$514.25

EMCYT

(Also Known As: ESTRAMUSTINE SODIUM PHOSPHATE)

Use this medicine only as directed by your doctor. Do not use more or less of it, and do not use it more often than your doctor ordered. The exact amount of medicine you need has been carefully worked out. Taking too much may increase the chance of side effects, while taking too little may not improve your condition.

Do not take estramustine within 1 hour before or 2 hours after meals or after the time you take milk, milk formulas, or other dairy products, since they may keep the medicine from working properly.

This medicine commonly causes nausea and sometimes causes vomiting. However, it may have to be taken for several weeks to months to be effective. Even if you begin to feel ill, do not stop using this medicine without first checking with your doctor. Ask your health care professional for ways to lessen these effects.

If you vomit shortly after taking a dose of estramustine, check with your doctor. You will be told whether to take the dose again or to wait until the next scheduled dose.

Dosing

The dose of estramustine will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's size, and whether or not other medicines are also being taken. If you are taking estramustine at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of estramustine, ask your doctor.

Missed dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store in the refrigerator, away from direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For estramustine, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to estramustine, estrogens, or mechlorethamine.

Pregnancy There is a chance that this medicine may cause birth defects if the male is taking it at the time of conception. It may also cause permanent sterility after it has been taken for a while. Be sure that you have discussed this with your doctor before taking this medicine. Before taking estramustine, make sure your doctor knows if you intend to have children.

Older adults Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of estramustine in the elderly with use in other age groups.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking estramustine, it is especially important that your health care professional know if you are taking any of the following:

• Acetaminophen (e.g., Tylenol) (with long-term, high-dose use) or
• Amiodarone (e.g., Cordarone) or
• Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or
• Androgens (male hormones) or
• Anti-infectives by mouth or by injection (medicine for infection) or
• Antithyroid agents (medicine for overactive thyroid) or
• Carbamazepine (e.g., Tegretol) or
• Carmustine (e.g., BiCNU) or
• Chloroquine (e.g., Aralen) or
• Dantrolene (e.g., Dantrium) or
• Disulfiram (e.g., Antabuse) or
• Divalproex (e.g., Depakote) or
• Estrogens (female hormones) or
• Etretinate (e.g., Tegison) or
• Gold salts (medicine for arthritis) or
• Hydroxychloroquine (e.g., Plaquenil) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Mexate) or
• Methyldopa (e.g., Aldomet) or
• Naltrexone (e.g., Trexan) (with long-term, high-dose use) or
• Oral contraceptives (birth control pills) containing estrogen or
• Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or
• Phenytoin (e.g., Dilantin) or
• Plicamycin (e.g., Mithracin) or
• Valproic acid (e.g., Depakene) May increase the risk of liver problems

• Tobacco, smoking Smoking causes narrowing of blood vessels and may increase the risk of serious circulation problems, which can lead to stroke or heart attack

• Asthma or
• Epilepsy or
• Mental depression (or history of) or
• Migraine headaches or
• Kidney disease Fluid retention sometimes caused by estramustine may worsen these conditions

• Blood clots (or history of) or
• Stroke (or history of) or
• Recent heart attack or stroke May be worsened because of blood vessel problems caused by estramustine

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles) Risk of severe disease affecting other parts of the body

• Diabetes mellitus (sugar diabetes) Estramustine may change the amount of antidiabetic medicine needed

• Gallbladder disease (or history of) May be worsened by estramustine

• Heart or blood vessel disease Estramustine can cause circulation problems

• Jaundice or hepatitis (or history of) or other liver disease Effects, including liver problems, may be increased

• Stomach ulcer May be aggravated by estramustine