Bicalutamide monotherapy has been associated with abnormal liver function tests such as elevated liver enzymes in % of men relative to % for standard care.   Hepatic changes such as marked increases in liver enzymes or hepatitis that necessitated discontinuation of bicalutamide have occurred in approximately to 1% of men in clinical trials.   Monitoring of liver function during treatment is recommended, particularly in the first few months.   In men of advanced age with prostate cancer, bicalutamide monotherapy has been associated with an increase in non-prostate cancer mortality , in part due to an increase in the rate of heart failure.   These mortality-related effects are thought to be a consequence of androgen deprivation, rather than a specific drug-related toxicity of bicalutamide.