Erleads Medication

[lgordo12]

Started Erleada roughly 1 month ago. Have prostate Cancer diagnosed since early 2001. Various treatments over the years Lupron, Casodex, firmagon injection have kept my PSA low at the cost of severe side effects, I.e. moody, angry, tired, etc. All have kept the Prostate Cancer contained. Erleada has taking my PSA from the 6-7 range to .32 at last reading. One issue with this medication is tiredness, and completed exhaustion, aching legs, and high blood pressure. I started with 4 tabs at day, and recently reduced to 2 tabs after discussing with urologist. Still exhausted even at the 2 tab level. Not sure it worth the effort taking this medication. There has to be something else.

[CantChoose]

Zytiga and Xtandi play in that same space. Surprised that your doc would go to Erleada, given the expense and that it's not officially SOC yet for insurance.

Did you already try one or both of the alternatives?

[Tall_Allen]

Xtandi has also been approved for non-metastatic castration-resistant PC. I don't know if the side effects will be any better, though.

[Fairwind]

Is a Urologist your lead doctor or hopefully you have a Medical Oncologist too.. ?

[tango65]

Abiraterone is also effective in non-metastatic castration resistant cancer:

ncbi.nlm.nih.gov/pubmed/296...

I don't know if there is a way your doctor could get the insurance company to cover this med.

Dr. Morris at MSKCC told me erleada and xtandi are practically the same drug. Side effects could be similar. Only way to know will be to change to xtandi.

[NPfisherman]

Have you tried taking them in the evening/at night--help facilitate sleep...may relieve some of the fatigue... As for the fatigue, I had some with Zytiga and started exercising and that helped---walking a few miles each day initially.... Now, The Sensei of Fish/ Dayatatime has me trying to run them--a work in progress...

For the hypertension--I had an issue with Zytiga initially and that got better with losing 10#, if you are overweight...

Muscle cramping is not a common SE of Apalutamide/Erleada-- joint pain is---consider getting a potassium, calcium, and magnesium test to r/o electrolyte imbalance:

rxlist.com/erleada-side-eff...

mayoclinic.org/diseases-con...

Hope some of this helps....

Don Pescado

[snoraste]

I found the foremost way to combat fatigue for me was to stay active. All drugs mentioned here - to varying degrees - will cause fatigue (your T is close to zero). Besides the daily exercises that you should be doing, I recommend keeping yourself mentally engaged as well (perhaps hobbies, activities, chores).

[mcp1941]

I think the fatigue is a common side effect of all HT drugs. My cardiologist had my BP well controlled using 2 meds. When I started Erleada BP went crazy. Cardiologist added a third drug but that was like pouring gasoline on a fire. First BP reading in the morning was in the area of 150/100 with a resting heart rate (HR) of 110. After 4months Erleada failed, PSA started gouing up. MO took me off Erleada and BP and HR returned to normal (BP 110/78 HR 58).

[Pmann]

Your post on disease history mimics mine almost exactly.

I have been on Erleada now for seven months. Had to add another BP med to the one I already take.

I have dealt with the fatigue by exercise and in some cases just plowing through it. Walk a mile every day, swim three times a week and light weights three times, that is if I am not traveling with my work.

I know this ride is temporary and we will move on to something else.

Fight the good fight.

[Hidden]

Hi lgordo,

I’ve been on Erleada since March 2018, 4 tabs a day combined with Eligard. Although Erleada is not a cure for Metastatic Castration Resistant Prostate Cancer, for me, the drug has been very effective at driving the cancer into remission.

The side effects you’re experiencing are a constant problem for me too. I also experience near syncope...basically the medical term for almost passing out...that started in Feb. 2019...also a known side effect...they just call it falling.

Bottom line, fighting prostate cancer sucks, and you’re a true survivor!

Btw...about leg cramps...for me they come at night usually they wake me up. My experience is that the drugs dehydrate me and if I can keep the water intake up, the cramps are not nearly as bad and are more infrequent.

[fritz1 in reply to Hidden]

CRK2. Re that near syncope experience. I experience that too. Are there particular times when it hits you? I.e., when driving? when stressed out? Is the near feinting associated with a panic attack (which I understand can be a side effect of Lupron)? Is there anything in particular you do to deal with it? What thoughts has your doctor expressed to you about this issue? I’ve not seen this condition mentioned on the forum previously. Glad you’ve brought it up.

[rogerwegner]

I have been on Erleada for 8 months and my palliative care doc suggested american ginseng. Mayo did a study in 2012 and found that it helped with cancer related fatigue. It has really helped me.

[j-o-h-n]

Greetings Igordo12,

We know you're a male, and based on your ID "overweight", but can you tell us more about yourself: age? location? Psa and Gleason scores? Treatment center? doctor's name(s)? All info is voluntary, but it helps us help you and helps us too. Thank you.If you wish to reply please do so on a future date and Not directed to me.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 06/25/2019 6:00 PM DST

[bubbles48]

I have been on Erleada for almost 4 months. I have experienced the fatigue you are talking about, and it is more pronounced than any other fatigue I have had with other treatments. However, as the time has gone by my days of fatigue have lessened. So have many of the other side effects. The hot flashes are more pronounced, and I have overactive urinary problems after taking the pills each day. Someone on here suggested caffeine to me on here, and it has helped some with the fatigue. All in all,though, I am getting better with all of these each day that goes by. I agree that staying active and exercising is very important to reducing many of the symptoms. Hang in there!

[lgordo12]

Thanks for all the replies. Give me more encouragement to battle thought fatigue, hot flashes, and leg aches. Am going to try American, or Korean Ginseng as suggested. By the way am starting Venlafaxine as prescribed by my urologist for Hot Flashes. Will update in week or two to see it if works.