Advanced Prostate Cancer
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Elevated liver enzymes

Been on Zytiga a month and liver enzymes shot up. Anyone else have this issue, and if so, how did you get it controlled? If they don’t come down, it may be time to take 1 Zytiga with a meal rather than 4 on an empty stomach. My PCP suggested I stop metformin for now.

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Hi Canoehead dont have anything specific about Ztyga( im not there yet but its down the road).What I can suggest and its something I plan to do myself is to have milk thistle to strengthen your liver.Also Dandelion and Artichoke are suggested.

they way I'll do it is getting Milk thistle leaves and Dandelion root and prepare a tea from it.seems to me more efficient than having off the shelf Milk thistle capsules.

Good luck

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Are you taking Prednisone also? I would of course inform your MO if you want to change your routine. But Prednisone is usually prescribed when taking Zytiga.

Ralph

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I had this problem with Ketoconozale which works similar to Zytiga with similar warnings.

First of all most important, stop all herbs and vitamins except Vit D. Reaction to herbs and protein drinks or vegetable shakes that contain extra vitamins or herbs. Herbs cause serious liver problems with this medication.

2nd, get a prescription for Ursodiol to help with liver protection. Dr Charles Myers (retired) always prescribed this for liver issues and it helps.

3rd, drink more fluids.

4th, make sure you have normal bowel movements so the meds dont concentrate in your body.

If you liver numbers are off the scale, you may need to wait for the liver to recover before continuing, and slowly work into the full dose until your liver numbers look OK.

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Dorke--I agree with!

Nalakrats

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Doc cut my prednisone to 5 mg/day, but not because of liver enzymes. Will order milk thistle. I was also told to exercise more

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When I started Zytiga/predisone, I was on 1,000 mgs (four tablets daily). but liver tests were worrysome. MO cut me to three tabs, then two and the liver seemed happy. Have stayed on 500 mgs for 10 months now. I asked MO if two were as good as four and he said, "The only reason we prescribe four is that's what they did in the study (which proved the early-Zytiga efficacy). Psa has been undetectable, down from 24.

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Unfortunately, Zytiga causes liver problems. My oncologist had to reduce the dosis twice to 500 MG. We're trying 750 MG now. We are also checking liver functions every two weeks. I am also taking Prednisone 5 MG daily.

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It happened to me Doctor cut mine down to 750 mg. Enzymes returned to normal and PSA still undetecable. Leo

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Like, hopefully everyone else taking Z&P, I had a blood test every 2-week's for the first 3 months when I first started Z&P. My ALT & AST went up but never above the max in the Zytiga prescribing documents. Those numbers are not the standard numbers. My MO & I kept an eye on them. In my case, my numbers went down consistently as the weeks went on. No adjustment in dosage.

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I had the same problem. Wine! I was drinking "a glass" of wine nightly. Stopped that. Went off my statins. Off anything that requires the liver to detox it.

Went off Zytiga for two weeks, then slowly added as my liver numbers recovered.

Good luck,

Craig

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Hi Canoehead, any news on your liver enzymes ?

I just started Zytiga and would like to hear your experiences

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I added milk thistle, drank more water, stopped my metformin, and cut my beer drinking to once per week. Enzymes back to normal. Thankfully. Have restarted Metformin. Will wait until next blood test before I start Lipitor, which I talked my MO into prescribing, but which he asked me to hold until we verify that liver enzymes are normal. Now it’s on to radiation.

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