Estramustine
- Atc Codes:L01XX11
- CAS Codes:2998-57-4#52205-73-9
- PHARMGKB ID:2998-57-4#52205-73-9
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Estracyt; Belgium: Estracyt; Czech Republic: Estracyt; Denmark: Estracyt; Estonia: Estracyt; Finland: Estracyt; France: Estracyt; Germany: Cellmustin, EstraCept, Estracyt, Estramustin, Medactin, Multosin; Greece: Estracyt; Hungary: Estracyt; Italy: Estracyt; Netherlands: Estracyt; Poland: Estracyt; Portugal: Estracyt; Romania: Estracyt; Slovakia: Estracyt; Spain: Estracyt; Sweden: Estracyt; UK: Estracyt.
North America
Canada: Emcyt; USA: Emcyt.
Latin America
Argentina: Estramustina, Suloprost, Tratina; Mexico: Emcyt.
Asia
Japan: Biasetyl, Estracyt, Proesta.
Drug combinations
Chemistry
Estramustine: C~23~H~31~Cl~2~NO~3~. Mw: 440.40. Estra-1,3,5(10)-triene-3,17-diol, 3-[bis(2-chloroethyl)carbamate], (17β)-. CAS-2998-57-4 (1987).
Estramustine Phosphate Sodium: C~23~H~30~Cl~2~NNa~2~O~6~P. Mw: 564.35. Estradiol 3-[bis(2-chloroethyl)carbamate] 17-(dihydrogen phosphate), disodium salt. CAS-52205-73-9 (1978).
Pharmacologic Category
Other Antineoplastic Agents. Hormone; Estrogen/Nitrogen Mustard. (ATC-Code: L01XX11).
Mechanism of action
A complex of 17β-estradiol and nitrogen mustard, estramustine is an antimicrotubule antineoplastic agent. It appears to bind to microtubule proteins, preventing normal tubulin function. The antitumor effect may be due solely to an estrogenic effect. Estramustine causes a marked decrease in plasma testosterone and an increase in estrogen levels.
Therapeutic use
Palliative treatment of prostatic carcinoma (progressive or metastatic).
Pregnancy and lactiation implications
Not intended for use in women. Due to the mutagenic potential of estramustine, an effective method of contraception should be used during therapy with the drug.
Unlabeled use
Contraindications
Hypersensitivity to estramustine, estradiol, nitrogen mustard, or any component of the formulation. Active thrombophlebitis or thromboembolic disorders (except where tumor mass is cause of thromboembolic disorder and benefit may outweigh risk).
Warnings and precautions
Hazardous agent. Thrombotic and thromboembolic disorders, including thrombophlebitis, MI, pulmonary embolism, and cerebrovascular accident, reported (drug should be used with caution in history of thrombophlebitis, thrombosis, or thromboembolic disorders, and in cerebrovascular or coronary artery disease). Leg cramps reported. Hypertension may occur. Decreased glucose tolerance may occur. Sensitivity reactions, including angioedema, reported. Elevated blood pressure, exacerbation of preexisting or incipient peripheral edema or congestive heart disease may occur (should be used with caution in conditions which might be aggravated by fluid retention (e.g. congestive heart failure, epilepsy, migraine, renal dysfunction)). Elevated AST (SGOT), LDH concentrations and elevated bilirubin concentrations. Estramustine may influence the metabolism of calcium and phosphorus (should be used with caution in metabolic bone diseases associated with hypercalcemia or in renal impairment). Use with caution in the elderly. Decreased metabolism in hepatic impairment (use with caution). Estrogen use may cause gynecomastia and/or impotence. Use with caution in diabetes mellitus (may decrease glucose tolerance).