Flutamide: a simple guide to what it is and why liver safety matters

Here’s a blunt fact: flutamide can help control prostate cancer but it can also damage the liver. If you or someone you care for has been offered flutamide, it pays to know what it does, how to use it safely, and what signs mean “stop and call your doctor.”

How flutamide works & when it's used

Flutamide is a nonsteroidal antiandrogen. That means it blocks male hormones (androgens) from acting on cancer cells. Doctors mainly use it for prostate cancer, often with other treatments that lower testosterone. In the past it was more common; today other antiandrogens like bicalutamide or newer drugs are often preferred because they tend to be easier to take and may have fewer serious side effects.

Some clinicians have used low-dose flutamide off-label for female conditions like severe acne or unwanted hair growth, and a few transgender patients have tried it. But because of liver risks, safer alternatives are usually recommended.

What to expect: dosing, side effects, and monitoring

Typical historical dosing for adults was 250 mg three times a day, but don’t use that as a rule—follow your prescriber's instructions. The important side effects to know:

• Liver injury: This is the biggest concern. Symptoms include yellowing skin or eyes, dark urine, pale stools, nausea, vomiting, abdominal pain, and unusual tiredness. If you spot any of these, stop the drug and get urgent medical help.
• Common effects: Hot flashes, breast swelling or tenderness (gynecomastia), loss of libido, and gastrointestinal upset.
• Less common: Skin rash, blood count changes, or allergic reactions.

Monitoring is practical: get baseline liver tests before starting flutamide and repeat them regularly—especially during the first months. Your doctor will tell you how often. Don’t drink alcohol while on flutamide; it adds stress to the liver.

Also, tell your provider about every other medicine and supplement you take. Flutamide can interact with other drugs and raise the risk of side effects. Don’t stop suddenly without medical advice—some treatments need a careful plan when changing.

Why it’s less common now: safer, once-daily antiandrogens and newer hormonal drugs have largely replaced flutamide in many places. If your doctor suggests flutamide, ask why it’s chosen over alternatives, how they’ll monitor you, and what the plan is if liver tests change.

Bottom line: flutamide can help in certain prostate cancer cases, but liver safety is non-negotiable. Ask for baseline labs, learn the warning signs, avoid alcohol, and keep open contact with your healthcare team. If anything feels off, call your clinic—fast.