Zytiga versus xtandi

[Roches]

Husband with metastatic prostate cancer since 2012, he is on prostap 3

Psa at start 101, after numerous treatments psa starting to increase, doctor talking about Zytiga or Xtandi, i am worried about side effects.

Any comments please.

Thank you

[Grumpyswife]

My husband has been on both of them and Zytiga by far has had less side effects for him. He was only able to tolerate half dose of Xtandi from the side effects.

I wish we had started with Zytiga first as that was our prostate cancer specialist's first choice. We moved and got a different MO who preferred Xtandi.

Better yet to perhaps consider chemo first while younger and stronger.

[Roches in reply to Grumpyswife]

Thanks got your reply,

Seeing doc tomorrow,will see what happens

[LearnAll]

Zytiga is working well for me. Hardly any side effects. I take 250 mg of Zytiga with a full cup of full fat milk yogurt.

[Jbooml in reply to LearnAll]

I take 500 with a banana...I'm sure I'm over dosing a fair bit but I've got the beasties hog tied and duck taped rather effectively...amazing how many similar stories one hears about...read yesterday they've possibly identified PC's master controller and how its dificiency can be rejigged to repair this master checkpoint. It suggests that although not all PCs arise from its missing allele...but many ultimately share this treatable defect.

eurekalert.org/pub_releases...

[Roches in reply to LearnAll]

Thanks for your reply

[Roches in reply to LearnAll]

Thanks for your reply, see doc tomorrow.

[carbide in reply to LearnAll]

Zytiga is to be taken on empty stomach.

& no food for 1hr. after.

Those are the directions.?

[westof in reply to carbide]

Hmm... I take mine when I wake up and wait an hour before taking prednisone with food.

[LearnAll in reply to carbide]

yes. those are the original directions. There is new research which shows if Zytiga is taken with high fat breakfast, its absortion gets 6 to 8 times higher.

You can find that research on pubmed. I am believing this new research. And above all my PSA keeps heading down..last was 0.4.

[Rkoma in reply to LearnAll]

As trial was started it was known how absorption of Zytiga is depending on breakfast fat. To keep results comparable, trial participants have bern requested not to eat 1 hour before and 2 hours after taking ZytigaRkoma

[herb1 in reply to LearnAll]

Question: when Zytiga is taken with fat/breakfast, is prednisone still used? Again, when taken with breakfast I presume dose is down to 250 mg/day, right?

[LearnAll in reply to herb1]

Yes. Prednisone is still needed because Zytiga partially shuts down adrenal cortisol(stress hormones) which are needed to fight infections etc.

250 mg of Zytiga is still working like 1000 mg ...because due to presence of fat it is being absorbed 6 times at least according to the research study.

I am able to get along fine with just 5 mg Prednisone a day..but I guess everyone is different.

[herb1 in reply to LearnAll]

thanks, was curious. Hope it keeps working for you.

[Grumpyswife in reply to LearnAll]

Great that the reduced amt is working for you.

However, reducing to 250 did not work for my husband (taken with food in the morning). Just sayin' everyone's different and if money is not a concern may be best to stick with full dose as prescribed for other people considering reducing--especially without side effects.

[Hex40]

For me the Side effects of Xtandi were far worse than Zytiga. Go with Zytiga or the generic version.

[Roches in reply to Hex40]

Thanks for that

[Hidden]

I'm currently on Zytiga because I was concerned about the side effects of Xtandi. So far Zytiga has not added additional side effects to ADT. I've been on it for about 18 months now. My last PSA was .01

[Roches in reply to Hidden]

Thanks for your reply been very helpful.

[Shooter1]

Xtandi made me a complete invalid at full dose. Cut, cut and recut to 80 mg dose which I can handle. PSA went from 63 and climbing fast to 0.120/0,130 with taxotere (9 cycles) and Xtandi. Stayed there for last 18 mo. Onc. says to hope for another 3-4 yrs stability, then ???

[tallguy2]

Anecdotal evidence: because my father had a seizure on Xtandi I will be starting Zytiga in the coming months.

[herb1 in reply to tallguy2]

tallguy2: not really anecdotal, seizures are one of the potential side effects of Xtandi, I believe.

[tallguy2 in reply to herb1]

Yes, I understand. [It's still anecdotal in that I am reporting my father's experience.]

[billdippel]

I was on Xtandi for 11 months and now on Zytega with no side effects.

[Roches]

Thanks everybody, been very helpful

[dmt1121]

I have taken 1000 mg/day for 1 year and side effects are minimal. It does help one live longer. I think that is a great side effect!

Good luck.

[JuanVV]

My husband takes Xtandi for the moment little side effects. I started a thread about Xtandi, if you can access it it has more info.

[Survivor1965]

I failed Zytiga after 10 months. Been on Xtandi/Lupron for 35 months, PSA undetectable and stable scans. They are different modalities.

[leo2634]

I've been on Zytiga 2 years this February and PSA has been 0.1 since first month. My side effects are hot flashes , weight gain primarily in my gut, and some fatigue but all in all very tolerable. I'm on 750 mg. With a full bottle of water around 5:00 in the morning followed by my Prednisone at 8:00 with Breakfast. Leo

[lincolnj8]

I've been on Zytiga for over 2 years. I take 2- 500mg pills each day with 2 prednizones and lots of vitamins. I have some fatigue but my psa is undetectable. And yes I have mets everywhere, in lymph nodes, organs and bones. I get tired a lot but I'm pain free and push to be as active as I was before I was diagnosed. Oh yea, A nice bowl of chocolate chip ice cream keeps me going. lol. Hope this info helps.

[joeguy]

I had amazing results with Xtandi. I was on it for 10 months, and it got PSA to 0.000 ! The down side was it brought on heart problems, so I had to stop.

[LearnAll in reply to joeguy]

What kind of heart problems extandi caused ?

[joeguy in reply to LearnAll]

I started having tachycardia and palpitations shortly after starting ADT with firmagon and eligard injections. This was controlled somewhat with meds for 2 year until I started xtandi. After starting xtandi the palpitations and skipped beats were happening all the time, plus started having shortness of breath. A heart cath discovered 70% blocked left coronary. I suspect it had been developing for some time and ADT just brought it on

[LearnAll in reply to joeguy]

Seems like you already had some coronary artery disease to begin with. ADT causes weight gain and increases LDL cholesterol and triglycerides. This in turn can cause coronary artery blockages which can cause heart attacks..

Thats why, its so important for us who are on ADT to keep our bodyweight low and lipids in normal limits.

[joeguy in reply to LearnAll]

Yes, it did all of the above to me. Bad cholesterol and triglycerides sky high, and gained abot25 lbs. the tachycardia and palpitations did start just a couple weeks after starting ADT however.

[gamemaster34]

I started taking Zytiga on June 2019. You do have some fatigue but I am not sure if it is from the lupron or both. I have hot flashes from time to time. No major side effects. PSA is still 01. Hope your Husband can keep up the fight for many more years.

[Roches]

Thanks for that.

[monte1111]

Believe Zytiga is recommended. BUT I was put on Xtandi (after 8 cycles chemo) and psa is now 0.1 There is fatigue but Xtandi has worked for 29 months. (I have extensive bone mets). Xtandi has worked even longer for Larry_dammit. But who knows? It seems to be a crap shoot. Guessing you should go with what doctor recommends. Best of wishes.