abiraterone
Abiraterone (Zytiga) is an oral medication used to treat certain types of prostate cancer. It's taken by mouth once a day. But you'll also have to take it with a steroid, which is typically taken once or twice a day. You might also need to take another medication that targets GnRH (gonadotropin-releasing hormone), unless you’ve had surgery to remove both testicles (bilateral orchiectomy). Some common side effects caused by abiraterone (Zytiga) include high blood pressure and swelling from fluid build up. Zytiga is available as lower-cost generics, but Yonsa currently isn't.
What is Abiraterone (Zytiga)?
What is Abiraterone (Zytiga) used for?
Prostate cancer that has spread to other parts of the body, in combination with a corticosteroid:
- Cancer that needs testosterone to grow (Zytiga only)
- Cancer that can still grow when there’s not much testosterone (Yonsa and Zytiga)
How Abiraterone (Zytiga) works
Most prostate cancer cells need testosterone to grow and spread. Testosterone is a type of male sex hormone called an androgen.
Abiraterone (Zytiga) is an androgen synthesis inhibitor, a type of hormone therapy. It works by lowering the amount of testosterone your body makes. Without testosterone, prostate cancer cells won’t have the fuel they need to grow or spread.
Drug facts
Side effects of Abiraterone (Zytiga)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Tiredness (39%)
- High blood pressure, with or without symptoms such as dizziness and headache (up to 37%)
- Joint swelling or discomfort (30%)
- Muscle discomfort (26%)
- Swelling in your body from fluid buildup (edema) (27%)
- Constipation (23%)
- Diarrhea (up to 22%)
- Hot flash (up to 22%)
Less Common Side Effects
- Heartburn
- Fever
- Runny nose, sore throat, and other cold-like symptoms
- Trouble breathing
- Trouble sleeping
- Fall, broken bone, or bruising
- Groin pain
- Urinating more (especially at night), bloody urine, or other symptoms of urinary tract infection
- Rash
- Headache
- Changes in heart rhythm, chest pain, or heart failure
Abiraterone (Zytiga) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Liver damage: nausea, vomiting, right-sided stomach pain, tiredness, loss of appetite, or yellowing of the skin or eyes
- Dangerously low levels of stress hormone: fast heartbeat, feeling faint, headache, confusion, muscle weakness, and pain or swelling in your legs
The following Abiraterone (Zytiga) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Bladder pain
bloating or swelling of the face, arms, hands, lower legs, or feet
bloody or cloudy urine
blurred vision
bone fracture
bone pain
chest pain or discomfort
decreased urine
difficult, burning, or painful urination
fainting
fast, pounding, or irregular heartbeat or pulse
feeling of warmth
frequent urge to urinate
headache
increased thirst
increased urge to urinate during the night
lightheadedness, dizziness, or fainting
loss of appetite
lower back or side pain
mood changes
muscle pain or cramps
nervousness
numbness or tingling in the hands, feet, or lips
pain or swelling in the arms or legs without any injury
passing urine more often
pounding in the ears
rapid weight gain
redness of the face, neck, arms, and occasionally, upper chest
seizures
slow heartbeat
sudden sweating
swelling
swelling with pits or depressions on the skin
trouble breathing
unusual tiredness or weakness
unusual weight gain or loss
vomiting
waking to urinate at night
Less common
Arm, back, or jaw pain
chest tightness or heaviness
clay-colored stools
cool, sweaty skin
dark urine
decreased urine output
difficulty with breathing
dilated neck veins
extreme tiredness or weakness
irregular breathing
itching skin or rash
light-colored stools
stomach pain or tenderness
sweating
weakness
yellow eyes or skin
Incidence not known
chills
cold sweats
coma
confusion
cool, pale skin
difficulty swallowing
general feeling of discomfort or illness
increased hunger
irregular heartbeat, recurrent
muscle pain, spasms, stiffness, tenderness, wasting, or weakness
nightmares
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
shakiness
slurred speech
stomach pain, continuing
thickening of bronchial secretions
unpleasant breath odor
unusual tiredness or weakness
vomiting of blood
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Belching
body aches or pain
difficulty with moving
ear congestion
indigestion
joint pain
loss of voice
runny or stuffy nose
stomach discomfort or upset
swelling or stiffness of the joints
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Abiraterone (Zytiga)
Pros
- Oral pill, taken once daily
- Recommended option for certain types of prostate cancer
- Zytiga is available as a lower-cost generic
Cons
- Must be taken with a steroid
- Can raise your blood pressure or cause fluid buildup
- Zytiga needs to be taken on an empty stomach
Pharmacist tips for Abiraterone (Zytiga)
- Take Zytiga on an empty stomach. Don’t eat food 2 hours before and 1 hour after taking abiraterone (Zytiga). Swallow tablets whole. Don’t cut, crush, or chew the tablets. Yonsa can be taken with or without food.
- If you miss a dose of abiraterone (Zytiga) or your steroid, don’t try to make up that dose. Skip the missed dose, and take your next dose at your next regularly scheduled time. Don't take two doses at the same time. Let your provider know if you miss more than one dose.
- Certain medications, such as rifampin (Rifadin), can interact with abiraterone (Zytiga), which can change the levels of abiraterone (Zytiga) in your body. This can affect how well abiraterone (Zytiga) works to treat prostate cancer or raise your risk of side effects. Tell your provider and pharmacist about all the medications you take, including supplements and over-the-counter medications. Before starting any new medications, make sure your provider knows you're taking abiraterone (Zytiga).
- Abiraterone (Zytiga) isn't meant to be taken alone to treat prostate cancer. Typically, you should be taking it at the same time as a medication that targets a hormone called GnRH (e.g. Lupron Depot (leuprolide) or Firmagon (degarelix)), unless you’ve had surgery to remove both testicles. Check with your provider if you aren’t receiving a GnRH-targeting medication. Don’t stop taking these medications without talking to your healthcare provider first.
- If your partner is able to become pregnant, use appropriate birth control measures, such as condoms or birth control pills, while you’re taking abiraterone (Zytiga), and for 3 weeks after your last dose. It’s possible for abiraterone (Zytiga) to cause birth defects or pregnancy loss in female partners of males who are taking this medication. Talk with your provider if you have questions about birth control options for you and your partner.
- Ask your healthcare provider or pharmacist about the best way to handle and dispose of this anticancer medication. These medications can be very harmful to people who handle or come into contact with them, so you need to get rid of them safely.
Common questions about Abiraterone (Zytiga)
Zytiga (abiraterone) and Yonsa (abiraterone) both contain the same active ingredient and are taken once a day by mouth. They’re also both approved for the treatment of metastatic prostate cancer. But there are some differences. One difference between these medications is the steroid they're recommended to be taken with. Zytiga should be taken with prednisone and Yonsa should be taken with methylprednisolone. The medications also have different dosing. Zytiga is dosed at 1000 mg and Yonsa is dosed at 500 mg. Another important difference is that Zytiga shouldn’t be taken with food. This is important because food changes how much medication is absorbed in the body. This isn’t a problem with Yonsa, as Yonsa can be taken with or without food.
You'll need to take steroids, like prednisone and methylprednisolone, with Zytiga or Yonsa to help replace the cortisol (stress hormone) lost during treatment with either medication. While abiraterone (Zytiga) does a good job at lowering the amount of testosterone your body makes, a side effect is that it also causes your body to make less of another hormone called cortisol. This isn't good — if you don't have enough cortisol, your body can get in trouble. You can experience side effects of low cortisol, such as dizziness, weakness, and changes in your mood. In addition, you might notice other problems, such as swelling from fluid build up, changes in your heart’s rhythm, and high blood pressure — these are results of changes in other hormone levels caused by low cortisol. Be sure to take your steroid as your provider prescribes to lower your risk for these side effects.
It’s important that you take Zytiga (abiraterone) on an empty stomach because food affects how much Zytiga (abiraterone) gets absorbed in your body. If you take it with food, your body might absorb too much medication. This means that Zytiga (abiraterone) can cause more side effects.
Abiraterone (Zytiga) isn’t a chemotherapy medication. Chemotherapy is a class of medication that targets and kills cancer cells in your body. Abiraterone (Zytiga) doesn’t kill cancer cells. Instead, it’s a form of hormonal therapy called an antiandrogen. It works by lowering the amount of testosterone your body makes. Most prostate cancer cells need testosterone to grow and spread. By lowering the amount of testosterone, abiraterone (Zytiga) there is less “fuel” for cancer cells to grow or spread.
It's possible that abiraterone (Zytiga) can affect your ability to have children. While there isn't enough research done in people, animal studies show that abiraterone (Zytiga) can lower the amount of sperm you make and damage your sperm. Talk to your provider if you have concerns about fertility.
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Risks and warnings for Abiraterone (Zytiga)
Abiraterone (Zytiga) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Swelling from fluid buildup, heart problems, and low potassium levels
- Risk factors: Blood pressure that’s not controlled | Low potassium levels | Heart problems
Abiraterone (Zytiga) can cause changes in certain hormone levels that can lead to problems like low potassium, fluid buildup, changes in your heart’s rhythm, and high blood pressure. These problems can be serious, especially in people that have other heart problems, like heart failure or a recent heart attack. Your provider will monitor your blood pressure, as well as potassium levels through lab work. They’ll also monitor you for symptoms of fluid build up (e.g., pain or swelling in your arms or legs). Your provider will prescribe a steroid to take with abiraterone (Zytiga) to lower your risk of these side effects. Let your provider know if you experience dizziness, fast heartbeat, lightheadedness, confusion, or pain or swelling in your legs or arms. These could be symptoms of side effects related to abiraterone (Zytiga).
Low stress hormone levels
- Risk factors: Interruption or dose change of steroid therapy | Infection | Stress
Taking abiraterone (Zytiga) causes your body to produce less stress hormone. Your provider will prescribe you a steroid, such as prednisone or methylprednisolone (a man-made version of your stress hormone), to make up for the loss. But if you suddenly stop taking your steroid or when you experience too much stress, your body isn't able to make enough of its own stress hormones to meet your needs. Let your provider know right away if you experience symptoms of low stress hormones, such as weight loss, tiredness, confusion or stomach pain
Liver damage
abiraterone (Zytiga) can cause liver damage, especially in the first 3 months of you starting this medication. Not everyone experiences symptoms with liver damage. Sometimes, your provider can only tell you have problems with your liver by looking at your lab work. Because of this, you'll probably get bloodwork done weekly in the beginning, then less frequently after that, so your provider can check the health of your liver. Let your provider know right away if you experience symptoms of liver damage, such as tiredness, loss of appetite, nausea or vomiting, dark urine, right-side stomach pain, or yellowing of the eyes or skin.
Harm to unborn baby
Based on animal studies, abiraterone (Zytiga) can harm an unborn baby or raise the risk for miscarriage (pregnancy loss). If your partner is able to get pregnant, you should use birth control measures, such as condoms, while taking abiraterone (Zytiga), and for 3 weeks after your last dose. To reduce their risk of exposure to the medication, your partner should also not touch the tablets. Let your provider know right away if your partner becomes pregnant during this time.
Low blood sugar
- Risk factors: High blood sugar that’s treated with certain medication
Low blood sugars were seen when abiraterone (Zytiga) was taken by people with high blood sugar (diabetes) who were taking certain medications (like pioglitazone (Actos) and repaglinide) to control their blood sugars. If you have diabetes your provider might monitor your blood sugars more closely while you’re taking abiraterone (Zytiga). They might need to adjust the dose of your other medications treating your diabetes. Let your provider know if you experience any symptoms of low blood sugar, like sweating, shaking, fast heartbeat, confusion, or dizziness.
Abiraterone (Zytiga) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 250mg | 120 tablets | $113.18 | $0.94 |
| 500mg | 60 tablets | $252.75 | $4.21 |
Typical dosage for Abiraterone (Zytiga)
Zytiga (abiraterone) and its generics:
- The typical dose is 1,000 mg taken by mouth once daily. In addition, you’ll also take prednisone 5 mg by mouth, either once or twice daily, depending on your prostate cancer type.
- The typical dose is 500 mg taken by mouth once daily. In addition, you’ll also take methylprednisolone 4 mg by mouth twice daily.
Your dose might differ if you’re taking other medications that interact with abiraterone (Zytiga) or if you have liver problems.
Interactions between Abiraterone (Zytiga) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Dasabuvir
- Eliglustat
- Selexipag
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Amiodarone
- Amphetamine
- Apalutamide
- Benzphetamine
- Carbamazepine
- Cilostazol
- Clozapine
- Dabrafenib
- Dextroamphetamine
- Dihydrocodeine
- Domperidone
- Donepezil
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Enzalutamide
- Fluoxetine
- Fosphenytoin
- Ifosfamide
- Lisdexamfetamine
- Lumacaftor
- Lurasidone
- Methamphetamine
- Mitotane
- Naloxegol
- Olaparib
- Ospemifene
- Oxycodone
- Ozanimod
- Paclitaxel
- Phenytoin
- Piperaquine
- Pixantrone
- Radium Ra 223 Dichloride
- Rifampin
- Rosiglitazone
- Simeprevir
- St John's Wort
- Tamoxifen
- Thioridazine
- Tucatinib
- Vortioxetine
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Abiraterone (Zytiga) cost?
What are alternatives to Abiraterone (Zytiga)?
Prostate cancer that has spread to other parts of the body, in combination with a corticosteroid:
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