Advanced Prostate Cancer
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Stopping Zytiga + Prednisone, Liver Enzymes up

I have been instructed to stop Zytiga and prednisone and waiting for liver function to recover. Its been 2 weeks and waiting for next retest. I've been on Zytiga and prednisone and Lupron for 4 months before stopping. The side effects before stopping were tolerable. I'm now experiencing light headed, drowsy, fatigue and wondering if coming off 5 mg of prednisone is the culprit. I'm looking into milk thistle and dandelion. Should I have stayed on the prednisone until liver function recovers?

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My understanding is that you're supposed to scale out of prednisone over a period of time, and not to stop it abruptly. Double check with your MO

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If you don't ramp down from prednisone, it may cause blood pressure to drop and fall further when standing, causing dizziness or fainting. Other symptoms may include fatigue, loss of appetite, weight loss, nausea, vomiting, diarrhea, muscle weakness, irritability, and depression.

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The two herbs are the best we have for liver enzyme recovery---from a Naturopathic prospective.

Nalakrats

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Milk thistle and what else?

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Dandelion Extract

Nalakrats

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I took 6 weeks to come off pred - gradually reducing the dose until we got down to 1mg every second day. Tried coming off faster but BP went haywire. Just be patient.

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I had to stop Zytiga for a couple of weeks due to elevated liver enzymes at about 3 months. Don't drink any alcohol when on it. My liver enzymes came down when I quit my "glass of wine" nightly. Stopped statin also.

I stayed on prednizone, after 2 weeks and better liver numbers, I started Zytiga at 2 pills a day. After 2 more weeks and improving liver numbers, went to 3 pills a day. I am now on 4 pills and liver enzymes are normal.

It was the alcohol.

Craig

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My latest ALT,AST test after 2 weeks off Zytiga are normal. I consider it at the high end of the range. MO wants to restart Zytiga 3 pills and back on Presnisone. I said to MO that I want to wean off Pred if we have to do this again. Will retest every week.

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Yeah, start up at less than standard. My nurse told me to stay on prednizone. I think it was the right choice as I didn't stay off Zytiga for long.

You "normalized" liver function quickly, took me longer. Any idea why liver numbers went up? Statins? Alcohol? Taking Zytiga too near meal? Anything else that puts "strain" on liver?

Craig

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I think the stampede study of 900+ patients, there was about 15% with liver issues. I would have to look it up to be correct. I stopped alcohol about June last year, although I was about a 6 pack per week, no wine or booze. I wasn't on any drugs before findings last year. No statins, no b/p pills. I did take my Zytiga 1 hr before my coffee and then eat breakfast. Pred is during breakfast. In the future, I'm going to wait at least 1 1/2 hr before my first coffee and probably take 3 Zytiga at my last pee about 4am.

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Mystery. Maybe the 1 hour before eats? I take the Zytiga between 12 midnight and 3 am (same pee thing). No food conflict, but got to put pills in sight, by toilet.

Craig

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I have been on prednisone since Christmas (2 tablets or 10.g per day) albeit in conjunction with docetaxal not zytiga. Now that docetaxal is finished I have also stopped prednisone

MO told me to cut back to 1 tablet (5mg) per day for a week then half a tablet (2.5.g) per day for a week. So 2 week weaning process finished 2 dàys ago. No issues experienced as far as I can tell.

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