Upping my Zytiga intake

[Parscore]

So I have been taking 500 Zytiga w/food AM. Now the PSA is on the move. Doc wants me to up it to 1,000 on a empty stomach. I do not think it will make a difference. Any thoughts on this would be helpful.

[Magnus1964]

Interesting, I found that taking zytiga with food to be more effective.

[GP24]

You should try whether 1000 mg make a difference.

[LearnAll]

Before changing the dose of Zytiga, you need to check your serum total testosterone level. If it comes less than 10, you do not need any change in dose as your current dose is doing what is needs to do. i.e. keeping castrate level of T. That,s the whole point of taking Zytiga. Depriving cancer of T. 250 mg a day of Zytiga with food is keeping my total T at or below 4 ng/dl If your T level is already at castrate level (less than 10 ng /dl), some of your your cancer cells may have started becoming castrate resistant. So ask you Doctor to check total T and Free T before taking any other action.

[CAMPSOUPS in reply to LearnAll]

Truth in what you say LA.But too what I like about Zytiga is its work within the tumors themselves. Not just a T stopper like standard ADT.

Abiraterone acetate is designed to treat these tumors by inhibiting the production of androgen in the testes, adrenal glands, and prostate cancer tumors themselves.

Just too bad as with everything it wont work forever.

[Tall_Allen]

Try the empty stomach approach. The problem with the "with food" approach is that absorption is highly variable - it depends on the person and what he ate. You can also try switching from prednisone to dexamethasone.

[GeorgeGlass in reply to Tall_Allen]

Do you think the same principle applies to orgovyx ADT tablets? Take on empty stomach vs with food?

[Tall_Allen in reply to GeorgeGlass]

No food absorption effect with Orgovyx.

[noahware]

To take it "with food" needs to be more specific, since fat is the key to higher absorption. If 500 Zytiga is taken w/ somewhat FATTY food it is likely to put more of the active med in your system than 1,000 on a empty stomach is. [If I recall correctly, the study on dosing found a range of 2x to 7x the absorption w/ food than on empty stomach, but can'tr remember if that was low-fat or higher fat.]

I agree with LearnAll that you want to know what your T is. When I was on abi, my T stayed at <4 the whole time. When PSA was rising, and T stayed that low, it was pretty clear that the abi was working perfectly fine to keep T low but NOT working on my PC as well as before (i.e., that I was developing resistance).

[dhccpa in reply to noahware]

The U of Chicago study on low dosing used low-fat meals.

[Concerned-wife in reply to dhccpa]

And I thought only 250, not 500. One pill

[dhccpa in reply to Concerned-wife]

Yes. I think both patients and doctors have tinkered around with different foods and amounts of Zytiga.

[rhenrick in reply to noahware]

Low fat breakfast when reducing dose of Zytiga. 300 cals and low fat. Not high fat.

[Lettuce231]

Lots of advice here to take on board. I too have been taking Zytiga with food, for three and a half years. The fat content is the key to absorbtion as mentioned by noahware. I have a fried egg on toast, followed by a yoghurt, not a skimmed milk or low fat type. " Food " doesn't help you unless you know what food to take it with. It seems odd that 1000 mg on an empty stomach should produce a better result than 500 mg with the correct intake.

Wishing you all the best.

[Chrisbaird]

I was on 1000gm. ( 2x 500gm daily ) taken before food 18 month ago I ended up with liver toxicity had to revert 500gm after a two week break with zytiga been fine since

[Rolphs]

I’ve been on Enzo and ADT (Firmagon) for a year. I take it in AM on empty stomach and then do exercise also on empty stomach . I do intermittent fasting from 8PM to 1PM. May 2021 DX9 Gleason, multiple bone Mets PSA 930. Edema and fatigue major side effects but manageable . Now PSA 1 and clean on bone scans. This regiment has worked for me so far.

[MateoBeach]

Appears unlikely that the dose change will make a difference, unfortunately. Because you are probably developing abiraterone resistance. Will likely mean a round of chemotherapy would be the next best sequence of therapy, as enzalutamide following directly often fails rather quickly. BAT (or modified BAT) or Lu-PSMA are other considerations if you don’t have a specific genetic marker indicating other therapy. With support for you. Paul

[Parscore]

Thank you for all the input.

[j-o-h-n]

I would say....It's Par for the course.....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 06/17/2022 10:03 PM DST