Blood pressure, abiraterone, prednisone, and eplerenone update

[Gearhead]

A couple of months ago, I posted a note regarding my blood pressure increase after taking abiraterone for three years and my attempts to lower my BP:

healthunlocked.com/advanced...

This note is an update that reports some success with eplerenone. Here is a condensed history:

March 2019 – Started 1000 mg abiraterone + 10 mg prednisone. Average BP in early 2019 = 142/64

Feb 2021 – Prednisone reduced to 5 mg following clearer reading of Zytiga guidelines. BP increase accelerated.

Late 2021 through early 2022 – BP average = 167/80

Jan 27, 2021 – Prednisone increased to 10 mg to address BP

Feb 11, 2022 – Negligible BP change. So decreased prednisone back to 5 mg and started eplerenone 50 mg

April 1-6, 2022 – Average BP = 132/64

A legitimate speculation is that continuation of 10 mg prednisone might have resulted in similar BP decrease, and I don’t dispute that. An issue that contributed to the confusing sequence involves MO and PCP non-communications. While 132/64 isn’t great, it’s better than before I started abiraterone, and I’m pleased with that.

As usual, this is just one person’s experience, and everyone is different. But I thought it might be helpful to post this because I see that BP increases with abiraterone are not uncommon.

[tango65]

Eplerenone blocks aldosterone a hormone wich may be increased when zytiga is used. The hypertension, edema and hypokalemia during zytiga are caused by aldosterone. Blocking aldosterone leads to the control of those complications.

[Tall_Allen]

I think your BP is very good now. Looks like a great solution.

[j-o-h-n]

Thank you for the info..........Hopefully your BP continues hitting the spot....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 04/10/2022 7:08 PM DST

[Hidden]

Glad you got it down. I also had Zytiga induced high BP. I increased my prednisone and eventually got it down (thanks for the recommendation TA). I also used some calcium and other minerals (thanks Nal).

5. Prednisone increase to combat Zytiga induced BP increase: Risk of hypertension in Cancer patients treated with Abiraterone: a meta-analysis - PMC

ncbi.nlm.nih.gov/pmc/articl...

6. Efficacy of eplerenone in the management of mineralocorticoid excess in men with metastatic castration resistant prostate cancer treated with abiraterone without prednisone - PMC

ncbi.nlm.nih.gov/pmc/articl...

7. Serious Hypokalemia Associated with Abiraterone Acetate in Patients with Castration-Resistant Prostate Cancer

hindawi.com/journals/criu/2...