Problems with Zytiga?

[ekirkland]

I’m on Lupron/Zytiga/prednisone for a little over two months. I started Zytiga at 1000mg but after less than a month had to drop down to 500mg because of liver problems. Prednisone has been at 5mg. Last Thursday I fainted while fishing (I was celebrating the end of 25 days of radiation to pelvic lymph nodes) and went to the ER. I have a history of high BP but at the ER it was fine. Before fainting (7:30AM) I became very tired, sweating profusely, blurred vision. The doc at the ER said I was dehydrated with heat exhaustion (really? It was early morning). Anyway they gave me a bag of fluids and sent me home. Over the weekend my BP shot up to 170/96 average so I quit taking the Zytiga but kept taking prednisone. I called my MO Monday and will meet her tomorrow. I’m wondering what the next step might be. I’m definitely having problems with Zytiga although it and lupron are definitely working. T is undetectable and psa is 0.2 down from 2.0. Should I ask for a different treatment plan?

[Magnus1964]

If zytiga is giving you problems you could switch to casodex or xtandi.

[tango65]

The increase in the blood pressure could be caused by Zytiga. Increasing prednisone to 10 mg a day may correct the problem.

accessdata.fda.gov/drugsatf...

[Tall_Allen]

Maybe your prednisone dose is insufficient. Talk to your oncologist about increasing the dose.

[HopefulSis]

Similar results for my brother, elevated liver enzymes and blood pressure even with reduced dose. Switched to Erleada 👍🏻

[ekirkland in reply to HopefulSis]

How long has he been on Erleada and how is he doing on it?

[HopefulSis in reply to ekirkland]

He started Erleada 6/1, feeling much better than abi/pred, …psa remains undetectable.

[SeosamhM]

Sorry to hear about this, EK. Being on abiraterone myself, I hope that it is a steroid dosing issue (or steroid type - Zytiga can be used with dexamethasone, too) that will allow you to continue. But liver toxicity with abiraterone is a known issue - especially in early dosing - that seems to resolve itself about 50% of the time. See:

pubmed.ncbi.nlm.nih.gov/321...

Good luck. - Joe M.

[MateoBeach]

Don’t give up on abiraterone prematurely. You want all possible mileage out of it since it is working. Try the increased prednisone first. Maybe an easy fix. Save your other bullets.

[diamondrn]

I had a similar experience with my BP skyrocketing to over 200/100.

Tall_Allen showed me a link to research that indicated the the Prednisone 5 needed to be double to twice daily.

After seeing the research, the doctor upped my Prednisone 5 to twice a day and added Hydrochlorothiazide 25mg once daily to help with fluid retention because my ankles had swollen so much.

Within less that 2 weeks I was back to normal blood pressures and haven't experienced any side effects related to the Prednisone being doubled.

This is the link to my article >>> healthunlocked.com/advanced...

Blessings.

[ekirkland]

I met with my MO yesterday and she is putting me on 5mg twice daily of prednisone. She is also having me hold off on the Zytiga for a week or so. I hope the increased prednisone rate does not have me too wired to sleep. I’m taking the second dose around 3pm.