Bicalutamide (Casodex) and Ketamine Therapy | Tovani Health
Casodex (Bicalutamide) — First-generation anti-androgen (prostate cancer)
Verdict at Tovani Health
Fully compatible with KAP.
Bicalutamide and ketamine have no clinically significant interaction. Older anti-androgen, often used with a GnRH agonist (leuprolide, goserelin) for combined androgen blockade. The intrinsic considerations — hepatotoxicity monitoring, gynecomastia, hot flashes — are bicalutamide-class concerns independent of KAP. Largely supplanted by enzalutamide in modern practice but still in use, especially in earlier-stage disease.
If you take Casodex regularly and are considering at-home ketamine therapy, the combination is generally safe at therapeutic doses. This page covers the brief pharmacologic context and what we do at intake.
How Casodex interacts with ketamine
Bicalutamide competitively binds androgen receptors. CYP3A4 substrate with mild CYP3A4 inhibitor activity at higher doses; not clinically significant for ketamine.
What we do at intake
Continue as prescribed.
Bottom line
Bicalutamide and ketamine have no clinically significant interaction. Older anti-androgen, often used with a GnRH agonist (leuprolide, goserelin) for combined androgen blockade. The intrinsic considerations — hepatotoxicity monitoring, gynecomastia, hot flashes — are bicalutamide-class concerns independent of KAP. Largely supplanted by enzalutamide in modern practice but still in use, especially in earlier-stage disease.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Casodex (Bicalutamide) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 22, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.