Others include hot flashes, decreased muscle mass, decreased bone mass and an associated increased risk of fractures, depression, and sexual dysfunction including reduced libido and erectile dysfunction. In women, flutamide is, generally, relatively well tolerated, and does not interfere with ovulation. The only common side effect of flutamide in women is dry skin (75%), which can be attributed to a reduction of androgen-mediated sebum production. General side effects that may occur in either sex include dizziness, lack of appetite, gastrointestinal side effects such as nausea, vomiting, and diarrhea, a greenish-bluish discoloration of the urine, and hepatic changes. Because flutamide is a pure antiandrogen, unlike steroidal antiandrogens like cyproterone acetate and megestrol acetate (which additionally possess progestogenic activity), it does not appear to have a risk of cardiovascular side effects (e.g., thromboembolism) or fluid retention. Gynecomastia
Flutamide, as a monotherapy, causes gynecomastia in 30 to 79% of men, and also produces breast tenderness. However, more than 90% of cases of gynecomastia with NSAAs including flutamide are mild to moderate. Tamoxifen, a selective estrogen receptor modulator (SERM) with predominantly antiestrogenic actions, can counteract flutamide-induced gynecomastia and breast pain in men. Diarrhea
Diarrhea is more common and sometimes more severe with flutamide than with other NSAAs. In a comparative trial of combined androgen blockade for prostate cancer, the rate of diarrhea was 26% for flutamide and 12% for bicalutamide. Moreover, 6% of flutamide-treated patients discontinued the medication due to diarrhea, whereas only 0.5% of bicalutamide-treated patients did so.
More research is necessary to determine whether flutamide is effective in the treatment of OCD. References
Further reading
Sogani PC, Whitmore WF (1988). "Flutamide and other antiandrogens in the treatment of advanced prostatic carcinoma". Cancer Treat. Res. Cancer Treatment and Research. 39: 131–45. doi:10.1007/978-1-4613-1731-9_9. ISBN 978-1-4612-8974-6. PMID 2908604. Brogden RN, Clissold SP (1989). "Flutamide. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in advanced prostatic cancer". Drugs. 38 (2): 185–203. doi:10.2165/00003495-198938020-00003. PMID 2670515. Neri R (1989). "Pharmacology and pharmacokinetics of flutamide". Urology. 34 (4 Suppl): 19–21, discussion 46–56. doi:10.1016/0090-4295(89)90230-6. PMID 2477934. Newling DW (1989). "The use of flutamide as monotherapy in the treatment of advanced prostate cancer". Prog. Clin. Biol. Res. 303: 117–21. PMID 2674980. Labrie F, Dupont A, Cusan L, Manhès G, Bergeron N, Lacourcière Y, Pineault S, Bélanger A, Monfette G, Emond J (1989). "Combination therapy with castration and flutamide: todays treatment of choice for prostate cancer". J. Steroid Biochem. 33 (4B): 817–21. doi:10.1016/0022-4731(89)90499-8. PMID 2689788. Goldspiel BR, Kohler DR (1990). "Flutamide: an antiandrogen for advanced prostate cancer". DICP. 24 (6): 616–23. doi:10.1177/106002809002400612. PMID 2193461. S2CID 26125621. Brogden RN, Chrisp P (1991). "Flutamide. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in advanced prostatic cancer". Drugs Aging. 1 (2): 104–15. doi:10.2165/00002512-199101020-00003. PMID 1794008. Labrie F (1993). "Mechanism of action and pure antiandrogenic properties of flutamide". Cancer. 72 (12 Suppl): 3816–27. doi:10.1002/1097-0142(19931215)72:12+<3816::aid-cncr2820721711>3.0.co;2-3. PMID 8252497. S2CID 2195250. Iversen P, Melezinek I, Schmidt A (2001).