Best time to take Zytiga: I have just... - Advanced Prostate...

Advanced Prostate Cancer

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Best time to take Zytiga

Dastardly profile image
65 Replies

I have just started on Zytiga (500mg) and Prednisolone (5mg) and have been recommended to take Zytiga soon after I get up in the morning and then wait the required time before taking the Prednisolone with breakfast. Trouble is, I don't normally eat breakfast and am having to eat an extra snack I would rather not have as I am concerned about weight gain. I just wondered if anybody takes Zytiga at a different time of day and how that works.

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Dastardly profile image
Dastardly
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65 Replies
Magnus1964 profile image
Magnus1964

I was on a trial with Zytiga and it was found that taking it "with" food improved its performance. I don't think it matters what time of day you take it.

Shams_Vjean profile image
Shams_Vjean in reply to Magnus1964

Were you taking 1000mg with food, Magnus?

Magnus1964 profile image
Magnus1964 in reply to Shams_Vjean

yes.

dhccpa profile image
dhccpa in reply to Magnus1964

Wow. That must be quite effective. Can you tell us the trial details? Thanks.

Magnus1964 profile image
Magnus1964 in reply to dhccpa

The trial was the first step to get approval from the FDA to allow Zytiga to be administered before chemo. The dosage was standard with the low dose prednisone. The first part of the trial had us taking Zytiga on an empty stomach. Then in mid trial the we were to switch to taking it with meals. My PSA took a further nose dive when I started to take it with food.

dhccpa profile image
dhccpa in reply to Magnus1964

Thanks

Doggedness profile image
Doggedness in reply to Magnus1964

I am pretty sure it definitely matters whether you take Zytiga with food or not because the dosage will need to be drastically different in each case.

Scout4answers profile image
Scout4answers

I take it at night Usually around midnight, or first time I get up to pee. I take the prednisone in the morning.

Has worked well for 5 months.

Vangogh1961 profile image
Vangogh1961 in reply to Scout4answers

I put it on the counter and take it when I get up in the night. Then no worries to have breakfast with the prednisone.

GoBucks profile image
GoBucks

I take it when I get up to pee. Sometimes I am lucky and sleep late and just take it when I get up. I am not sure you need a full meal to take prednisone. Have a banana. Ask your Doc to be safe. Why are you only taking 500mg Zytiga?

Dastardly profile image
Dastardly in reply to GoBucks

Doh. They are 500mg tablets, and I take 2, so I am taking 1000mg. I must report this new and unknown side effect that makes you stupid. Or, to be really factual, more stupid than normal

j-o-h-n profile image
j-o-h-n in reply to Dastardly

Come on now DASTARDLY DO RIGHT.....You're not stupid you've got Pca.......

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/27/2022 10:38 PM DST

Alice85 profile image
Alice85 in reply to Dastardly

Please no name calling.No question, answer, or knowledge is stupid.

Dastardly profile image
Dastardly in reply to Alice85

Alice, I hope you didn't think j-o-h-n called me stupid, because he didn't. I called myself stupid for overlooking the blindingly obvious, and he was telling me not to be so hard on myself. I hope I've cleared this up for you.

Alice85 profile image
Alice85 in reply to Dastardly

Thank you for clearing that up. You are not stupid. Your sensitivity comes out for your love for John.I am a sensitive MAN with Team sensitivity training.

My code name is from my loving kitty, Alice. This is a critical time for all of us living with cancer.

I hope a pray we all come away healthy.

It's especially tough on our loved ones.

Keep strong.

TylexGP profile image
TylexGP

Hi There,

I am not necessarily recommending this but it is how I take my Zytiga. 1000mg when I get up. Do my morning chores which takes about 45 minutes run down to the local coffee shop to pick an iced coffee with cream. By that time it’s been an hour since taking my Zytiga and I take my pred and other non pca drugs. That’s my breakfast. So far it has worked well T less than 1 for almost a year.

Dastardly profile image
Dastardly in reply to TylexGP

Yeah, it's all about routine isn't it? I guess the best answer is whatever works for you

Tall_Allen profile image
Tall_Allen

The normal prescribed dose of Zytiga is 1000mg. It should be taken on an empty stomach (2 hrs since last meal) and wait an hour before eating. Prednisone may be nauseating if you take it without a meal. It is taken early in the day to mimic your normal cortisol patterns. If you take it too late, you will have a hard time sleeping.

ukulele_grandpa profile image
ukulele_grandpa in reply to Tall_Allen

I take my second Prednisone (5mg) just before bed, with 3mg Melatonin. Generally sleep well until 2 to 4 am.

Tall_Allen profile image
Tall_Allen in reply to ukulele_grandpa

Try taking it before noon to better simulate the natural cortisol pattern.

CAMPSOUPS profile image
CAMPSOUPS

TA's response sums it up.

My routine: The effect of prednisone isn't hard on my stomach so I take it with my Zytiga.

Whether I plan on waking up or not one of my nighttime pee's is between 6 a.m. and 8 a.m. I take my Zytiga and prednisone at that time and either go back to sleep or get up.

Coffee is the first order of the day and I'm not starving when I get out of bed so and hour easily goes by after my dose of Zytiga/pred.

StePeteMN profile image
StePeteMN

Like others here, when on Zytiga I took it during the night and that worked well for me. Prednisone after breakfast. The huge Zytiga dosage as I understand was to make bioavailabilty more consistent across patients in the original trials. Taking 1000mg on an empty stomach means you're peeing away an awful lot of that spendy drug. You need enough of it, and enough is enough. Some doctors advise cutting dose in half, to reduce side effects, after it proves effective.

CAMPSOUPS profile image
CAMPSOUPS in reply to StePeteMN

One more dosage trial would be nice to get clarity on the dosage. I have fantasized about it lol.

Reduced dosage on empty stomach.

Reduced dosage with food containing X percentage of fat.

I can't gamble so its full dose on empty stomach for me.

GoBucks profile image
GoBucks in reply to CAMPSOUPS

Due to liver issues I had my dose reduced to 750 mg. Almost 4 years now. Still <0.01.

Si52 profile image
Si52

I started on 1000mg Zytiga with 10 mg of Pred. PSA dropped from 78 to 0.1 in about 4 months. I then reduced the dosage to 500 mg a day for about 6 months and then to 250 mg a day with low fat yoghurt. Then they stopped making 250mg pills. So I now take 500mg every alternate day with 5 mg Pred daily. PSA has remained below 0.015 for the last 2 years. Also doing quarterly Zoladex and Xgeva injections. Was diagnosed Gleason 9 with several bone metastases 3 years ago. Scans have been clear for the last 2 over years

katartizo61 profile image
katartizo61 in reply to Si52

That is so very good to read this morning, thank you Si52 for your post. 10 months for me and hoping he will adjust my dosage at some point down

Si52 profile image
Si52 in reply to katartizo61

You are most welcome, Sir. Unfortunately, with due respect, the typical oncologist will just follow what is printed. So, sometimes it's up to us to tell him/her that you would want to give dosage reduction a try. All the very best on our long journey

dhccpa profile image
dhccpa in reply to Si52

My search reveals that at least generic abiraterone acetate is available in 250 mg. Is this something brand new?

Si52 profile image
Si52 in reply to dhccpa

As far as I know, the original Zytiga is only available in 500mg dosage

dhccpa profile image
dhccpa in reply to Si52

Thanks, didn't know that, I'm not on it, but I've been pricing the generic.

Scout4answers profile image
Scout4answers in reply to Si52

I am taking a generic Abiraterone 4x 250 mg

ukulele_grandpa profile image
ukulele_grandpa in reply to Si52

I'm on 250mg Abiraterone, the generic for Zytiga. in California USA. I'm 86 years old, had rad.prost. 17 years ago. Hip pain brought me in for CT, etc. when prostate cancer was found to have returned with a 6cm tumor inside the bone behind the socket. Stage 4 they tell me, because those pesky cells are likely all over my body. Took 5 radiation treatments two months ago and started Zytiga. Tumor has shrunk slightly psa dropped from 15 to 0.4, no pain medication necessary. I can walk without limping if I try.

ukulele_grandpa profile image
ukulele_grandpa in reply to ukulele_grandpa

Is there a way to edit our entries? I meant four 250mg pills every morning.

Bronzee profile image
Bronzee in reply to Si52

Weget generic Zytiga 500 from India. Three months supply for $515 including shipping.

GoBucks profile image
GoBucks in reply to Si52

I take 3 250mg pills daily. Abiraterone acetate.

Chrisbaird profile image
Chrisbaird

Started on 1000gms tablets dec 20 with 5gm prednisone with food Taking it once wake 1 hour before food was working well for me but after 4 months I was getting liver toxicity so has a break of a month then down to 500gm daily Dr put it down to other tablets I was taking for pulmonary fibrosis blood pressure to strong acidity PSA has been fine on 500gm for past 10 months

Bronzee profile image
Bronzee

Hi, my husband is exactly on the same meds as you. Zytiga 2x500 upon waking up and 5 mg prednisone after eating breakfast. He is also given injections every 6 months of Pamorelin and xgeva every 3 months. He was diagnosed 2013 July Gleason 4+3 and was cancer free after RP for 8 years. No Chemo no radiation

PSA went up to 259 last Sept 2021 indicating a recurrence and mets to the iliac and 1 lymph node . He has no pain and no severe side effects except loss of muscle mass.

His PSA is now .198 after the injections and zytiga.

He is being monitored every 3 months

ukulele_grandpa profile image
ukulele_grandpa in reply to Bronzee

The loss of muscle mass is a concern. I have a series of exercises I do 6 days a week...wall weights, a stationary Pogo stick, standing back exercises. It seems to help. I swam laps 3 mornings a week and walked 3 mornings before Covid, but they shut down the county pool and with my hip tumor I just walk a little.

michael00 profile image
michael00

I take it around 11 at night. And prednisone in the morning. It has worked well for me, close to 4 years now

dougnola profile image
dougnola

Hi Dastardly, I take it in the middle of the night when I pee. I put the nightly dosage in a pill box rather than straight from the bottle -since I’m groggy at night, it ensures you’ve taken your dose the next morning. I don’t think you need to wait exactly one hour for your prednisone w meal. It’s more to wait at least one hour. I’ve been taking it for 5 years and haven’t missed a dose with my trusty pill box! ✌️ DougNOLA

katartizo61 profile image
katartizo61 in reply to dougnola

are you on 5 mg Preg twice a day of do you take 10 mg once a day

dougnola profile image
dougnola in reply to katartizo61

I’m on 5mg once per day. I take it with my morning cereal/banana in work weekdays and with my late breakfast/brunch on weekends.

katartizo61 profile image
katartizo61 in reply to dougnola

5 mg one time a day, bonus!!! I have been wanting to try that due to sleep problems. Maybe without my MO's approval, might simply do that

in reply to dougnola

That's exactly my routine, except I also take Synthroid, which has to be on empty stomach at least 30 minutes before food. So I usually wake up to pee in my bedside bottle around 2:00 am and take Synthroid. Then next time I pee (between 3 and 5 am) I take my Zytiga. So I'm ready for that glorious coffee as soon as I get up, and Prednisone with breakfast! ☕😄

Finding a routine with Synthroid and Zytiga restrictions was like a Chinese puzzle.

CAMPSOUPS profile image
CAMPSOUPS in reply to dougnola

Kind of same. I put my dose in a empty Altoids tin.

Duk26 profile image
Duk26

My husband just started Zytiga/Prednisone this week. I read you can also take the Prednisone with a glass of milk vs food. Maybe that will help keep your calories down.

leo2634 profile image
leo2634

I take it around 4:00 or 5:00 am depending on what time I get up to pee. I take it with a generous glass of water and the Prendisone with Breakfast. You said you don't eat breakfast if so maybe just a banana or a few crackers. The Prendisone can be a little harsh so eat something with it. I see you don't want the weights gain very noble approach but my Brother its coming. Stay active and hopefully enjoy many more years. I've been on Zytiga for over four years now and My PSA has been 0.1 since the start. If weight gain is your only side effects count your blessings. Never give up Never surrender. Leo

db36867 profile image
db36867

I take prednisone twice a day (once in the morning and once at night). If I do not take it with breakfast I make sure to eat a few crackers just to put something in my stomach. If not I feel nauseated. I was taking 1000mg of Zytiga but had liver problems so decreased to 700mg and no complications. I take it right before going to bed (at least 2 hours after my last meal).

GoBucks profile image
GoBucks in reply to db36867

Nice to find someone else on reduced dose. Almost 4 years for me.

BaliDream profile image
BaliDream

I take Zytiga at 9 in the morning, not with food…eat 1 hr before, or 2 hrs. after taking…take Prednisone at 6pm with food….

Texan423 profile image
Texan423

Prednisone 5mg with 2 of my meals , usually breakfast and supper, Zytiga 1000 mg in between on an empty stomach usually 2hrs after breakfast and an hour before small midday meal. No side effects and good results +2 years now

onajourney profile image
onajourney

I have ritualized my medication taking. In the morning I take 1000mg of Abiraterone (Zytiga) any time after 5AM. I have it premeasured in a pill box kept in the bathroom so I don't have to identify pills or count in the early morning. Then I go back to bed.

When I get up for the day, usually 6:45 or later, I am ready for the first of my 5mg prednisone tabs. I make my wife and I lattes, then take that prednisone along with my other morning meds and eat a biscotti.

At 4PM my phone alarm goes off and I have my second 5mg prednisone. I usually pair it with a piece of dark chocolate and occasionally have an espresso too. (Sometimes I have a craft beer!)

This has been my routine since late 2018 and it has been working for me.

Best wishes as you find what works well for you.

CocoTheAlphaCat profile image
CocoTheAlphaCat in reply to onajourney

Zytiga first thing in the morning; Prednisone with my first meal, which with intermittent fasting usually means early lunch. Whatever works, works.

Dastardly profile image
Dastardly in reply to CocoTheAlphaCat

This sounds more like my sort of thing. I'll give it a go. Thanks

21cakes profile image
21cakes

I've been on it for about 9 month now. 10pm, no food 2hrs or more before, with prednisone and some other drugs, PSA over 1000 at start, dropped it to 12, started doubling every 6 weeks, then leveled off at 74 last 3 months. No adverse effects, slow steady improvement in blood composition, likewise for strength and endurance in daily workouts. PET scan this week showed resolution of some of the bone scan hot spots since the last one April 2021. Best of luck to you.

garyjp9 profile image
garyjp9

Like CampSoups, I take the prednisone and zytiga together on an empty stomach.

NRH_Beach profile image
NRH_Beach

I try to take Zytiga when/if I get up to pee at 4/5/6am. I was also no breakfast for 30 years. I have added a non-fat yogurt+ fruit smoothy in the bullet blender.

Flash64 profile image
Flash64

I take my Zytiga right before bed, so no evening snacking for me. I take the Prednisone in the morning just before breakfast.

Lieto55 profile image
Lieto55

Hi Dastardly - the key is to take Zytiga on a empty stomach as it's fat-soluble and a meal will amplify its impact at an unpredictable level, always much higher than fasting. The prednisone can be taken any time that day. It doesn't need to be as soon as possible. I share your eating pattern for the same reasons. So Zytiga whenever I wake up with a good slug of water ( a reason I don't take it late at night is purely that I don't want to try to sleep on a loaded bladder). Whenever I "break fast", usually 11-noon, I take the prednisone. It's not critical when, but food helps keep it from irritating the stomach. You blow the intermittent fast and all its benefits if you snack for the prednisone, so don't. Just take whenever you do eat.

Dastardly profile image
Dastardly in reply to Lieto55

Thanks for your info. Much appreciated

j-o-h-n profile image
j-o-h-n

It's fine as long as you're drinking with a straw..........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/27/2022 10:40 PM DST

Parscore profile image
Parscore

I take my 500 Zytiga with food in the morning and the 5mg Prednisone at the same time. Hard to find a consensus even from Oncologist, if you go outside the guidelines of the clinical trials?

Bspouse profile image
Bspouse

Hi - My husband has an extra pill - Prilosec - that he needs to take before the prednisolone. So he usually takes that at night. Then prednisolone with breakfast and ABI 2 hours later. Works unless there is a doctor appt in the morning. They originally prescribed protonix but that didnt agree with him so switched to prilosec. Possibly this isl due to stomach issues he had in the fall because no one else mentions it. Is he the only one taking prilosec to protect his stomach from the steroids?

ukulele_grandpa profile image
ukulele_grandpa

Hi, For two months I've been taking Zytiga 1000mg and Prednisone 5mg together in the morning an hour to hour and a half before breakfast, then another Prednisone in the evening. My psa has dropped from 15 to 0.4 so far. I'm 6' tall and weigh 205 pounds, trying not to gain any. Seems like my belt size is increasing. Hmmm. I'm in California, USA If I were going to skip a meal every day it would be dinner, not breakfast.

Alice85 profile image
Alice85

My doctor prescribed taking 4 tablets daily on an empty stomach, wait one hour then breakfast-No orange juice or grapefruit.Then I can take Prednisone about an hour later and another at dinner.

5weeks ago it was one Zytiga tablet, which did not stop the cancer growth in my lungs. But my PSA was still low. Another blood test and CT scan in two weeks.

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