Zytiga dosage

[Jamtu27]

My No just put me on four 250mg of zytiga per day and I' m having a tough time with it. Has one been on smaller dosage and gotten good results? I'm also on monthly Lupron shots.

[6357axbz]

I’ve been on Zytiga (abiroterone) for about 6 weeks now, same dosage as you, along with 5mg prednisone 1x per day. Fortunatly I have no additional side effects other than those from Lupron which I’ve been on for 7 months.

[Fairwind]

Age, PSA, history, Gleason score, ? Prednisone doseage ? Lots of things going on here, What kind of trouble are you having? When do you take it ? (time of day)

[Jamtu27 in reply to Fairwind]

I'm 80 and PSA was 74 seven months ago when I started lupron. PSA now is 0.22 but my Mo feels the zytiga will help lower it more. I feel extreme fatigue, horrible hot flashes, and dizziness. I take it at night before bedtime. With breakfast I take 5 mg prednizone.

[Shooter1 in reply to Jamtu27]

Never been on zytiga, but with xtandi had to cut dose in half to survive side effects.

[tom67inMA in reply to Jamtu27]

I've been on zytiga about two weeks now and have had similar side effects that vary from day to day. Will discuss with MO on Wednesday. I've also been very active recently which may not be helping with the fatigue

[GoBucks in reply to tom67inMA]

To the contrary-you fight fatigue with strength. I'm into month 17 of Zytiga. You can't be too active.

[tom67inMA in reply to GoBucks]

Yep, agree completely. My problem is increasing activity too quickly seems to be causing some transient fatigue while the body adapts. I should be more gradual but activity is almost addictive

[Fairwind]

Since I had to get up and pee anyway, I took mine at Midnight and had no problems..The fatigue is just a normal part of this game..I took afternoon naps..

[timotur]

I’ve been on Z/P for two months and PSA dropped from 33.5 to 1.0 using only 750mg/d, even though I was prescribed 1Kmg/d. I choose to take a smaller dosage because I thought the normal dosage probably applies to an average weight male in the U.S., which is about 197lbs, and I only weigh 145 lbs.

[Hirsch in reply to timotur]

Agree entirely

[Coco2535]

There is a study that my husband’s urologist believes is true. “Low-fat meal enhances efficacy of reduced-dose abiraterone for prostate cancer”. The study showed one tab, 250 Zytiga, was effective with a low fat meal.

[WXYZ123 in reply to Coco2535]

We read these studies too and John did one 250 mg with a low fat breakfast. 2.5 mg pred AM/PM.

Can't say it did anything for him but neither did Lupron.

He is on Firmagon/Xgeva once per month and Docetaxel low-dose every other week.

Lots of exercise, walking, biking,swimming, weights. Eats organic, lots of veggies and all types of proteins (mostly grass-fed if red) lighter on the carbs and sweets but not none.

No alcohol, yes Maté and coffee. every man is different. You just need to find what works for you and then when it stops, what's next.

Wish you the best!

[cesanon]

What exactly is the "tough time"?

What about vivelle estrogen patches?

They help with basic androgen deprivation therapy. Do they help with Zytiga?

[Hidden]

Sorry to hear that you are having challenges. I am on same dosage, but 2 500mg and Lupron every 3 months (equals 3 monthly injections) Do you take 5mg prednisone? It helps with Zytiga

[WXYZ123]

We read these studies too and John did one 250 mg with a low fat breakfast. 2.5 mg pred AM/PM.

Can't say it did anything for him but neither did Lupron.

He is on Firmagon/Xgeva once per month and Docetaxel low-dose every other week.

Lots of exercise, walking, biking,swimming, weights. Eats organic, lots of veggies and all types of proteins (mostly grass-fed if red) lighter on the carbs and sweets but not none.

No alcohol, yes Maté and coffee. every man is different. You just need to find what works for you and then when it stops, what's next.

Wish you the best!

[FCoffey]

I had a rough time with Zytiga as well, but I had agreed with my MO that we would stop Zytiga and Lupron once my PSA had fallen by 80%. I was on Zytiga only 12 days before reaching that goal - it worked extremely well.

It took me another full month after stopping Lupron+Zytiga to start producing testosterone and feeling halfway decent, but that was far better than the 6 to 18 months of living hell I had previously endured on Lupron.

Your PSA is now 0.3% of its initial value. If the drugs are making your life miserable, why not take a break? The goal isn't the lowest PSA, there is no contest for that. My goal is to have a good quality of life for as long as possible. Your goal may be different. Is PSA lower than 0.22 compatible with your goals?

Good luck!

[Jamtu27 in reply to FCoffey]

I agree with you. My focus is the quality of life also. Whatever time I have left on this side of life I pray that it will be minimally comfortable.

[FCoffey in reply to Jamtu27]

I want more than minimally comfortable. I want to get out of bed each morning feeling the POWER, wondering what the day will bring, eager to find out. I want to laugh a lot, drink too much whenever I can, and get laid regularly. I'm going to eat well and live large for as long as I can.

[gleason9guy]

I was convinced that over time the Zytiga amplified the side effects of the Lupron. I took occasional breaks from Zytiga, as a result. My PSA is still undetectable to it seemingly worked.

[SeosamhM]

Sorry about the difficulties with Zytiga, Jamtu. I've been on it for 2 months now and do not care for the side effects myself (I am 51).

The typical study-supported dose is 4 x 250 mg on an empty stomach, but there is growing "standardized" support for 250 mg/day with a meal (uptake of Zytiga is more efficacious with food, but since meals aren't standard, this lower dose isn't fully vetted). So, my man, you are on the lowest dose that the medical community seems comfortable officially supporting, and even these doctors are more cutting edge than not.

I wholeheartedly agree with FCoffey, and you need to have a frank discussion with your MO about their seeming quest for 0 PSA and why they feel that this is the goal...

You do seem to be responding to Zytiga. You could come up with a compromise. Generic doses have nothing to do with you personally - it could be that you need more of a drug or less than another person for similar results. It's simply that "personal dosing" is not studied and therefore not officially supported. But it's your life, and with the right doctor you could come up with a personalized plan.

With your MO you could devise a month-by-month plan - 250 mg/day for another month to see if PSA is driven down, and then a personalized study on 250 mg every other day for another month to see if your PSA responds one way or the other. If you keep responding to a lowered dose, you could try 250 mg every 3rd day, etc.

I would not recommend simply doing this on your own, however - it's always best to be honest with your doctor! Most of them respect their patients' wishes, even if they cannot officially support them! Good luck. - Joe M.

[GoBucks]

I am currently taking 750 mg Zytiga with 5 mg prednisone. 1000mg messed up my liver numbers. I had to stop for 7 weeks, restart at 500mg for a month and then up to 750. With your PSA already responding great with the lupron I'd ask your MO if there is any reason not to try 500 mg of Zytiga. I have found all side effects diminish the more I am active. Finally, search the site for advice on hot flashes.

[Bogey0723]

I been on 1000mg zytiga for a year. Great results. Little effects. On the other hand the lupron gave me many problems. Monthly firmagon seems much better. That's just me. And goid luck

[leo2634]

17 months on 750mg. Zytiga and 10mg. Prednisone. Started on 1000mg. But after first month liver numbers started acting up. I was switched to 750 no side effects and numbers are all good. I'm also on Eligard six month injection and Xgeva for bone Mets.

[leo2634]

I also take it at 6:00AM with a full bottle of water and Prednisone when I have Breakfast 2 hours later and a second Prednisone at lunch or dinner.

[Gearhead]

Sorry that you are having the reactions that you describe. I think it's clear from all the responses that almost everyone's reactions and benefits are different depending on their situation for sure and probably even their specific physiology.

I take 1000 g Zytiga plus 10 mg prednisone daily. Plus I get Lupron and Xgeva injections every 30 mo, and I just stopped Casodex. After 3.5 months, I have slight hot flashes, occasional night sweats, but no fatigue. BTW, I'm 76, drink 1-2 glasses of wine per day, eat sort of healthy, go to gym 3/week, and do challenging but interesting technical work to avoid over-thinking my Stage IV situation.

One reaction to Zytiga is astonishment at my Medicare Part D statements, which show a monthly Zytiga total cost of $11,300 of which I pay $565.

[Gearhead in reply to Gearhead]

Of course that should be every 3 months for the injections.

[j-o-h-n]

Quality of life, is never having to say..... "Hello Doctor".....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 05/30/2019 6:01 PM DST