I posted about a month ago regarding my dad that his PSA levels are rising even though he is taking Zytiga doctor suggested we first do a scan and then to proceed to possible chemotherapy well I am following up and I did some investigation and I need some help.
My father is 81 years old and yes he has been through a lot of stress this past year losing my mom and losing his brother all in the past year plus obviously he’s got cancer he is taking Zytiga two tablets once a day with two prednisones tablets I noticed through investigating on his coffee table that he was not consistently taking his Zytiga so from what I counted pills wise he has about three weeks worth of not taking pills other somehow he has missed taking 42 tablets he claims he takes them religiously daily but I said dad if you take them daily your blood levels wouldn’t be rising and you wouldn’t have almost 42 tablets on your coffee table so that tells me you’re not taking them consistently daily so now I am the Zytiga Police and I call every day and go there three times a week count the pills and make sure he’s taking out my question to everyone there that knows anything about Zytiga before I see his doctor next week if you don’t take Zytiga consistently daily would that make your numbers for your PSA levels rise he does take them but not daily so at one point for a full year he was doing excellent and his levels were low but now that I notice he has three weeks left over of pills the levels are rising.
He takes medication for his other ailments too and no he doesn’t have dementia I think he’s sick of taking the pills on an empty stomach and pretty much not eating for 3 hours until the pillls get into the system
So basically my question is if you do not take Zytiga daily and miss a day here or miss a dose there for a total of three weeks worth would that affect the PSA levels
The scan showed nothing new thank God can the cancer is still where it was 5 years ago when he was diagnosed, Femur bone and humerus bone
Yes I have told my dad the importance of taking zytiga I also informed him if he fails to next step would be chemo so he got scared and he’s taking the pills religiously
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Olivia007
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I think to really get at the heart of your answer, you would need to do a large scale study of people not taking their zytiga consistently. From a pharmaceutical perspective, medications are going to be less effective when taking irregularly because they don't keep a consistent level in your blood, therefore reducing effectiveness.
It's good that you became the "zytiga police" lol and explained to him about the next step being chemo, that was great to do. You're just going to have to wait until the next PSA after this one and make sure to explain to the doctor of what was going on.
The best thing to do is get one of those pill containers with openings for each day of the week. I sometimes can't remember whether I took my pills or not. With the pill container you can just look to see. I would recommend it if he doesn't already have one.
I take it he is on Lupron as well.....This can cause brain fogginess and people forget things....he is also 81.....My MO said to take it regularly at the same time every day...my other concern is that he takes other meds, and possibly supplements which can effect Zytiga liver clearance... Do I think if he missed 3 weeks of meds that his PSA could be up?
Yes.... You're a good daughter to be so concerned ....God bless you...
"The mean half-life of abiraterone in CRPC patients is 12 ± 5 hours." [1]
Seems that there is great variability among patients. The significance of the missed doses depends on how quickly he clears the drug, & also his pattern for missing doses, but 42 pills is a lot of missed doses.
You could step-up your policing between the next two PSA tests, so as to get a handle on the significance of missed doses.
Good for you be the police! I am 65 diagnosed at 62. I can tell you I have an app on my phone that reminds me to take my meds. ALSO I have a little clicker on the side of my zytiga for a week which reminds me if I took it for that day! Being on Lupron and Zytiga can cause fogginess of the brain. Scary so please watch over him andthe best to you and dad!
I agree with gregg57. I would have put money on me taking my pills...my wife bought me one of those pill containers gregg57 is talking about and I was blown away by how often I forgot to take pills.
Everyone I've heard from on here are taking 1000 mg zytiga per day and 5 mg prednisone. Also you can eat after 1 hour not 3 hours. I take them as soon as I wake up. I've heard of guys getting up at 4 am, taking them and going back to bed, we usually have to pee anyhow.
My dad 87 is on the Zytiga pills,mom makes sure he takes them a hour before lunch. Just had a 6 week checkup his PSA was down another 3/4 of a point. So I have to say that skipping pills would affect his PSA. It’s tough to keep them on the straight and narrow, Keep up the good work 🙏🙏🙏
I weigh 132 down from 151 from the Zytiga. When I first lost weight my Dr. took me off it for a week. Appitite came back in 2 days so they don't last very long. I am not good with my timing and sometimes eat to soon. My PSA has still been undetectable. 32 pills is a lot
but I would think if he gets back on track he should get the PSA his Dr. is expecting.
They also don't use size or weight to determine dosage.
I asked my Lupron nurse about it and he said they have started using weight for dosage in females who get Lupron for breast cancer. So I am taking the same dose as someone who weighs 250? Yup!
Good luck with your Dad. I also use a twice a day, one week pill container.
I agree with the idea of the 7 day a week pill container. If they won't all fit we have saved old pill bottles and removed the label and marked them.. One bottle a day or One bottle a day/AM/PM pills. It is easy to forget.
If he gets up at night to go to the bathroom it is a great time for empty stomach pills. In this case I would have a separate bottle each day for mid-night-time pills. My husband uses his bathroom trips for empty stomach supplements.
He does take them at night 3am so his stomach is empty and goes back to bed to sleep and wakes up at 7 am and then eats
My zytiga refill is on a 4 week schedule (28 days) and each refill is 120 pills, meaning on average I gain pills in time even though I take my 1000mg dose everyday. Right now I figure I have about $15k extra in zytiga just laying around in my big pills container.
I asked MO if it was ok to have a cup of tea/coffee before the one hour had passed. He said Ok as long as I did not use anything in coffee/tea such as sugar, dairy, etc.
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My dad’s test result :( 
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