Pharmacist, nurse, and drug info sheet all say to take with food because it increases bioavailability by 2 to 2 1/2 times.
I’m curious, how much food is enough. I know with other drugs, a piece of cheese, or some crackers is good enough. Would it be the same with the NUBEQA?
I have been taking NUBEQA for about seven-eight months now. When I started I asked if "with food" means I should take it before, during or after meals. Nobody was able to tell me. I suppose it probably doesn't matter. I am taking NUBEQA shortly after I finish eating breakfast and dinner. I eat my normal amount. I am guessing the food is to mitigate any adverse reaction of your stomach and to help the drug to spread from the digestive system to the blood. So any amount is better than nothing. So far it seems to be working.
Great question - I've often wondered the same thing. I usually don't have much of an appetite in the morning so I usually take it with a very light breakfast. So far I haven't noticed any issues from taking it on a light stomach, but would love to hear from others if anyone has more insight.
It’s specifically to help absorption with this drug, increasing it by 2 to 2.5 times
See 12.3 on this link accessdata.fda.gov/drugsatf...
The question I have is how much food does it take.
what about the side effects from Nubeqa? Have you had any side effects. My side effects are pretty noticeable after about a week on Nubeqa. Did this happen to you. I have the fatigue and small rash, mild body and headaches. Lack of concentration etc.
I just take it immediately before or during the meal. If I forget (rare) because we’ve eaten away from home, then I’ll take it when we get back with some nuts or cheese.
what about the side effects from Nubeqa? Have you had any side effects. My side effects are pretty noticeable after about a week on Nubeqa. Did this happen to you. I have the fatigue and small rash, mild body and headaches. Lack of concentration etc.
More important would probably be the "type" of food... Lipids as a carrier and agent which would provide the drug being absorbed at a higher rate. Just spitballing, no data, study or other referable information provided or implied. I just took my Nubeqa with a bowl of cereal, lol. Not overthinking it! Will follow up with some coffee and fruit! But an sausage, egg & cheese sandwich would probably have been better!
what do you mean, lipids as a carrier? Do you mean that fats might help deliver it better? Or were you joking? Hard to tell with written words. I have noticed some shakiness and a weird surge in my head earlier. This is only my first day on full dosage (2 pills twice a day). I does give me gas that I didnt have previously.
Lipophilic vs Hydrophilic absorption... There is a difference. Whether or not it has impact with Darolutamide/Nubeqa is anyone's guess. I noted I had no data and was just spitballin... And I don't really shape my meals to the drugs, I just eat.
I asked my MO how do we know what level of drug is circulating, do we test for efficacy and I got that strange look, lolz 
So once the trials establish the maximum safe dosage, I believe that is where they leave it. No need to test efficacy with various foodstuffs or diet.
Good thoughts CO. I wonder how much the side effects on men are related to how much they weigh. Why is a 300 pound guy, getting the same 400 mg daily dose of nubeqa, s as the 160 pound guy? It seems like that would cause a difference in effectiveness and/or side effect likelihood.
Even with stuff like statins: why have 10,20,40 out 80 mg options, instead of every five mg increments? Same reason why the car color options are so shitty and limited; because it’s driven by manufacturing efficiency, unfortunately.
Have you had any side effects. My side effects are pretty noticeable after about a week. Did this happen to you. I have the fatigue and small rash, mild body and headaches. Lack of concentration etc.
No, nothing out of the ordinary that I can remember, lol. Maybe slight fatigue, but otherwise no. I've been pretty fortunate this way with most the drugs I've taken.
The side effects I have are mild, if any. Perhaps some fatigue, but nothing out of the ordinary. I am not in my thirties, fourties or fifties anymore. Concentration is OK too. I work ~40 hours a week with no problems that I can see. I have been taking Nubeqa only for about 7-8 months. Not sure if there are any side effects that show up later.
checked with my specialty pharmacist and here is the response - seems a small amount of food iOS sufficient and helps .
“It is highly recommended for the Nubeqa to be taken with food because food will actually help the body absorb the medication into the blood stream. There is not exact amount of food that you should be taking however oatmeal or cereal is sufficient enough. When food is digested the acidity of the stomach increases which will then help with the absorption of the medication. “
Great answer. I was going to call mine today but you’ve saved me the trouble. Thanks.
would bad side effects occur more likely, if taken on an empty stock? That’s what happens with alot of supplements, drugs etc. Because it’s upsetting to the nervous system or stomach etc
The take with food recommendations are specifically because taking it with food increases absorption by 2.5x according to my specialty pharmacist.
ok thanks. I’m adjusting my schedule, getting up earlier, so u can get the morning pills into me, are least 10 hours before dinner. I normally only eat during an 8 hour window and fast the other 16.
In the morning I take mine with coffee and a small piece of string cheese. I’m not on any kind of restricted time window diet, but in typically don’t eat until I’ve been up for 3-5 hours.
Been on Nubeqa 19 months. I spoke at length with the Led Specialty Pharmacist and her answer was two slices of toast or a bowl of cereal at breakfast is enough. As to timing she stated during eating but that might mean after one bite or when taking the last or in-between.
Did the pharmacist mention anything about what type of ADT to use with it. One guy on this site, said that the company who makes nubeqa, said to use a specific type of ADT, but that does not sound right to me.
I am on Lupron, monthly by my choice. No adverse effects other than zero energy and rare hot flush, mostly at night. I do go to the gym M-F and exercise some at home. Exercises I have done for knee replacements. Not told of a requirement for specific ADT but Nubeqa is not a mono therapy. I have been on Lupron before so easy choice.
I just read a thread where a couple of guys are claiming to be using darolutimide off-label as monotherapy. One claims to have a testosterone of 700 for an extended period with no PSA rise.
Exciting news if legit.
healthunlocked.com/advanced...
One of the guys on this site did nubeqa mono-therapy last year but it stopped working after only eight months, and then the psa kept rising, after he added it to the nubeqa. That's the risk. Less time period that it is effective.
Did anyone on this thread develop neutropenia from Nubeqa, or a lowering of your neutrophils at all?
I've only been on NUBEQA for about a month, but my neutrophils actually went UP considerable from labs taken on December 6 and January 31. I started NUBEQA on January 4.
December Absolute neutrophils 4670 (1500-7800) and neutrophil % = 54.3 (quest Diagnostics)
January 31 Absolute neutrophils 22.9 (1.9 - 6.0) and neutrophil % = 82.1 (City of Hope in house lab)
GI, something doesn't seem right about that. Did you talk to a doctor? 22.9 and 83% are so far above normal that it's seems like that would be very dangerous to have those numbers.
Hey GG, my oncologist reviewed the labs that day as they were chemo labs an hour before she decided my chemo dose. We didn’t discuss that number in particular.
my numbers are similar on in 2/21/23 for my third chemo.
But they’re not that far above normal. The normal range for nietrphil % on that particular lab at CoH is 42.5 to 78.2%. 83% is just above normal.
GG, in my reply last night I focused on the percentage and not the absolute number.
You’re correct, my most recent numbers of 22.9 and 22.7 Segmented Absolute Neutrophils are almost 4x the normal maximum number of 6.
A little Googling shows that prostate cancer that has metastasized into the bones recruits neutrophils increases. I assume to fight the cancer, but need to read more.
Some articles seem to focus on Neutrophils to Lymphocytes ratio as a predictor for poor PCa survival in certain patients with castration resistant cancers.(1)
I do have bone metastases in the hip, sacrum, and spine. I’ll certainly ask my oncologist about this when I go for my 4th chemo next week.
This might be a good topic for a separate post.
Thanks for pointing this out!
edit/notes—
(1) seems like that neutrophil to lymphocytes ratio prognosis is a predictor for mCRPC and localized PCa prior to treatments. Need to look more for after treatments begin.
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