Before taking estramustine

Before taking estramustine make sure your doctor or pharmacist knows:

• If you and your partner are trying for a baby or intend to have children in the future.
• If you have liver or kidney problems.
• If you are under 18 years of age.
• If you have ever had a stomach or duodenal ulcer.
• If you have any heart problems, for example, heart failure (a condition where the pumping action of the heart is reduced).
• If you have diabetes.
• If you have high blood pressure.
• If you have epilepsy.
• If you have been told you have high levels of calcium in your blood.
• If you have porphyria (a rare blood disorder).
• If you have ever suffered from blood clots or strokes.
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If you have ever had an allergic reaction to this or to any other medicine.

How to take estramustine

• Before beginning treatment, read the manufacturer's printed information leaflet.
• Take your medication exactly as directed by your doctor. Your doctor may ask you to separate the doses throughout the day. If you are unsure about when to take your doses, check with your doctor.
• Try to take estramustine at the same time(s) each day to avoid missing any doses.
• If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a missed dose.
• Swallow estramustine capsules whole, on an empty stomach. Take your dose at least one hour before or two hours after meals.
• Do not take milk, milk products or medicines containing calcium (for example, some indigestion remedies) at the same time as estramustine as it may affect the absorption of this medicine.

Getting the most from your treatment

• There is a risk of reduced fertility after estramustine treatment. If you and your partner intend to have children in the future, ask your doctor for advice about family planning before you begin estramustine.
• It is important that you do not father a child while you are taking estramustine. Ask your doctor about suitable contraception.
• While you are taking estramustine and for a while after you stop treatment, do not have any immunisations (vaccinations) without talking to your doctor first. Estramustine lowers the body's resistance and there is a chance that you may get an infection from the vaccine.
• Keep your regular appointments with the doctor or hospital so that your progress can be checked. You will need to have regular blood tests during your treatment with estramustine.
• If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
• Do not stop taking this medicine without speaking to your doctor first.
• If you buy any medicines, check with a pharmacist that they are safe to take with estramustine.

Can estramustine cause problems?

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

• Any shortness of breath, rash or swelling of the mouth or face.
• Chest pain.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store estramustine

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Estracyt Capsules®, Pharmacia Limited, electronic Medicines Compendium. Dated July 2009, accessed October 2010.
• British National Formulary; 60th Edition (September 2010) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)