Apalutamide side effects

[miina]

I was on Zytiga but discontinued due to raised liver enzymes. I am still hormone sensitive with a PSA of .008. I have just been prescribed apalutamide (Erleda).How have side effects been for others . I sense that they may be worse than Zytiga's

[NPfisherman]

I took apalutamide for only a month as part of a clinical trial before surgery, but they weren't bad for me....minimal fatigue...

Don Pescado

[TonyS58]

I'm just finishing month 2 of Apalutimide plus Lupron and I haven't noticed the side effects being any worse than Lupron alone... with multiple trips to urinate overnight and chronic fatigue.

[WaltN in reply to TonyS58]

Been on Apalutamide almost a year. My immune system has crashed, now in "chemo-induced neutropenia." Take 4 pills per day.

Has anyone had the injection to boost the immune system back to normal, or lowered doseage?

I have many other things that need done such as teeth cleaning, colonoscopy, carcinoma Mohs surgeries, pnemonia vaccine, Shingrix vaccine, etc, that are prohibited during this crisis of my immune system to below 1000 absolute neutraphils.

The good news is my PSA went from 23 to 0.2. The Apalutamide is a success but at the life-threatening expense of my immune system.

Currently also on Lupron for @14 years but its resistive now. Have not had PC surgery or radiation due to porphyria restrictions.

[ctflatlander]

I have had to reduce my dose from 1000mg to 750 to 500mg where I'm at now. Been on 500 for about 6 mos now and ALT/AST normal. Min side effects and PSA undetectable.

[miina in reply to ctflatlander]

Hi are you referring to Zytiga or Apalutemide dose reduction

[ctflatlander in reply to miina]

sorry for my reply. I'm referring to Zytiga.

[pilot52]

Up your activity and have fun...I am on Xtandi and had my choice...they say 70% experience fatigue...I decided to be the 30%..Still on Lupron...I have been on a tractor, chain saw, mower , blower, and other equipment 9 hours a day for the last 4 days ...feel great...the more I bust my ass the better I sleep. Will be 67 on the 11th...My second Stage 4 cancer...not trying to brag just trying to point out not to let the monster rule our brain...this afternoon when my glass is half full getting another cold one...Baby Braves are having a good season and college football in full swing...everyone have a great day ,Fall is here.....A still Grounded Sky King....supposed to hear something soon!!! Cheers, even to that New York dude. J-O-H-N

[j-o-h-n in reply to pilot52]

Thanks for the cheers....May your days be filled with busting your ass... I'll keep trying to bust your immies.....

Good Luck, Good Health and Good Humor

j-o-h-n Monday 09/02/2019 11:15 AM DST - Pinnes

[bubbles48]

Periodic fatigue and nausea has been my experience so far. I have been on apalutamide 6 months already. I have far more good days than bad ones, and I do not let any of it stop me from what I need to do. When I get really tired, I take a power nap, and then get up and continue on. I watch my diet and try to exercise and do strength training periodically. I am grateful to have this medication to continue to lower my PSA.

[pilot52 in reply to bubbles48]

V1.........V2.......Rotate....we have positive rate of climb...wheels up....400 ft ...flaps up....turn left to 270 climb and maintain flight level 240 expect 410 at hand off. Blue Skies a Grounded Sky King....Glad it is working for you and you are working it!!!!!happy Labor Day

[monte1111 in reply to pilot52]

"Curse you Red Baron!" Sounds like you are on Gracie's dog house. Aviator's cap, goggles and scarf blowing in the wind. Hope you get up in that Blue Sky soon. Enjoy.

[pilot52 in reply to monte1111]

Gracie is getting a little wary of ground travel. My Mercy Air Corps and Angel Flight passengers are wondering where I have gone....however as we say in Georgia...God willing and the creek don't rise I will be flying soon....!!! Blue Skies!

[WaltN in reply to bubbles48]

Me2! Naps alleviate exhaustion.

-----

Been on Apalutamide almost a year. My immune system has crashed, now in "chemo-induced neutropenia." Take 4 pills per day.

Has anyone had the injection to boost the immune system back to normal, or lowered doseage?

I have many other things that need done such as teeth cleaning, colonoscopy, carcinoma Mohs surgeries, pnemonia vaccine, Shingrix vaccine, etc, that are prohibited during this crisis of my immune system to below 1000 absolute neutraphils.

The good news is my PSA went from 23 to 0.2. The Apalutamide is a success but at the life-threatening expense of my immune system.

Currently also on Lupron for @14 years but its resistive now. Have not had PC surgery or radiation due to porphyria restrictions.

[Garbonzeaux]

I thought Apalutamide was approved only for castrate resistant patients, which you don't appear to be. Don Pescado got it in a clinical trial. Am I missing something?

[NPfisherman in reply to Garbonzeaux]

I was part of a clinical trial to give apalutamide to pre-surgical patients with ADT prior to surgery for 1 month--had surgery--still got APC....I was PT3A--still....glad I did the trial...It was prior to final approval of apalutamide... do not know the final outcome of that study, but it makes sense for high risk--gleason >=8 patients...I do wonder what the final outcome from the study will be....

Don Pescado

[TonyS58 in reply to NPfisherman]

Insurance covered my prescription for Apalutimide even though I suspect you are correct and it is an off-label use. I believe that the Titan trial results, which were published in May, might have been the influencing factor. ascopost.com/News/60096

[TonyS58 in reply to TonyS58]

Here's TA's writeup on the report.

pcnrv.blogspot.com/2019/05/...

[Hidden]

Hi everyone, Ive been through the ringer...RP, radiation firmagon but they didn’t get everything and after all that, I had a PSA doubling time of 8 weeks and bone Mets 2 months after the radiation was completed. That said, I was prescribed Erleada and have been on it since March 2018. I have experienced just about all the side effects, but not at the same time and they come and go. But it worked, within 3 months, my psa was .05 and the bone Mets were gone.

[tallguy2 in reply to Hidden]

Great results!

[Hidden in reply to tallguy2]

No kidding...I'm very blessed to have responded so well. Hopefully it's for a long run

[WaltN in reply to Hidden]

No neutropenia?

Been on Apalutamide almost a year. My immune system has crashed, now in "chemo-induced neutropenia." Take 4 pills per day.

Has anyone had the injection to boost the immune system back to normal, or lowered doseage?

I have many other things that need done such as teeth cleaning, colonoscopy, carcinoma Mohs surgeries, pnemonia vaccine, Shingrix vaccine, etc, that are prohibited during this crisis of my immune system to below 1000 absolute neutraphils.

The good news is my PSA went from 23 to 0.2. The Apalutamide is a success but at the life-threatening expense of my immune system.

Currently also on Lupron for @14 years but its resistive now. Have not had PC surgery or radiation due to porphyria restrictions.

[Hidden in reply to WaltN]

Hi WaltN, this post is somewhat out of date...To answer you question, I did not experience neutropenia...the toughest side effect was blackouts (falling down). As a result, I was taken off the Apalutamide @ October, and just started 6 rounds of Taxotere. After that is done, I’m told that Darolutimide will be next.

[Eliga]

Talking to your doctor should prescribe Enzalutamide is better tolerated, effective and safe with fewer side effects

[GoLowPSA]

I have been taking Apalutamide with Relugolix for about 4 weeks now....only significant side effects are tolerable hot flushes and some fatigue. Hope you do well.