Honvan

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Συχνές Ερωτήσεις

When is this used?

Diethylstilbestrol diphosphate — high-dose estrogen for advanced metastatic prostate cancer. Largely replaced by LHRH agonists; remains in resource-limited or palliative settings.

Side effects to watch?

Hot flushes, gynaecomastia, fatigue, sexual dysfunction (anti-androgen class effect). Drug-specific monitoring as outlined in the safety boxes above.

Drug interactions?

Vary by molecule — abiraterone is CYP3A4 substrate; bicalutamide is CYP3A4 substrate. Always disclose all medications. Strong CYP3A4 inhibitors/inducers significantly affect levels.

When should it be stopped?

On disease progression, intolerable toxicity, or successful response with planned treatment break. Always specialist-decided — abrupt cessation can result in transient PSA rise (withdrawal response) which is generally not concerning.

PSA monitoring?

PSA every 1-3 months while on therapy. Rising PSA on castration suggests castration-resistance — may need switch to second-line agents (abiraterone, enzalutamide, docetaxel).

Combined androgen blockade?

LHRH agonist (goserelin, leuprolide) + bicalutamide is a common combination. Maximal androgen blockade has modest survival benefit over LHRH alone.

Bone health?

Long-term androgen deprivation accelerates bone loss. Add a bisphosphonate (zoledronic acid) or denosumab in osteopenia/osteoporosis. Calcium and vitamin D supplementation.

Pregnancy?

Anti-androgens are teratogenic — partners must use effective contraception during therapy. Most relevant for younger men with localised disease.

What if I miss a dose?

Take when you remember if same day; otherwise skip. Specialist may have specific guidance for missed doses depending on regimen.

Cardiovascular monitoring?

Mandatory for fosfestrol; advised for abiraterone (BP, fluid retention, electrolytes); routine for bicalutamide (occasional CV review).

Other Cancer & Anti-Androgen Therapy

• Calutide — bicalutamide 50 mg — alternative anti-androgen brand
• Xbira — abiraterone 250 mg — CYP17 inhibitor for mCRPC
• Honvan — fosfestrol 120 mg — diethylstilbestrol diphosphate
• Estramustine — estramustine phosphate — alkylator for hormone-refractory disease
• Zoldria — zoledronic acid IV for bone metastases

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