Which statin to take with Nubeqa/Darolutamide? Pitivastatin or a different statin?

[GeorgeGlass]

I took someone's advice and called Bayer Corp today. What a waste of one hour. Minimum wage level 1 employee bumbling around trying to get me answers. I already read the entire product packet. It says that Crestor and Lipitor (and other statins) can accumulate and cause problems/side effects. Looks like Lipitor is better, with Nubeqa, than Crestor. However, they list Lipitor as a potential interaction as well. Thus, I researched and saw that Pitavastatin/Livalo does not process through the liver, in the same way as the aforementioned statins. I think they said it is water based as well, which could reduce interactions that are related to Lipitor or Crestor, with Nubeqa.

Does anyone have an opinion or experience with this? Bayer does not have any data on Nubeqa with Livalo, or else they have the data and won't share it with me because they are afraid of some lawsuit down the road. I read a previous post about statins, and some guys liked its effects, and Patrick O'Shea responded poorly to it. This post/question has more to do with taking it with Nubeqa, and not just a specific assessment of statins. Crestor has been good to me for six years, but it's listed as moderate interaction with Nubeqa. I've also asked cardiologists and oncologists about this subject and they don't have an answer, other than "refer to the prescription packet" for answers.

If Livalo is the best option, then would one assume that any of the Livalo dose options would not interact with Nubeqa?

Another interesting thing about Pitivastatin is that it's shown to have some anti- lung cancer effects, which could possibly help fight other types of cancer as well. Here is one article related to that topic -

pubmed.ncbi.nlm.nih.gov/320...

thanks,

George

[cesces]

You need to find a doc that has been working with all these drugs.

Might be hard to impossible, but that's what you need.

[Tall_Allen]

FWIW - I have no side effects from pitavastatin 4 mg/day. I get it from India to save money, but the new Medicare drug cap of $2,000/yr may change that next year.

[GeorgeGlass in reply to Tall_Allen]

thats good news. thanks. I'll see what my cardiologist says about my request for the switch. I did read something about needing to be careful if you have hypothyroidism. My current Free T-4 level is .79, so I'd like to find a safe way of raising that. Apparently, having it too low and taking pitivastatin could cause renal kidney issues of some kind.

[Purple-Bike in reply to Tall_Allen]

Do you take it against PCa?

[GeorgeGlass in reply to Purple-Bike]

I take it for coronary artery disease but i have to endure no interaction with nubeqa. Cancer fighting benefits would always be welcome as well.

[Purple-Bike in reply to GeorgeGlass]

Thanks, George. The possible anti-PCa effect seems promising, Did you see the link posted by Bigm789 recently? The Anti-Cancer Effect of Pitavastatin May Be a Drug-Specific Effect:

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

Reading up, I see its cardiovascular benefits. My LDL is fairly low, but lower, even much lower, is better .

health.harvard.edu/blog/ldl...

Good against CVD and possibly PCa, with probably low side effects on top of it. What a substance! Belatedly I understand why statins are so popular on this forum. And Pitavastatin seems to be the best one. Thanks to you and Bigm789 for bringing it up. Now to get hold of it. It´s not even available in my country. It will probably be India.

[Scout4answers in reply to Tall_Allen]

?hat is the cost of pivitastatin from India?

how long have you been taking it?

[Tall_Allen in reply to Scout4answers]

61¢/pill from alldaychemist. I've been taking it for 2 years. All lipids are good. No side effects.

[Scout4answers in reply to Tall_Allen]

Thanks , is a prescription required?

is it Livalo or Zypitamag

or a knock off of PITAVASTATIN ?

[Tall_Allen in reply to Scout4answers]

It's generic. No prescription, but there is a shipping fee and it takes about a month to arrive - so I always put in a large order and order well in advance. I also get my Xarelto from them.

[Scout4answers in reply to Tall_Allen]

ThanksI used to get Cialis from overseas but with GoodRx it is now cheaper here and I feel it's more trustworthy.

[Tall_Allen in reply to Scout4answers]

Most US drugs are manufactured in India, so it is probably closer to the source. I've found them to have good quality (at least in effectiveness and no side effects), but I haven't taken them to a lab to be tested. But with the new $2000/yr Medicare drug co-pay limit and negotiation of drug prices, I may get my drugs here eventually.

[Scout4answers in reply to Scout4answers]

Thanks so much TA you just saved me some real coin, $750 for the first 90 days

Mozart bets on my long term survival

[tango65]

One can't take crestor, because daro will increase the blood level a lot. I changed Crestor for Lipitor 40 mg and Zetia. My cholesterol is around the 130s, with LDL below 80.

[cigafred in reply to tango65]

". . . daro will increase the blood level a lot." Yhe blood level of what?

[tango65 in reply to cigafred]

crestor

[cigafred in reply to tango65]

Thanks. Obvious, in hind sight.

[EdBar]

Snuffy Myers switched the statin that I was on (I think it was Lipitor) to Crestor back when I started taking Xtandi a little over 8 years ago. He said Crestor won’t interfere with the Xtandi. Not sure if it’s the same for Nubeqa. I’ve had no issues, cholesterol and LDL numbers have been great. I take 5 mg daily.

Ed

[GeorgeGlass in reply to EdBar]

Nubeqa says to avoid Cresor and others. I requested Livalo. Simvastatin would be safer than crestor because of the shorter half life, from what I was told. nubeqahcp.com/clinical-info...

[Medline]

Livalo and Crestor do not interact with Nubeqa.

Nubeqa/Darolutamide is mainly metabolized by the CYP3A4 hepatic enzyme, but Livalo/Pitavastatin and Crestor/Rosuvastatin are metabolized by CYP2C8, CYP2C9 and CYP2C19 enzymes.

go.drugbank.com/drugs/DB12941

go.drugbank.com/drugs/DB08860

go.drugbank.com/drugs/DB01098

[GeorgeGlass in reply to Medline]

Why do you think they have Crestor listed on here: nubeqahcp.com/clinical-info...

[Medline in reply to GeorgeGlass]

Concomitant administration of Nubeqa increases the plasma concentration of Crestor approximately 5-fold.

Crestor is a substrate of OATP1B1 and OATP1B3 and is mainly taken up into the liver through these transporters, but Nubeqa inhibits these hepatic transporters.

Other OATP1B1 and OATP1B3 substrate drugs can be found in the following links:

go.drugbank.com/categories/...

go.drugbank.com/categories/...

Therefore, consider dose reduction of these substrates.

[GeorgeGlass in reply to Medline]

Thanks Medline, that’s good info. I appreciate it. I can use that with my cardiologist.

[GeorgeGlass in reply to Medline]

Bottom Line - what do you think is the best option for trying to slow the cancer - Livalo and Nubeqa, Simvastatin and Nubeqa, or reduced dose of Crestor and Nubeqa. One article says that daro and simvastatin worked the best on CRPC. Livalo did well at fighting lung cancer but prostate cancer hasn't really been researched I presume.

[wagscure259]

FYI when I call Bayer for info like you were looking for I immediately ask to speak to one of their pharmacists. Hope that helps in case there are any future inquiries you may need to make

[GeorgeGlass in reply to wagscure259]

I did that at first but i received one of the rudest people of all time. She also couldn’t help me because i got the drug through my doctors office, and not through the bayer pharmacy. I had some choice words for her before i hung up. She was a true bitch and wouldn’t let me finish a sentence. She was doing it on purpose. Very sad.

[Izzygirl1]

My husband starts Darolutamide tomorrow. He is currently on Rosuvastatin tablets 10mg a day. Will that interfere with his Daro or have bad side effects?

Thanks for your help!

❤️

[Seasid in reply to Izzygirl1]

Yes, according to the information from above. He should stop crestor.

[Izzygirl1 in reply to Seasid]

Thank you. Wasn’t sure if that was the same as my husbands med. I’ll make sure I check with his doctor today!!

[Seasid in reply to Izzygirl1]

Also check that he is really prescribed Darolutamide (Nubeqa) from Bayer. Crestor is Rosuvastatin.

[Izzygirl1 in reply to Seasid]

Yes... he is... and he starts today! Praying it helps clear up the cancer cells in his bone marrow so he can start chemo (right now he is too anemic). Thanks so much!

[Seasid in reply to Izzygirl1]

He may be able to get 5mg crestor per day if his cardiologist agree with that. See joeguy.

[GeorgeGlass in reply to Izzygirl1]

what is your current statin status and what were his before and after lipids results/numbers?

[Izzygirl1 in reply to GeorgeGlass]

My husband is still taking his Rosuvastatin (crestor) every day along with his darolutimide. No side effects and all his blood work looks good. His lipid results before were good, and I'm not sure what they are now. He is having blood work done on Tuesday so I'll ask them to check that and I'll get back to you! Thankfully my husband is doing quite well and we were thankful our doctor put him on the triple therapy because his cancer was very aggressive. I hope you are doing well !!! ❤️

[joeguy]

I take Crestor (the generic version Rosuvostatin) with Nubeqa, but because the Nubeqa increases the dose of Crestor, my cardiologist reduced the amount to only 5 mg every other day. No problems so far...

[Izzygirl1]

Thank you... very helpful info!

[joeguy]

I take Nubeqa and Crestor (the generic version). Since Nubeqa increases the amount of Crestor by about 4 times, my cardiologists reduced me to only 5mg every other day...... so far so good

[GeorgeGlass in reply to joeguy]

what were your before and after lipids results/numbers? what about adding zetia to the Crestor?

[CV43]

I take Nubeqa with 5 mg of Crestor daily. My cardiologist added 10 mg of Zetia to make up for the 40 mg of Crestor I was originally on before starting Nubeqa.

[GeorgeGlass in reply to CV43]

what were your before and after lipids results/numbers?

[Scout4answers]

20 mg pill for $0.63 from Osco drug with GoodRX pricing

[Cooolone]

Just wondering how the Statin use has been working out for all?

I began Nubeqa last Nov and was already on Crestor. Dropped it to 5mg per day, but the lipids increased. So doctor is thinking to increase it to 10mg per day. I did it and haven't suffered any side effects, ie, the Darolutamide making the Crestor 5x more (effect). I was on 20mg before dropping it to 5mg.

So just looking to revive this thread and get some feedback.

[GeorgeGlass in reply to Cooolone]

C1, when you switched to 5mg Crestor, did you also add 5 or 10mg of zetia, as well? I changed to 5 mg of Crestor and 10 mg zetia. I’ve been cutting too 7.5 Crestor and 5 mg zetia, every other day and no additional side effects. I haven’t got new lipids test yet. I’m due for that in a few weeks. I think the study showed that Crestor could increase levels by 5x, however, they didn’t say how frequently that happened. It may have only happened in a small % of people it was wrong of them not to report that %. The reason i cut the zetia sometimes odd because a study showed lipid reduction the same (26 vs 25 %) composting 10 mg with 5 mg.

What were your before and after lipids results? All of us need to share our data with each other, using this discussion thread. I hope the other guys are reading this too.

Lastly, i had problems using pitivastatin , with muscle aches and tendon ligament pain and weakness. Then i tried simvastatin and the problem continued, although, i wasn’t on it long enough to vilify simvastatin as well. Crestor and zetia don’t seem to be bothering me.

[Cooolone in reply to GeorgeGlass]

I'll have to look up the #'s as I don't remember off hand. Definitely interested too if anyone has examined the difference with Hydrophilic vs Lipophilic Statins. Aside from the potential Daro CYP effects...