Before taking estramustine, tell your doctor if you have:
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liver disease;
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kidney disease;
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a metabolic bone disease;
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diabetes;
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heart disease, high blood pressure or a history of heart attack;
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a history of stroke;
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bleeding or blood clotting problems;
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migraine headaches;
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epilepsy or other seizure disorder; or
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problems with swelling.
You may not be able to take estramustine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
Estramustine may cause birth defects in an unborn baby when conception occurs during treatment. Contraceptive measures are recommended during treatment with estramustine.
It is not known whether estramustine passes into breast milk. Do not take estramustine without first talking to your doctor if you are breast feeding a baby.
Take estramustine exactly as directed by your doctor. If you do not understand these instructions, ask your doctor, nurse or pharmacist to explain them to you.
Take each oral dose with a large glass of water.
Take estramustine on an empty stomach, at least 1 hour before or 2 hours after meals.
Do not take milk, milk products, or calcium-rick foods or drugs (such as calcium-containing antacids) simultaneously with estramustine.
Your doctor will probably want you to have regularly scheduled blood tests and other medical evaluations during treatment with estramustine to monitor progress and side effects.
Store estramustine tablets in the refrigerator. Do not freeze.
Contact your doctor if you miss a dose of estramustine.
If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:
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an allergic reaction (shortness of breath; closing of your throat; difficulty breathing; swelling of your lips, face, or tongue; or hives);
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chest pain;
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severe headache, confusion, or weakness;
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shortness of breath;
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redness, pain, warmth, or numbness in an arm or leg;
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swelling of feet or lower legs; or
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yellowing of the eyes and skin.
Other less serious side effects may be more likely to occur. Talk to your doctor if you experience
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tiredness;
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loss of appetite, nausea or diarrhea;
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rash or itching;
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tenderness or enlargement of breasts in men; or
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impotence.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
Estramustine should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.
Serious side effects have been reported with the use of estramustine including: allergic reactions (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); blood clots (including those causing heart attacks and strokes); and others. Talk to your doctor about the possible side effects from treatment with estramustine.
Do not take milk, milk products, or calcium-rick foods or drugs (such as calcium-containing antacids) simultaneously with estramustine.
Other medications may interact with estramustine. Talk to your doctor and pharmacist before taking any other prescription or over-the-counter medicines, including herbal products, during treatment with estramustine.
If for any reason an overdose of estramustine is suspected, seek emergency medical attention or contact your healthcare provider immediately.
Symptoms of an estramustine overdose tend to be similar to side effects caused by the medication, although often more severe.
