Liver enzyme increase after Zytiga

[snoraste]

After two weeks on Zytiga, my liver enzymes have gone up. My MO suggested suspending Zytiga for a couple of week and trying it again. Has anyone had a similar experience?

[snoraste]

I should add that I'm taking statins also, and I wonder that maybe the culprit

[npaulson1 in reply to snoraste]

Hi Snoraste:

I started on 1000 mgs Zytiga and liver enzymes went up. Oncologist pulled me off for a week and cut the dosage to 750 mgs. Still troublesome liver numbers meant another week off and a drop to 500 mg, which seems to be the sweet spot for me. Does that mean it's a less effective dose? My oncologist says no, that the only reason that they start at 1000 mgs is that's what was used in the trial. Still, I'll be checking PSA monthly for awhile.

[snoraste in reply to npaulson1]

Thank you for your response. I suspect if Zytiga doesn’t work at the current 1000mg level, I either have to do what you did, or get on Xtandi. But I need to make sure it’s not the statin, or taking it with some food.

-shayan

[Dan59]

I had High liver numbers back in 2006 when on Casodex 150, I stopped and liver numbers recovered,No other drug caused high LFT since. Do you take a lot of Supplements? Are you taking zytiga on an empty Stomach and waiting an hour to eat after? High high did liver numbers go?

Dan

[snoraste in reply to Dan59]

Not really taking a lot of supplements. Vitamin D3. But I am taking statin (crestor). ALT went up to 75, and AST to 41.

I’ve been taking Zytiga on semi empty stomach. I know it’s potency and side effects go up if you’re stomach is not empty. Did you experience any difference?

[Dan59 in reply to snoraste]

I think not doing it on an empty stomach can increase the dose, Perhaps that is whats going on, My numbers were in the hundreds at the time.

[npaulson1]

Since you're worried about statins, perhaps I should amend my earlier post by noting that I've been taking a statin (simvastin) for 10 years and continue to do so. Metformin too. My psa has gone down to .21 It was 24 before treatment with lupron and Zytiga began in July. Taking Zytiga carelessly on a non-empty stomach laid me out with a 102-degree temperature and killer muscle cramps for a couple hours. Best to take it when you get up in the middle of the night to pee -- for us, that's a normal annoyance. I haven't seen any other comments on Zytiga dosage, but my oncologist isn't concerned about lowering

it.

[snoraste in reply to npaulson1]

Thanks for the explanation. It maybe taking on empty stomach, or the dosage issue, or interaction with this particular brand of statin. I have no difficulty taking it in the middle of the night since I get up to go to the bathroom anyways. I’m going to eliminate all and see what happens in 10 days when the re introduce Zytiga.

[Sisira]

I have seen Dr.Charles Myers recommending Ursodiol 300mg twice a day for his patients to reduce liver damage caused by Pca drugs such as bicalutamide and the like. You may discuss this with your Onco.

Sisira

[snoraste in reply to Sisira]

I’ll definitely look into it. Would be good to stay with Zytiga now. I’m hesitant to switch from Zytiga at the beginning stage of my treatment, just to have others in the pocket if/when Zytiga fails. I know Dan had switched early on with good results, so at the same time I’m not overly worried either.

[Dan59 in reply to Sisira]

I also did Ursodiol, It is hard to get a Dr. to prescibe it, I was able to get it by having an appointment with a liver specialist in digestive disease. PCRI also suggest milk thistle as Nalakrats did. Good idea to take Zytiga in middle of night ,and fast.

[Apollo123]

You have to take them on an empty stomach or the potency increases. That could be your problem. 👍

[snoraste in reply to Apollo123]

That was my first reaction also. My MO was not so convinced though. but next week when I get back on it, I’ll do the middle of the night intake. Maybe adding some herbal remedies per Nak

[snoraste]

Thanks for the suggestions. I’ll definitely look those up on the internet.

[Apollo123]

I was taking lots of herbal remedies but some cause a reaction with my Zytiga, I have had to by elimination drop the ones that were causing issues. I would feel sick if I took certain supplements. I’m still taking Curcumin and vitamin C and a few others. Unfortunately I can’t drink any alcohol I used to like an occasional glass of wine but I would feel ill for days after. I hope you can remain on it but as far as I’m aware Zytiga has the largest effect on liver enzymes.

[snoraste in reply to Apollo123]

I have taken down my alcohol consumption as well. Now to a glass or two a week. I have stopped it until the next two rounds of blood tests. I’ll definitely be doing the process of elimination as well for the side effects and interactions.