Breakfast - Low Fat, High Fat, No Fat? What works best with 250mg Abi?

[JazzMan42]

Thanks to encouragement from my two MO's and the gang on this forum, I am trying the 250mg Abi with food instead of the full dose without food. Question: is there a definition as to the type of breakfast that maximizes the absorption of the 250mg pill? I have heard low fat/high fat/no fat and am confused as to the best for effective use. A friend who asked his MO at UCSF says toast with butter or bagel with cream cheese. What about an egg every other day or oatmeal?

Would appreciate advice from anyone who is on this regime and the results. Or, anyone who understands the biological mechanism of 250mg Abi with food.

[Adlon57]

Find I have diabetes 2 and Prostrate Cancer; bowl of cereal, no dried fruit, low sugar, [usually have fun once a week, picking preference, types of boxes or bags, then mix together for weekly mixture] banana, Greek style yoghurt, and milk [usually with metformin pills and turmeric and black pepper, optional?] that's my daily breakfast!

[cesanon]

The general rule is to make sure you have some proteins with all the breakfast carbs.

It seems like you can do that without any contraindications it would seem.

[Concerned-wife]

cinj.org/sites/cinj/files/d...

healthsystem.osumc.edu/pted...

[JazzMan42 in reply to Concerned-wife]

Thank you, Concerned. First I've seen of a medical institution defining the right kind of breakfast!

[HikerWife]

HI - my husband on same regimen since Feb 1. There is VERY little info out there, sadly. We went with the breakfast parameters used in clinical trial - 300 calories, 9 g of fat. He hates eggs and smoothies. Have devised several sandwiches, a couple of soups, and cuban black beans/rice as options. Takes some tweaking of fat content and serving sizes to accomplish correct parameters.

[Shams_Vjean]

I’m not able to locate the source just now, but one publication I saw regarding this said that when taken with food the effective dose of the drug in the bloodstream can vary between 5Xs and 10Xs of that experienced when taken without food. The concentration of fat in the food is commonly indicated to be the primary variable involved in the absorption and concentration of the drug in the blood. Therein could be a potential problem for some individuals with liver issues/disease, if absorption/concentration is significantly higher than the On Label dosing parameters .

The original, and only, clinical trial published for this was done using a low-fat breakfast. I think it’s interesting to note the study observed there was a greater variance in the blood level concentration of the drug among those in the ‘control’ group which took the standard 1000mg. dose without food daily. It suggests drug absorption may vary widely between individuals even when the drug is administered per On Label direction. Study also observed the length of time for effective concentration within individuals using food was generally shorter than that for those using the On Label dosing.

cancer.gov/news-events/canc...

There was only a total of 72 patients in the trial; but it seems there has also perhaps been a fair amount of MOs who’ve seen patients trying the low dose w/food protocol, and they may recommend it where financial toxicity is an issue. The principle argument that financial toxicity should not be an issue for generic abiraterone could be subject to supply chain problems, as was reported in recent month(s) past.

Without RCT data to support it, I’d be surprised to see any of the Centers of Excellence for Cancer Treatment in the US publish a recommend menu/meal plan for low-dose Abiraterone taken with food.

[JazzMan42 in reply to Shams_Vjean]

Thanks for your comments and the link.

[j-o-h-n]

Eat Food..........Bite - Chew - Swallow (in that order)....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 03/02/2023 7:54 PM EST