AST and ALT levels higher a week after stopping Zytiga?

[Mw921000000]

Hi all, in my previous post I mentioned my dad’s high liver enzymes (current treatment: Zytiga and prednisone). We went to his doctor and he told him to stop taking the Zytiga and to come back for blood in a week. We just got his results and his levels are even higher now. When should they start to regulate? Is this normal? Thank you for any suggestions.

[EdBacon]

What are the numbers? I'd see what happens in a week, I would expect them to level off or start going down in a few weeks after stopping.

[Mw921000000 in reply to EdBacon]

ALT- 220 AST- 98 ALK is in normal range, complete blood count is normal also. Should we be worried?

[EdBacon in reply to Mw921000000]

Yeah it's high, but I wouldn't be worried at this point. Especially seeing how the most likely cause has been addressed. . Of course if it doesn't start coming down or continues to rise, the cause will have to be investigated. Sounds like your doctor is on top of it with frequent blood tests. What is AST?

[Mw921000000 in reply to EdBacon]

thanks for the reply! His AST (Alanine Aminotransferase) is 220, August 17th it was 137. He stopped Zytiga on August 20th, so as you can see it’s higher after stopping rather than going the other direction

[EdBacon in reply to Mw921000000]

It does happen with Abiraterone. Here's an article on the subject:

ncbi.nlm.nih.gov/books/NBK5...

"ALT elevations above 5 times the upper limit of normal (ULN) occur in 6% of abiraterone treated vs <1% of placebo treated subjects."

[Tall_Allen]

A week is too soon. Monthly blood tests are sufficient. A little elevation in liver enzymes is not dangerous - it's just an indicator. After it's back to normal range, you can slowly reintroduce abiraterone.

[winkoliu]

I take zytiga and I take supplement Milk Thistle to keep my liver healthy.

[GoBucks]

No worries, although we worry about too many things. I stopped Zytiga for the same reason and recall my numbers went up before they came down. I did my blood tests every 2 weeks.

[Mw921000000 in reply to GoBucks]

thanks for the reply, did you ever go back on or did you switch to different meds?

[GoBucks in reply to Mw921000000]

I went on 500mg for awhile then 750. 54 months on 750 at <0.01

[Doggedness]

so this recent blood test increase was PSA or liver enzyme? We are currently on Zytiga too, so your story is of interest. Thank you for sharing and good luck with the next step (would like to know what that is).

[Mw921000000 in reply to Doggedness]

Hi! Recent blood test increase was liver enzymes. Specifically his ALT and AST levels. He’s only been on Zytiga and prednisone for a few months his PSA dropped immediately and liver enzymes were only slightly elevated, it wasn’t a cause for concern. However now that they are trending even higher his doctor told him to take two weeks off and then restart at a half dose if they normalize. It’s been two weeks and they went higher instead of lower so he is going to take only half his dosage of prednisone. Next week he gets another blood test. If these levels are still elevated his doctor is most likely going to put him on a different pill. Zytiga is known to raise liver enzymes which is why most men have to take a break at least once. Hope this answers your question! Good luck

[Doggedness in reply to Mw921000000]

Thank you. And best of luck…