Zytiga and high BP

[marinerswife]

Has anyone experienced high BP from Zytiga?My husband already takes Lisinopril for BP,but day 2 of Zytiga his BP is over 160. He doubled his Lisinopril to no avail. Any insight greatly appreciated.

Thank you, Amber

[Tall_Allen]

He might not be taking enough prednisone. Symptoms of insufficient prednisone are high BP, low potassium and edema. Talk to his oncologist about adding a little more to see if his BP normalizes,

[marinerswife in reply to Tall_Allen]

Thank you so much Tall Allen, and for being so quick to reply.

[tango65]

Hypertension when taking zytiga is caused by an increase in aldosterone. The hypertension may be corrected with more prednisone but prednisone has its own problems.

One way to control the hypertension when taking zytiga is to use an anti hypertension drug called Inspra (eplerenone) which is a specific aldosterone receptor blocker. Once the aldosterone is blocked , the hypertension is controlled. It could be added to the lisinopril. Just discuss with a internal medicine doctor about using this medicine.

[Gearhead in reply to tango65]

I experienced high BP with Zytiga. I'm now on Zytiga, 5 mg prednisone, eplerenone for the reasons explained by tango65, and some other BP drugs. This seems to have lowered my BP, but please don't over-interpret this because there are some uncertainties, and the cause-effect relation is uncertain. More info is in my earlier post: healthunlocked.com/advanced...

[tango65 in reply to Gearhead]

Eplerenone has been used to substitute prednisone when taking abiraterone with the same PFS than when using prednisone.

ascopubs.org/doi/abs/10.120...

[marinerswife in reply to Gearhead]

Thank you Gearhead. I am compiling information now , so we can ask my husband's onco. My husband is worried he will lose zytiga from his arsenal. So, all of these replies from you and others helps immensely. Thank you so much. I wish you the best.

[Gearhead in reply to marinerswife]

marinerswife: Please be prepared for the possibility that your oncologist may brush this BP issue off onto your primary care physician. That's what mine did. I suspect that many oncologists aren't familiar with the BP effects associated with the prednisone dose (associated with Zytiga) noted by Tall_Allen. And even fewer are familiar with the potential use of eplerenone instead of prednisone as described by tango65.

[Concerned-wife in reply to tango65]

My husband asked his oncologist about this drug ( due to your prior suggestion) when he experienced being someone with very low bp to having it rise precipitously with Abi, 5 mg of prednisone. His doctor wouldn’t prescribe this but did get his BP under control with another bp drug and increased prednisone to 10 mg

He is experiencing much worse hot flashes. Does that make sense?

Thank you for your help.

[marinerswife]

Wonderful news ... thank you for Tango65.

[tango65 in reply to marinerswife]

I wish you the best of luck!

[marinerswife]

Thank you Tango65.

I wish you the best too!

[larry_dammit]

Yes my blood pressure was way to high as well. Had to add a second blood pressure medicine for me. Now it’s running in the low 140s. Doctor is happy. Check with you general practitioner to set you up with a second med.

[marinerswife in reply to larry_dammit]

Thank you Larry, will do. Best wishes to you and glad another bp med worked for you. It is worrisome to have elevated BP in addition to all that PC treatment causes.

[marinerswife]

Thank you Smurtaw, glad to hear you got it resolved. That sounds like a lot of trial and error and great doctoring. Bipolar AT sounds hopeful. Best wishes to you.

[Dastardly]

I have been taking 1000mg Zytiga & 5mg Prednisolone daily since March and I find that, if anything my BP is on the low side compared to what it was before. My Systolic is often around 105 to 115 and Diastolic can be as low as 55. I should mention that, at 76, I am no spring chicken. Doctor's don't seem bothered, so, nor am I, as long as Zytiga keeps working and my PSA stays at 0.04.

[marinerswife]

Dastardly, thats great that it didnt raise yours and that your PSA is steady! May it stay so until immuno therapy for PC breaks ground and ... Best to you.

[timotur]

Yes, my BP shot up from 110/70 to 165/98 on triple-blockade with Lupron/Zytiga/Casodex and dropped it after six months and continued on Lupron only. You may try a reduced dosage if suggestions above do not resolve. Goal is max benefit with min SE's.

[TEBozo]

I had to increase my Losartan and Carvedilol to combat high BP while on Zytiga.

[marinerswife]

Thank you TEBozo. Glad to hear you got it taken care of and didnt have to go off it.