I was prescribed 20mg daily, but told to start twice weekly and adjust dose to symptoms. It takes quite a while to build up the working level when you start, which is why it's good to start it when you start the Bicalutamide.
Do you get even temporary relief when taking a tablet? The last time I took them, I initially took a tablet when I had pain, which was me adjusting dose to symptoms. However, I continued for a while after any pain to reduce breast glands back again. Looking back at my records for the last spell I was on them, the days between 20mg tablets went:
2, 3, 3, 3, 4, 4, 5, 5.
Then I started snapping the tablets in half, and the days between 10mg doses went:
2, 3, 2, 2, 3, 3, 2, (repeating a mixture of 2 and 3), (then repeating a mixture of 3 and 4).
So, I was eventually on 2x10mg/week, but using initial dose escalation, which probably reflects that it takes time to build up the working level in the body when you are taking a long-acting drug. I did find many reports that the 20mg/week dose didn't work, and in part that might be because it would take months to get up to the working dose without initial dose escalation. If you start Tamoxifen when starting Bicalutamide, then you reach the working level around the same time gynecomastia would otherwise have started, and initial dose escalation wouldn't be needed. 2 x 20mg/week was another dose I heard of quite a bit for other people, and someone else on here was also prescribed 20mg/day without any instructions at adjust to symptoms, and had no problems with it. Tamoxifen is liver toxic for some people so you should have a liver function blood test when you've been on it for 3 months to check that, and repeat it every 6-12 months.
Women with specific types of breast cancer take 20mg/day for 5 years after their radical treatment to reduce recurrence, and it does result in 20% of them getting non-alcoholic fatty liver disease, but that risk is considered worth it for the resulting reduction in breast cancer recurrence, even though 2% go on to get cirrhosis of the liver, some of which will turn into liver cancer. The benefits of Tamoxifen for men on hormone therapy with prostate cancer are significantly lower, so exposing yourself to that level of risk is probably inappropriate, hence lower doses where possible.
By the way, I've not heard of 100mg Bicalutamide. It's usually 50mg as an anti-flare dose for 28 days, or as a double blockade (i.e. with hormone therapy injections), or just to shrink the prostate, and 150mg when used as a hormone therapy in its own right.
Edited by member 27 Dec 2022 at 08:47
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