Starting Zytiga / Prednisone Regimen

[Chivato646]

I am starting my Zytiga / Prednisone regimen on Thursday. I'm thinking about beginning with 250 / mg with a cup of fatty yogurt (understanding that the standard-of-care is 1,000 mg on an empty stomach) and see where my PSA is at 30 / 60 days hence. I would appreciate hearing any thoughts / experiences from my fellow warriors (will closely monitor blood pressure and liver function). Also, how would the prednisone dosage be affected by taking a lower dosage of Zytiga? I'm thinking it wouldn't be as the purpose of ingesting food is to ramp-up the absorption hopefully closely equating the lower dose of Zytiga to the higher SOC 1,000 mg dosage. Again, I am appreciative of any experiences / "words of wisdom" that can be shared as one begins the Zytiga / Prednisone evolution...very grateful for the opportunity to post here...D

[Grumpyswife]

IMO I would only cut the dose if paying for the pills is an issue. Otherwise, give it a try full dose and be so grateful if you have good results. The side effects have been minimal for my husband except for added belly fat from prednisone.

[Chivato646 in reply to Grumpyswife]

Thanks so much for taking the time to reply...best thoughts and prayers for you and your husband...

[tom67inMA]

If you can afford it, try full dose on an empty stomach first as it produces the most consistent absorption. It may take a few months for your body to adjust. I had a blip in my liver numbers that then returned to normal. Others have PSA or ALP spikes and that can actually indicate a better response long term.

You are correct that prednisone dose is independent of Abiraterone dose. A sufficient dose of A will stop your adrenal glands and the P is to replace the missing cortisol. I temporarily reduced my dose of P as it was giving me insomnia and making me a bit manic. Not the worst side effects ever. After a few months my body adjusted and now 5mg 2x a day is no problem.

Good luck! It's worked well for me and many others.

[Chivato646 in reply to tom67inMA]

Thanks for the response brother...been following your posts...hang tough...my thought process is more side-effect related than financial...seems like the consensus is to "let 'er rip" at 1,000 mgs with 2 x 5mg Prednisone and monitor blood pressure (I am hypertensive however controlled by diet, exercise and fosinipril)...thanks again for your kind thoughts...

[tom67inMA in reply to Chivato646]

Keep up the exercise. I was worried about side effects but decided they weren't severe after running a half marathon.

[LearnAll]

I have been taking Zytiga 250 mg with a full cup of fatty yogurt for last 6 months.. My copay is zero so there is no cost issue.

PSA and ALP keeps going down. Liver enzymes AST, ALT, LDH, Albumin all normal.

My blood pressure is better than what it was when I was taking 1000 mg.(may be coincidence) I only take 5 mg a day of prednisone as its enough for me,

People may have different results but this is my experience with 250 mg Zytiga.

[Chivato646 in reply to LearnAll]

Hey man...thanks very much for taking the time to reply...I read your posts often...my dosage decision, like yours, is not financially based but rather side-effects oriented. I'll begin my regimen tomorrow and calibrate as I move forward...hopefully side effects will be prednisone-related (great workouts and an uber-clean house)...best to you and yours...

[Tall_Allen]

It is a very poor idea to judge the effectiveness of your Zytiga dose by your PSA - Zytiga extends survival even in men with undetectable PSA who are only taking Lupron. If you can't afford the full dose, there are lower cost generics now available.

[Chivato646 in reply to Tall_Allen]

TA- thank you for taking the time to reply...the financial aspect of dosage is not vitally important right now...aside from PSA vigilance and watching BP and liver functions, are there other "markers" to keep an eye on as I begin this phase of treatment? (will note side effects, which to date have been minimal throughout Taxotere, Lupron and Zometa)...hopefully will continue my work-out routine...sincere thanks for your insightful posts and personal asides...best to you...

[Tall_Allen in reply to Chivato646]

Then there is no reason to cut back on Zytiga dose. Bone alkaline phosphatase is an important biomarker for bone metastases. But the best indicator of loss of effectiveness is radiographic progession when biomarkers rise. BP may rise and potassium levels decrease if you are not taking enough prednisone. I'm sure you are already checking blood calcium and Vitamin D levels. Are you using Celebrex?

[Chivato646 in reply to Tall_Allen]

I am currently taking 2 x 200 mg of Celebrex daily though I will discuss with my MO next month as the definitive study was done (I believe) with 800 mg...AlkPhos has remained steady in the low 50's throughout (was 271 as I began my 6 Taxotere trips on March 21st of 2019)...will watch BP, potassium...yes, am monitoring blood calcium and Vitamin D...many thanks for your kindness...

[Magnus1964]

I was on a drug trial with Zytiga and Prednisone. At the beginning of the trial I was directed to take the drugs on an empty stomach. About a year into the trail my PSA started to rise less than .04. I was then directed to take the drug with meals. and my PSA started to fall again. My total time on the drug was 3 1/2 years.

Don't know what to make of that. Should you start taking the drug on an empty stomach then move on to taking them with food or start with food and stick to it?

[Chivato646 in reply to Magnus1964]

Thank you for taking the time to respond Magnus...taking a full dose with food would have one feel as if they were hit by Chuck Wepner (the "Bayonne Bleeder"...a former prize-fighter)...the inability to accurately calibrate absorption gives me pause to take a lower dose with food although I respect the thought process and "see" the point of those who go that route...this part of our evolution may be filled under the category of "whatever works"...best thoughts and thanks again for your insight...

[middlejoel]

Been taking 1 pill with pred for 2 months (25%). Had blood labs and Psa down from 1.25 to .2, liver enzymes no problem, personal choice not related to cost.

jal

[Chivato646 in reply to middlejoel]

Thanks very much for taking the time to respond...seems like 250mg is working well for you...do you eat anything in particular to enhance absorption?...hope your downward trend continues...

[Milrod]

I have a bottle of 56 tablets @ 250mg each to GIVE to someone who can't easily afford it. My MO prescribed Zytiga + Prednisone but I never started the course. The expiration date is 5/03/2020. Let me know if you want it. I am not charging anything for it, but a gift card would help offset my cost.

[Chivato646 in reply to Milrod]

Thank you...my inquiry as to dosage is of a clinical nature and not financially influenced...I hope you are able to find a deserving spot for your offer...