ative ▁trial ▁of ▁combined ▁and ro gen ▁block ade ▁for ▁pro state ▁cancer , ▁the ▁rate ▁of ▁di arr he a ▁was ▁ 2 6 % ▁for ▁fl ut am ide ▁and ▁ 1 2 % ▁for ▁b ical ut am ide . ▁Moreover , ▁ 6 % ▁of ▁fl ut am ide - tre ated ▁patients ▁dis cont in ued ▁the ▁medic ation ▁due ▁to ▁di arr he a , ▁whereas ▁only ▁ 0 . 5 % ▁of ▁b ical ut am ide - tre ated ▁patients ▁did ▁so . ▁In ▁the ▁case ▁of ▁anti andro gen ▁mon other apy ▁for ▁pro state ▁cancer , ▁the ▁rates ▁of ▁di arr he a ▁are ▁ 5 ▁to ▁ 2 0 % ▁for ▁fl ut am ide , ▁ 2 ▁to ▁ 5 % ▁for ▁b ical ut am ide , ▁and ▁ 2 ▁to ▁ 4 % ▁for ▁nil ut am ide . ▁In ▁contrast ▁to ▁di arr he a , ▁the ▁rates ▁of ▁n ause a ▁and ▁vom iting ▁are ▁similar ▁among ▁the ▁three ▁medic ations . ▁ ▁R are ▁re actions ▁ ▁Liver ▁to x icity ▁Although ▁rare , ▁fl ut am ide ▁has ▁been ▁associated ▁with ▁severe ▁he pat ot ox icity ▁and ▁death . ▁By ▁ 1 9 9 6 , ▁ 4 6 ▁cases ▁of ▁severe ▁ch ol est atic ▁he pat itis ▁had ▁been ▁reported , ▁with ▁ 2 0 ▁fatal ities . ▁There ▁have ▁been ▁continued ▁case ▁reports ▁since , ▁including ▁li ver ▁trans pl ants