Estramustine (Generic Name)

Other Names: Estracyt®, Emcyt®

About This Drug

Estramustine is used to treat prostate cancer. This drug is given by mouth.

Possible Side Effects (More Common)

  • Diarrhea may occur
  • Difficulty catching your breath
  • Difficulty breathing when lying flat
  • Ankle swelling

Possible Side Effects (Less Common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets and may increase your risk of infection, fatigue, and bleeding.
  •  Mild nausea and vomiting
  • Thinning hair. You may notice hair thinning several days after receiving this drug. Usually hair loss is temporary; your hair should grow back when treatment is completed.
  • Skin and tissue irritation
  • Raised, red rash on your arms, legs, back, or chest
  • Dry skin
  • Headache
  • Unusual drowsiness
  • Watery eyes
  • Changes in liver enzymes. Your liver enzymes will be monitored as needed.
  • Trouble sleeping
  • Decreased appetite
  • Rectal gas
  • Pain or cramping in the groin or leg, especially the calf
  • Chest pain
  • Peeling of skin on fingertips
  • Night sweats
  • Fever
  • This drug may weaken the heart and decrease heart function. Your heart function will be checked as needed.

Sexual Problems and Reproductive Concerns

In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. In women, menstrual bleeding may become irregular or stop while you are receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may experience signs of menopause like vaginal dryness or itching.

    • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
    •  Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred. 
    • Breast feeding warning: Women are advised not to breast feed during treatment because this drug could enter the breast milk and seriously harm a breast feeding infant.
    • Mild to moderate breast enlargement may occur, starting with breast and nipple tenderness.

Treating Side Effects

  • Ask your doctor or nurse about medication to help prevent or lessen nausea and vomiting.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated. 
  • Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
  • Be careful when cooking, walking, and handling sharp objects and hot liquids.

Food and Drug Interactions

Take Estramustine one hour before or two hours after meals. Avoid taking estramustine with milk, milk products, calcium rich foods, or antacids. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's advice.

Allergic Reactions

Allergic reactions including anaphylaxis are rare but may occur in some patients. Signs of allergic reactions to this drug may include swelling of the face, feeling like your tongue or throat are swelling, shortness of breath, rash, itching, fever, chills, dizziness, and/or palpitations (feeling your heart beat rapidly). Do not take another dose of this
drug and seek immediate medical treatment.

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Difficulty catching your breath
  • Rash or itching, dizziness or lightheadedness, or palpitations
  • Unusual bleeding or bruising
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than two times in one day
  • Redness, pain, warmth, or swelling at the IV site
  • Chest pain
  • Leg swelling
  • Black, tarry stools
  • Coughing or hoarseness
  • Severe or sudden headache
  • Sudden slurred speech
  • Sudden change in vision
  • Weakness or numbness in an arm or leg
  • Pain in the groin or leg, especially the calf
  • Lower back or side pain
  • Sudden loss of coordination


Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Diarrhea of five or six stools in one day or diarrhea with weakness or lightheadedness
  • Nausea unrelieved by prescribed medication
  • Yellowing of the skin or eyes
  • Extreme tiredness that interferes with normal activities
  • Extreme drowsiness
  • Rash that is bothersome

Revised December 2011

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