When first reading about Zytiga 4 250mg pills, I assumed that was 4 times per day. I clarified that you take them all at once. Since taking them on an empty stomach are the instructions, I am wondering if people would share their thoughts about what time of day they take it. The doctor indicated many take it before bed, but some take it in the morning and have their first meal later in the day. I would appreciate thoughts on the subject of timing Zytiga and prednisone dosage. They said take prednisone with a meal.
Thanks
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Philly13
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I take it at 6:00 AM with a full bottle of Spring water then two hours later I take one 5 mg. Prednisone along with Breakfast. The second Prednisone with lunch or dinner. PSA has been 0.1 17 months now. Never give up never surrender. Leo
That recommendation was made to when I first joined this site from one of the Brothers here. I've done it ever since my first month and have had great results. I hope it works for you. Leo
I've been taking mine around 4pm, between lunch and dinner. For me it works because then I can have my coffee first thing in the morning, and go straight to bed after dinner if needed. Prednisone is taken with breakfast and dinner.
On at least one occasion I've downed my pills with a glass of water then went out for an hour long run/walk. I'm sure that has to muck about with the absorption.
I take the 4x250mg pills 2 hours after breakfast (about 10:30) and wait an hour before next meal. I take prednisone about 30minutes after breakfast, so about 9:00. I follow this routine pretty rigidly. I may have breakfast later or earlier but am strict about waiting the 2 hours after eating and 1 hour before eating again. I have had ZERO additional side effects since I added Zytiga (abiraterone) to my Lupron.
I was on a trial with zytiga. The trial started out with the instructions to take zytiga on an empty stomach. After a year or so my PSA started to rise. The instructions changed to take zytiga with food. My PSA started to go down. So my advice would be take it with food.
I take mine at night before bed. Even if we eat dinner late, I can still take them at a reasonable time before going to bed.
I like to have my coffee when I get up in the morning instead of waiting an hour after taking it.
I believe you can have coffee right after taking pills as it doesn’t affect absorption. Do not take food with the pills as this slows absorption and could affect the strength of the med going into the system. Or at least talk to your MO.
My understanding is that food prolongs the time the drug is in the gastrointestinal tract thereby increasing the dosage. But you could be right. In either case, current recommend dosage in one hour before meals or two hours after.
Food increases the bioavailability of the abiraterone. Some patients take it with meals and cut the dose to save money. The problem is the amount absorbed is variable. The new formulation, Yonsa, has consistently high bioavailability irrespective of meals.
Since I had to get up around midnight to pee, that's when I took the 4 pills..Recently, people trying to get more bang for their buck take just 2 pills but with some high fat food, like ice cream. This results in the same overall dose as taking 4 pills on an empty stomach....
The University of Chicago med school did a study two years ago that tested lower doses of Zytiga with food. Their conclusion was that the lower dose with food was likely as effective the full dose on an empty stomach. However, the study was a very small group and larger group studies are needed for it to be accepted as a standard of care. According to my MO, research money has been hard to come by since there is no incentive for drug companies to reduce the number of pills sold. The Chicago docs said a lot of the drug was being peer away.
I take three Zytiga 250mg/d, spaced out at 9am, 5pm, and 11pm, with 2.5 mg Prednisone, each dose about 30 mins before eating. PSA has dropped from 33 to 1.0 in two months.
I was prescribed the regular dose of 4x250mg/d, but chose to only take 3x250mg/d because I only weigh 145lbs and the ave US male weighs 197lbs. So at my low BMI, I figured a lower dose would be just as effective, and it seems to be the case.
BTW: this is one drug to be careful with because of the SE's. A couple of times I've noticed heart palpitations when I've taken it with food.
My MO didn’t give me a target PSA, but a 97% drop in 8 weeks is about as good a response as I could hope for. Also taking 7.5 mg Lupron shots, so that’s probably covering any shortfall in Zytiga dose. Zytiga makes my ears ring, so I think it’s also raising my BP.
My doc prescribed Lisinopril 10 mg per day. First sign for me was a slight headache. I never have headaches so I knew I had a problem. They told me to check it every day. I didnt
I practice IF--intermittent fasting....I take my Zytiga at 9:30 am with a large glass of water, and eat my first meal at noon or 1 pm....This has worked well for me....I stop eating at 9 or 10 pm....I still need to lose a few pounds...but lost about 50# sine diagnosis with exercise, diet chg, and IF.... Good luck....
Thanks. I have irregular eating habits and trying to decide if it makes a difference. I like the idea of IF as a regular routine may be helpful in assessing what the best method of injesting the meds are. I don't like to eat breakfast anyway.
I take mine first thing in the morning with water and black coffee at will. No food until about an hour later. One other thing, although the Rx says TWO 5mg prednisone per day, I only took one, in the morning. Blood lab work for the past year (and previous year before Zytiga) unchanged/normal.
My original Rx called for 2x5mg prednisone tablets daily. Since this was contrary to what I have read in this blog I read the manufactures blurb about Zytiga, confirmed independently by Tall Allen, that it’s 2 prednisone pills for mHRPCa and only one for mHSPCa. Consequently I started out taking just one prednisone and later my MO agreed and changed the script. To his credit he told me he usually starts out with prescribing 2 prednisone tablets and checks bloodwork after a month and if all looks ok goes back to 1 tablet/day.
Thanks to everyone for responding. I am started today with a morning dose of Zytiga. I will play with the prednisone to see if 1 pill a day works. At 5 PM I feel strange without being able to articulate why. It is day one and 24 hours after a Firmagon dose. Not much to report. I am still at my desk working. I was more fatigued over the last several months than today. Notes and comments are much appreciated. It is great to have this group as a Sounding Board.
Since no one has explicitly mentioned it... what I have been told is that it’s best to take the pred early in the day because it can tend to keep some people awake... and to take it with food because it can upset your stomach.
Personally, I get up and swallow the four Zytiga plus one pred all at once, and have had no stomach issues.
Got up my whole life for work at 4am. Still wake same time now that I don't work so take mine AT 4am. Wife is a OR nurse and gets up at 4:45am . I make her coffee and by the time she is ready for her to go (5:30am) I have my cup. I eat at 6 a.m.
I too was a bit confused 15 mos ago. I spoke to a specialty pharmacist. I get up around 7am and take a 1000mg and in one hour I eat breakfast. Simple. Hope this helps.
I take 2x550 tablets, I leave them by side of bed with a glass of water and normally have to go to the toilet during the night. 5hats when I take the tablets before going back to skep it is usually between 2 an 4 am
Set my alarm for 0600 and take the Zytiga. Wake up at 0800 and have breakfast and the rest of my pills and potions. Been working fine for me for 15 months now. PSA is undetectable and my bone mets have become undetectable also. My Onc has prescribed 2 x 500mg tabs. Much easier.
Philly13, did you expect to get so many replies and different methods? The Zytiga's dosing paperwork said at least 1hr before you eat or at least 2 hours after you eat. I do the 1hr before method and take 5mg Prednisone right after eating. In my case I only take Prednisone once a day. There was also the recommendation to take them the same time every day.
I did not expect so many replies or the variations. It is interesting that so many approaches are working well. I am going with first thing in the morning with lots of water for now and will see how it works. Today is day 2 and not much to report other than a mild increase in hot flashes yesterday.
I will try to do a long aerobic workout today and see how that goes.
i try to take the Zytiga about 6:00 am. It is not much of a problem to wait til about 7:00 (or so) to have a little breakfast. However, I usually have a little coffee shortly after taking the Zytiga. I only take one prednisone per day, usually some time in the morning.
A study done at university of Chicago found that taking 250 mg of Zytiga and .5 of prednisone with a low fat breakfast was as effective as taking 1000 mg and .5 pred on an empty stomach. My mo dropped my dosage to conform with the study. Less meds in my system and 1/4 the cost of the Zytiga
Hi, I've changed my dose from 1000 mg a day to 500, I take the presidone now 10 mg every other day one hour before I eat a fried egg on toast, plus a yogurt and the Zytiga goes down just before. I am less tired and am waiting to get a PSA done in July.
We need these drugs, but just how much I am not sure, I hate to mention the word profit at our expense. I'II let you know how it works.
My husband takes four 250 pills of Zytiga at 5am. Goes back to sleep and has breakfast between 7am and 8 am. After breakfast take 5mg Prednisone. He has been doing this for two years since his diagnosis of metastatic prostate cancer. His PSA has stayed low. One problem we had when we went to Hawaii and changed the time of his pills. He got a very bad headache. This happened coming and going back home. Now when we travel he takes it at the new location at what would be 5am at home. That stopped his headache problem.
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