Td_1_1_1_2" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Time After<br />Stopping</th><th id="hd_h_Nilutamide.Td_1_1_1_3" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">ALT<br />(U/L)</th><th id="hd_h_Nilutamide.Td_1_1_1_4" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Alk P<br />(U/L)</th><th id="hd_h_Nilutamide.Td_1_1_1_5" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Bilirubin<br />(mg/dL)</th><th id="hd_h_Nilutamide.Td_1_1_1_6" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Other</th></tr></thead><tbody><tr><td headers="hd_h_Nilutamide.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0</td><td headers="hd_h_Nilutamide.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0</td><td headers="hd_h_Nilutamide.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Normal</td><td headers="hd_h_Nilutamide.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Normal</td><td headers="hd_h_Nilutamide.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Normal</td><td headers="hd_h_Nilutamide.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_Nilutamide.Td_1_1_1_1 hd_h_Nilutamide.Td_1_1_1_2 hd_h_Nilutamide.Td_1_1_1_3 hd_h_Nilutamide.Td_1_1_1_4 hd_h_Nilutamide.Td_1_1_1_5 hd_h_Nilutamide.Td_1_1_1_6" colspan="6" scope="col" rowspan="1" style="text-align:center;vertical-align:top;">Nilutamide 150 mg daily after orchiectomy for prostate cancer</td></tr><tr><td headers="hd_h_Nilutamide.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">10 weeks</td><td headers="hd_h_Nilutamide.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0</td><td headers="hd_h_Nilutamide.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2360</td><td headers="hd_h_Nilutamide.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">231</td><td headers="hd_h_Nilutamide.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">7.5</td><td headers="hd_h_Nilutamide.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_Nilutamide.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">12 weeks</td><td headers="hd_h_Nilutamide.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2 weeks</td><td headers="hd_h_Nilutamide.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1510</td><td headers="hd_h_Nilutamide.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">290</td><td headers="hd_h_Nilutamide.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">42.5</td><td headers="hd_h_Nilutamide.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Admission. Protime <15%</td></tr><tr><td headers="hd_h_Nilutamide.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">13 weeks</td><td headers="hd_h_Nilutamide.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">3 weeks</td><td headers="hd_h_Nilutamide.Td_1_1_1_3 hd_h_Nilutamide.Td_1_1_1_4 hd_h_Nilutamide.Td_1_1_1_5" colspan="3" rowspan="1" style="text-align:center;vertical-align:top;">Death from hepatic failure</td><td headers="hd_h_Nilutamide.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_Nilutamide.Td_1_1_1_1 hd_h_Nilutamide.Td_1_1_1_2" colspan="2" scope="row" rowspan="1" style="text-align:center;vertical-align:top;">
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<b>Normal Values</b>
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|
</td><td headers="hd_h_Nilutamide.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<b><40</b>
|
|
</td><td headers="hd_h_Nilutamide.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<b><350</b>
|
|
</td><td headers="hd_h_Nilutamide.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<b><1.2</b>
|
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</td><td headers="hd_h_Nilutamide.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobNilutamideTe"><div id="Nilutamide.Te" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548158/table/Nilutamide.Te/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Nilutamide.Te_lrgtbl__"><table><tbody><tr><th id="hd_b_Nilutamide.Te_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medication:</th><td headers="hd_b_Nilutamide.Te_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nilutamide, 100 mg twice daily</td></tr><tr><th id="hd_b_Nilutamide.Te_1_1_2_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pattern:</th><td headers="hd_b_Nilutamide.Te_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hepatocellular</td></tr><tr><th id="hd_b_Nilutamide.Te_1_1_3_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Severity:</th><td headers="hd_b_Nilutamide.Te_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1+ (enzyme elevations without jaundice)</td></tr><tr><th id="hd_b_Nilutamide.Te_1_1_4_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Latency:</th><td headers="hd_b_Nilutamide.Te_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2 months</td></tr><tr><th id="hd_b_Nilutamide.Te_1_1_5_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Recovery:</th><td headers="hd_b_Nilutamide.Te_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75 days</td></tr><tr><th id="hd_b_Nilutamide.Te_1_1_6_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other medications:</th><td headers="hd_b_Nilutamide.Te_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LHRH agonist</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobNilutamideTf"><div id="Nilutamide.Tf" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548158/table/Nilutamide.Tf/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Nilutamide.Tf_lrgtbl__"><table><thead><tr><th id="hd_h_Nilutamide.Tf_1_1_1_1" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Time After<br />Starting</th><th id="hd_h_Nilutamide.Tf_1_1_1_2" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Time After<br />Stopping</th><th id="hd_h_Nilutamide.Tf_1_1_1_3" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">ALT<br />(U/L)</th><th id="hd_h_Nilutamide.Tf_1_1_1_4" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Alk P<br />(U/L)</th><th id="hd_h_Nilutamide.Tf_1_1_1_5" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Bilirubin<br />(mg/dL)</th><th id="hd_h_Nilutamide.Tf_1_1_1_6" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Other</th></tr></thead><tbody><tr><td headers="hd_h_Nilutamide.Tf_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0</td><td headers="hd_h_Nilutamide.Tf_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0</td><td headers="hd_h_Nilutamide.Tf_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">12</td><td headers="hd_h_Nilutamide.Tf_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">127</td><td headers="hd_h_Nilutamide.Tf_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0.40</td><td headers="hd_h_Nilutamide.Tf_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_Nilutamide.Tf_1_1_1_1 hd_h_Nilutamide.Tf_1_1_1_2 hd_h_Nilutamide.Tf_1_1_1_3 hd_h_Nilutamide.Tf_1_1_1_4 hd_h_Nilutamide.Tf_1_1_1_5 hd_h_Nilutamide.Tf_1_1_1_6" colspan="6" scope="col" rowspan="1" style="text-align:center;vertical-align:top;">Nilutamide 100 mg every 12 hours and LHRH agonist started for prostate cancer</td></tr><tr><td headers="hd_h_Nilutamide.Tf_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">8 weeks</td><td headers="hd_h_Nilutamide.Tf_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0</td><td headers="hd_h_Nilutamide.Tf_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">96</td><td headers="hd_h_Nilutamide.Tf_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">150</td><td headers="hd_h_Nilutamide.Tf_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0.50</td><td headers="hd_h_Nilutamide.Tf_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interstitial pneumonitis</td></tr><tr><td headers="hd_h_Nilutamide.Tf_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">18 weeks</td><td headers="hd_h_Nilutamide.Tf_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">10 weeks</td><td headers="hd_h_Nilutamide.Tf_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">13</td><td headers="hd_h_Nilutamide.Tf_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">132</td><td headers="hd_h_Nilutamide.Tf_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0.40</td><td headers="hd_h_Nilutamide.Tf_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_Nilutamide.Tf_1_1_1_1 hd_h_Nilutamide.Tf_1_1_1_2" colspan="2" scope="row" rowspan="1" style="text-align:center;vertical-align:top;">
|
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<b>Normal Values</b>
|
|
</td><td headers="hd_h_Nilutamide.Tf_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<b><35</b>
|
|
</td><td headers="hd_h_Nilutamide.Tf_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<b><130</b>
|
|
</td><td headers="hd_h_Nilutamide.Tf_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<b><1.2</b>
|
|
</td><td headers="hd_h_Nilutamide.Tf_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobNilutamideTg"><div id="Nilutamide.Tg" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548158/table/Nilutamide.Tg/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Nilutamide.Tg_lrgtbl__"><table><thead><tr><th id="hd_h_Nilutamide.Tg_1_1_1_1" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">DRUG</th><th id="hd_h_Nilutamide.Tg_1_1_1_2" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CAS REGISTRY NO</th><th id="hd_h_Nilutamide.Tg_1_1_1_3" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MOLECULAR FORMULA</th><th id="hd_h_Nilutamide.Tg_1_1_1_4" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">STRUCTURE</th></tr></thead><tbody><tr><td headers="hd_h_Nilutamide.Tg_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nilutamide</td><td headers="hd_h_Nilutamide.Tg_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135006493" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem">63612-50-0</a>
|
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</td><td headers="hd_h_Nilutamide.Tg_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">C12-H10-F3-N3-O4</td><td headers="hd_h_Nilutamide.Tg_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135006493" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=135006493" alt="image 135006493 in the ncbi pubchem database" /></a>
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