COSUDEX® (Bicalutamide)

Information in this fact sheet is meant to assist you in making decisions about your treatment. Always make medication decisions in consultation with your healthcare team.

What is Cosudex® 50mg used for?

Cosudex® 50mg is used in combination with other medicines to treat advanced prostate cancer.

Cosudex® 50mg belongs to the family of non-steroidal anti-androgens. Androgens such as testosterone are natural male sex hormones. In some types of prostate cancer, androgens may help the cancer cells grow. Cosudex® 50mg interferes with some of the actions of these hormones.

Cosudex® 50mg should only be taken by men.

Bicalutamide, the active component of Cosudex® 50mg, may be used to treat prostate cancer that has begun to spread into the tissues around the prostate gland (locally-advanced prostate cancer). It can either be given on its own or after surgery or radiotherapy.

In prostate cancer that has spread to other parts of the body (called advanced or metastatic cancer), Cosudex® 50mg may be given in combination with injections of another hormonal-therapy drug called a pituitary down-regulator such as goserelin, buserelin, triptorelin or leuprorelin. These drugs block the production of a hormone produced by the pituitary gland (luteinising hormone), which stimulates the production of testosterone.

For men with prostate cancer that is contained within the prostate gland (early prostate cancer), Cosudex® 50mg may be given as a short-term treatment (for a few weeks only) to prevent 'tumour flare'. Tumour flare is a temporary increase in symptoms that can occur when a man first starts treatment with a pituitary down-regulator so Cosudex is generally started about ten to fourteen days prior to these injections.

What does Cosudex® 50mg look like?

Cosudex® 50mg tablets are white, round film-coated tablets. One side of the tablet is marked CDX 50 and the other side has an arrow shape.

Cosudex® 50mg tablets are packed in blister foils of 28 tablets.

How is Cosudex® 50mg given?

The usual adult dose is one 50mg tablet taken each day.

Swallow your Cosudex® 50mg tablet whole with a full glass of water. Take Cosudex® 50mg at about the same time each day. Cosudex® 50mg is available only with a doctor's prescription.

Cosudex® 50mg is often commenced up to two weeks prior to other injectable hormone-therapy medicines you have been given for the treatment of prostate cancer.

It does not matter if you take Cosudex® 50mg before, with or after food.

If you miss a dose, take it as soon as you remember, as long as it is 12 hours before the next dose is due.

If it is less than 12 hours to the next dose do not take the dose you have missed.

Do not take a double dose to make up for the dose that you missed. If you are not sure what to do, ask your doctor or pharmacist.

What are the common side effects?

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Cosudex® 50mg.

Cosudex® 50mg helps people with advanced prostate cancer, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious; most of the time they are not. You may need medical treatment if you get some of the side effects.

Ask your doctor, nurse or pharmacist to answer any questions you may have. Tell your doctor, nurse or pharmacist as soon as possible if you notice any of the following and they worry you:

  • hot flushes or sweating
  • breast tenderness or changes in breast size
  • itching or dry skin
  • increased hairiness or hair loss
  • stomach pain or indigestion
  • nausea or vomiting
  • diarrhoea or constipation
  • flatulence (wind)
  • dry mouth
  • loss of appetite or weight changes
  • depression
  • unusual tiredness or weakness
  • dizziness or lightheadedness
  • difficulty sleeping
  • headache
  • chills
  • pelvic pain
  • decrease in your sexual drive
  • inability to get or maintain an erection.

These are possible side effects of Cosudex® 50mg.

What are the less common side effects?

Tell your doctor immediately if you notice any of the following:

  • frequent urination
  • shortness of breath and dizziness when exercising and looking pale (anaemia)
  • excessive thirst with weight loss, and passing large amounts of urine.

These side effects may be serious.

Tell your doctor immediately, call an ambulance or go to an Emergency Department at your nearest hospital if any of the following happen:

  • chest pain
  • yellowing of the skin or eyes and dark coloured urine
  • rash, hives or severe itching of the skin
  • swelling of the face, lips, tongue and/or throat, which may cause difficulty in swallowing
  • swelling of other parts of the body including hands, feet or ankles
  • serious breathlessness, or sudden worsening of breathlessness, possibly with a cough or fever
  • shortness of breath, wheezing or trouble breathing

These are all serious side effects. You may need urgent medical attention or hospitalisation.

Tell your doctor, nurse or pharmacist if you notice anything that is making you feel unwell.


Macmillan, Jan 2013, Bicalutamide (Casodex® 50mg), Macmillan Cancer Support, viewed 1st July 2013.

TGA Consumer Medical Information (CMI), March 2004, Cosudex® 50mg Tablets, Therapeutic Goods Administration, Canberra, viewed 1st July 2013.


Prostate Cancer Foundation of Australia develops materials based on best available evidence and takes advice from recognised experts in the field in developing such resource; however it cannot guarantee and assumes no legal responsibility for the currency or completeness of the information.