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What Is Nilutamide?

Nilutamide is a prescription nonsteroidal antiandrogen used to treat metastatic prostate cancer in patients who have undergone surgical castration. Previously marketed under the brand name Nilandron, it blocks the effects of testosterone and other androgens on prostate cancer cells. Nilutamide is used alongside surgical reduction of testosterone production rather than as a replacement for that procedure. Treatment requires monitoring for potentially serious lung, liver, and vision-related adverse effects.

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What Is Nilutamide?

Nilutamide is a prescription nonsteroidal antiandrogen used to treat metastatic prostate cancer in patients who have undergone surgical castration. Previously marketed under the brand name Nilandron, it blocks the effects of testosterone and other androgens on prostate cancer cells. Nilutamide is used alongside surgical reduction of testosterone production rather than as a replacement for that procedure. Treatment requires monitoring for potentially serious lung, liver, and vision-related adverse effects.

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How Does Nilutamide Work?

Nilutamide binds to androgen receptors and prevents testosterone and related hormones from activating them. Androgen signaling can stimulate the growth of prostate cancer cells. Surgical castration reduces testosterone production, while nilutamide blocks the effects of remaining circulating androgens at their receptors. This combined approach helps limit hormone-driven cancer activity. Nilutamide does not directly reduce testosterone production and is not a cytotoxic chemotherapy medication.

What Conditions Does Nilutamide Treat?

Nilutamide is indicated for metastatic prostate cancer when used with surgical castration. It is prescribed as part of combined androgen blockade in patients whose cancer depends on androgen signaling. Treatment is generally started at the time of surgical castration. Nilutamide is not approved for localized prostate cancer without the indicated treatment approach or for unrelated hormone disorders. An oncology specialist assesses cancer status, respiratory health, liver function, and potential treatment complications.

How Should Nilutamide Be Taken?

The recommended nilutamide dosage is 300 mg orally once daily for the first 30 days, followed by 150 mg once daily. Treatment begins on the day of surgical castration or the following day. Tablets can be taken with or without food. Patients should follow their oncology team's instructions and attend scheduled appointments for monitoring. Do not increase, interrupt, or discontinue the medication without consulting the prescribing clinician.

What Are the Side Effects and Warnings of Nilutamide?

Nilutamide can cause hot flashes, nausea, dizziness, and difficulty adjusting vision when moving from bright to dark environments. Serious adverse effects include interstitial pneumonitis and liver injury. Some patients experience alcohol intolerance involving flushing, nausea, or low blood pressure after drinking alcohol. New shortness of breath, persistent coughing, yellowing of the skin, or unusual fatigue require prompt medical evaluation. Patients experiencing impaired dark adaptation should avoid driving at night.

Common Questions About Nilutamide

Is nilutamide the same as Nilandron?

Nilandron is a brand name historically used for nilutamide. Both names refer to the same active medication, although product availability can vary.

Does nilutamide lower testosterone levels?

Nilutamide blocks androgen receptors rather than directly reducing testosterone production. It is used with surgical castration, which lowers testosterone levels.

Can nilutamide cause vision problems?

Yes. Nilutamide can interfere with adaptation from bright environments to darkness. Patients experiencing this effect should avoid nighttime driving and discuss symptoms with their clinician.

Can nilutamide cause lung damage?

Yes. Nilutamide can cause interstitial pneumonitis, a potentially serious lung condition. New breathing difficulties or persistent coughing require immediate medical attention.

References

DailyMed - NILANDRON (nilutamide) tablet. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5ccf0e9a-8935-4c8c-b883-b4967281eb4a. Date Accessed October 19, 2026.

Nilutamide. LiverTox. https://www.ncbi.nlm.nih.gov/books/NBK548158/. Date Accessed October 19, 2026.

Nilutamide. MedlinePlus. https://medlineplus.gov/druginfo/meds/a697044.html. Date Accessed October 19, 2026.

Nilutamide. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/drugs/nilutamide. Date Accessed October 19, 2026.

Nilutamide. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/nilutamide. Date Accessed October 19, 2026.