Eating regime and Zytiga

[BrentW]

Hi. I am starting on Zytliga tomorrow, with prednisone twice daily to counter its side effects. Meanwhile, I am already on a non-steroidal painkiller (Olfen) once daily to counter the discomfort from the growth of scar tissue from my radical prostatectomy. (I had brachytherapy in 2004, and attempted salvage surgery in 2012, and the combination of the two has resulted in very stiff and unforgiving scar tissue. As you will gather, both failed.)

The challenge is this: I cannot take the pred and painkiller together, but both need to be taken with large meals to avoid damage to my stomach. Meanwhile, the Zytiga must be taken without food.

Is anybody else in this illustrious group of unfortunate friends facing a similar regime? If so, can you advise how you are spreading the eating and meds throughout the day? Has this regime helped to avoid weight gain?

I look forward to any replies.

[pjoshea13]

Personally, I would take Zytiga with a high-fat meal. See:

ncbi.nlm.nih.gov/pubmed/260...

ncbi.nlm.nih.gov/pubmed/257...

ncbi.nlm.nih.gov/pmc/articl...

-Patrick

[YostConner]

I take my Zytiga between 4:30 and 7:00 am (it's all a matter of the bathroom break). I take the first prednisone after I arrive at work, following breakfast on the way to work. I take the second prednisone just before bed. That last one is not soon after a meal, but I usually have a small snack after dinner. For the prednisone, I don't think you need a big meal--you just don't want an empty stomach. Could you do something like this and do the pain med after lunch?

I've had weight gain as a result of ADT and Zytiga, but I work with a nutritionist to keep it in check. A few months ago one of my doctors started me on a diabetes medicine that caused my weight to shoot up rapidly. I got off that, and the weight is coming off.

[HalC in reply to YostConner]

Thanks for always being so helpful to folks here, Yost.

[PaulC2]

I agree with pjoshea13 — I take my Zytiga+prednisone just after a meal so as to maximize the Zytiga's effectiveness.

The only reason the label says to take it without food is that it wasn't possible to standardize the blood serum level of Zytiga-takers in the clinical trials unless they took it fasting. It's purely for the convenience of the manufacturer, and not at all for any health or efficacy reason (so far as I can tell). I have my oncologist's blessings on this modification.

So far as I know, there is no clinical drawback to taking Zytiga with food, and there is usually some benefit. The dosing instructions are purely a metter of metrology, not healthcare.

For a drug with such low toxicity as Zytiga, it's silly to create unnecessary problems with activities of daily living, especially when taking it with food potentiates its effect in most men.

[Spitzz in reply to PaulC2]

What is the dosage of the Zytiga you take with food? How do you measure the effectiveness of the food/Zytiga? What was your PSA before Zytiga and after? I do the Zytiga 2 Hrs. after any food as prescribed

BEST OF LUCK

[PaulC2 in reply to Spitzz]

I take the dosage prescribed — four 250-mg tablets — but I take two after breakfast and two after dinner. I don't measure the effectiveness (and indeed have no way of doing so); it's not a controlled experiment.

When I don't take Zytiga, my PSA doubling time is 60 days, regular as clockwork. Given two or three values in the 0.04 to 0.07 range, I'm able to predict within a week or two when it will hit 2.0. Since starting Zytiga, I've never let my PSA rise about 2.5.

[RonL]

I take Zytiga each morning when I wake up and an hour later I take my daily dosage (10mg) of Prednisone in one shot followed by a light breakfast. No side effects other than the fatigue I've had from Eligard since the beginning. Currently my PSA is running around 0.15 down from 20 when I developed CRPCa nine months ago.

Good luck.

[MelaniePaul]

My husband used to do the following: He took Zytiga in the morning at around 5AM, then would have breakfast at 7AM and take the Prednisolone with that. My husband would take both Prednisolone in the morning with his breakfast. If you have your dinner between 6PM and 8PM, you could maybe take the pain medication right before going to bed?

[Spitzz]

On Zytiga for 18 months and my routine is, as soon as I get up I take my Zytiga due to the 2 hr. eating before limitation. Start my day and wait at least 1 Hr. before eating breakfast, very easy regiment. As for the Prednisone I take it with my breakfast ..

[herb1]

Please teach me. Prednisone vs prednisolone when taking Zytiga? Are they the same, or are they effectively the same? Also, I thought i had read that dexamethasone (?) could be used instead. I have no idea whether it would be better or worse.

herb S.

[Beauxman]

I was unaware of the interaction between steroids and NSAIDs. Thanks for informing us. My pain med is Tramadol, so I don't have an interaction problem.

[sidnw]

I have been on Zytiga for 4 months. I take 4 tablets one hr. before breakfast and take prednisone 5 Mgs. at breakfast and 5 at dinner. My PSA has gone from 779 to 8.1. Luckily I have no side effects from the drug. ..and no weight gain.

Sid

[BrentW]

Many thanks for the replies to my question, and I hope I have such good results with Zytiga. My PSA having been as high as 423 ng/ml, it would be a relief to see it down in single digits again. It would also be good if it remained so for a while, although I read that the mean time before failure of this drug is one year only. Few messages, however, addressed the real issue of my question: how to take the painkiller, Zytiga and prednisone throughout the day? The suggestion that I delay the painkiller until lunchtime is not a viable option. Does anybody have any thoughts?