Orgovyx & Xtandi: Has Anyone Used This... - Advanced Prostate...

Advanced Prostate Cancer

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Orgovyx & Xtandi

Wynnsts profile image
29 Replies

Has Anyone Used This Combination and What Thoughts Does Anyone Have Regarding the combination. One MO at Moffitt has suggested that I avoid due to moderate interaction causing an increase in relugolix in your body.

Brief info on where I am. PSMA-PET 11/22/22, metastatic spots 2 ribs, 3 vertebrae, numerous lymph nodes from neck to pelvis. 12/27/22 Total PSA 7.3, free PSA 3.9. Prostate removed 08/2015, 39 radiation treatments Summer 2019 and 5 high dose treatments to 3 lymph nodes and 1 spot on lilac bone along with Eligard fall of 2021. Last Eligard 12/21.

Thanks in advance for your thoughts.

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Wynnsts profile image
Wynnsts
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29 Replies
tango65 profile image
tango65

According to Medscape drug interaction checker, Relugolix and enzalutamide does not interact.

reference.medscape.com/drug...

Wynnsts profile image
Wynnsts in reply to tango65

Thanks Tango, I’m about to start the combination, so I’m going to know sooner than later.

tango65 profile image
tango65 in reply to Wynnsts

Medscape reference and its interaction checker is a good place for medical info.

I wish you the best of luck!

Wynnsts profile image
Wynnsts in reply to tango65

I’m in God’s hands, thank you Sir!

Tall_Allen profile image
Tall_Allen

I never heard of an interaction. Did he give you a study?

Wynnsts profile image
Wynnsts in reply to Tall_Allen

TA, no they did not give any info other than the combination would make me a higher risk for side effects. Am I wrong in thinking that Eligard/Lupron combined with Xtandi or even Zytiga or Erleada(?) would create a similar higher risk due to side effects. The MO proposing Orgonyx and Xtandi gave me a study published in The New England Schools of Medicine dated 06/04/2020 and I didn’t find anything indicative and interaction, sometimes I miss thinks reading. I’m going to give it a go, I think I like the idea of oral form. Again, thanks for your input.

Tall_Allen profile image
Tall_Allen in reply to Wynnsts

Adding any second-line hormonal to ADT gives marginally higher side effects. But most of the side effects are from ADT.

TJGuy profile image
TJGuy in reply to Tall_Allen

Wouldn't Zytiga be the better choice for a first second level ADT than Xtandi. Is it possible Xtandi is being prescribed now by doctors perhaps due to profit motive now that Zytiga has gone generic.

Tall_Allen profile image
Tall_Allen in reply to TJGuy

How can a doctor make money by prescribing a more expensive drug?

TJGuy profile image
TJGuy in reply to Tall_Allen

Quite easy and done all the time. Drug reps get Doctors to prescribe a new or expensive drug for incentives.Pharma payments to physicians still deliver a big 'return on investment' in prescription growth, study finds | Fierce Pharma

fiercepharma.com/marketing/...

GSDF profile image
GSDF

Am currently on both... No obvious interactions... Only s/e - occasional hot flash... That is it! 🙂

Wynnsts profile image
Wynnsts in reply to GSDF

Thank you sir, maybe our paths will cross at Moffitt one day. Great place, I’ve been with them since late 2018. I’m also seeing a MO at TGH Cancer Institute, another great facility. Best of wishes in your journey!

leebeth profile image
leebeth

My husband is on both of these. They need to be taken 6 hours apart. He takes the Orgovyx with breakfast and the Xtandi at bedtime.

Wynnsts profile image
Wynnsts in reply to leebeth

Thanks Lee Beth, that’s good to know

rick8637 profile image
rick8637 in reply to leebeth

What is the reasoning behind that? I have been taking both around dinnertime. I have only been on this combo for 6 weeks but both say can be taken anytime. Is there an advantage?

leebeth profile image
leebeth in reply to rick8637

Directly from the Orgovyx package insert:

“Avoid coadministration of ORGOVYX with oral P-gp inhibitors. If coadministration is unavoidable, take ORGOVYX first and separate dosing by at least 6 hours. “

Enzalutamide is a P-gp inhibitor. Mild, but it’s metabolite even more so. Therefore, the administration should be separated by at least 6 hours.

Yes, separately they each can be taken at any time, with or without food in our house, breakfast is around the same time every day. Dinner time is more widely variable, plus we are more likely to find ourselves in restaurants in the evenings. Since Orgovyx really needs to be taken consistently at the same time of day, first thing in the morning seemed the safest bet for not missing a dose. He has not missed a dose in the 14 months he has been on it

rick8637 profile image
rick8637 in reply to leebeth

Well I will change my schedule then. Thanks for the heads-up. I'm not good with the fine print sometimes

leebeth profile image
leebeth in reply to rick8637

This is one great thing about this forum! Best of luck to you.

First off .. I do not trust the MO's at Moffitt for many reasons. First ad foremost they will not talk to any other Dr.s.. I have two teams at the Mayo Clinic in Rochester MN and Jacksonville Fl. The Dr.s in both of those hospitals are more than willing to share their findings with my "team" I use the term loosely at Moffitt but sadly the Moffitt MO's think who they are... It's a joke.. BTW my team at the Mayo is headed up by Dr, Kwon who is way more qualified and compassionate than my MO at Moffitt... PLEASE don't get me started. Moffitt did not want to give me a PSMA Pet scan because they do not have any new doses of LU-177 until march or April.. but if the mean time.. Mayo said.. if you get a PSMA scan at Moffitt have te results sent here and w will review it and should you be eligible we can start treatment with LU-177 immediately. .. "Why would you want to wait" three or four months to possibly let your disease advance? That's just one of the differences between Moffitt and Mayo.

Good Luck in your journey

Wynnsts profile image
Wynnsts in reply to TheWizardofWesley

Larry, I do understand a bit of what you’re saying, but mine pertains to the Gastro group at Moffitt. I’ve only had one visit with an MO at Moffitt in the 4+ years I’ve been treated there. In a colonoscopy they discovered cancerous polyps and 16” of my colon was removed. This group would not talk to you(me) or anyone else. The Radiation Department has been great, but MO wise I have no opinion as of yet. I’m talking with Dr Mayer Fishman at TGH Cancer Institute presently and he suggested this combo for the next year at least. Happy New Year and Best wishes in your journey.

TheWizardofWesley profile image
TheWizardofWesley in reply to Wynnsts

Mayer is the best he was my MO until he left Moffitt, you ate lucky to have him

Wynnsts profile image
Wynnsts in reply to TheWizardofWesley

Thanks Larry CT that’s great to hear. My wife and I were so excited after meeting with Mayer. He was fantastic and we’re excited about continuing our journey with him. 2023 will be a great year for both of us!!

Boywonder56 profile image
Boywonder56

Just wondering why the 1 year off from eligard......

Wynnsts profile image
Wynnsts in reply to Boywonder56

It was my understanding that they wanted to see if the radiation elimated the cancer or whether the Eligard suppressing its’ growth. And being honest it didn’t take a lot of talk to get me to quit Eligard.

Lrv44221 profile image
Lrv44221

Good December 31 2022

I have read your numbers and you seem to be doing well

I think, and I am a nutritional practitioner not a PC patient, that you should

do what your intuition tells you. Because i believe #

"Belief shifts Biology".(one of my posts)

You are going to be fine......believe that👍

Wynnsts profile image
Wynnsts in reply to Lrv44221

Like you I believe Your Mind is the Strongest Medicine!! Happy New Year!!

Lrv44221 profile image
Lrv44221 in reply to Wynnsts

🍏🦊

CRPCMan profile image
CRPCMan

I know several guys who use it intermittently with great results. The fact.that they are oral allows it. Orgovyx is super hard on the whole body so just know it.

Wynnsts profile image
Wynnsts in reply to CRPCMan

I haven’t heard this about being hard in the whole body, but I’m very interested. Could you direct me to some info on this. Thanks so much for this info. I hope you have 10 more years fighting this stuff!! Happy New Year, May it lead to a cure!

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