Side effect of a Rash with Xtandi and Apalutamide?

[spolyu]

Has anyone gotten a rash from either of these drugs? Has anyone taken an Antihistamine for the rash so they could continue with their medication? Has anyone been successful in lowering their dose?

Thank you

[GSDF]

I had very itchy red rash on inner left arm shortly after starting Xtandi... No OTC products helped. I began hot Epsom salt baths and that helped considerably but after applying raw unfiltered honey over the rash and covering with bandage, I was cured overnight. 🙂

[spolyu in reply to GSDF]

Thank you very much for your response.

[Kaliber]

I have been prescribed “ hydroxyzine “ HCL ( Atarax ) , 25 mg every 6 hours, for that itching and rash. It helps but makes me very sleepy and tired.

[Tall_Allen in reply to Kaliber]

If you still need it, try Claritin, Allegra, or Zyrtec instead. My PCP tried to get me to use hydroxyzine as a sleeping pill, but it made me drowsy for 2 days after each dose.

[Kaliber in reply to Tall_Allen]

I hear you, thanks.

😁😁😁

[spolyu in reply to Tall_Allen]

Thank you very much for both of your responses

[spolyu in reply to Kaliber]

Thank you very much

[Tall_Allen]

Apalutamide is infamous for such rashes. Maybe Claritin + topical steroid cream can fix it, as in this trial?

auajournals.org/doi/10.1097...

[CAMPSOUPS]

Appears I am lucky so far. On Xtandi for about a month and a half. This rash developed about 3 weeks ago. No itch. No pain.

inner leg rash

[spolyu in reply to CAMPSOUPS]

Thank you very much for your response

[Kaliber in reply to CAMPSOUPS]

ewwwwwwwwwww …. Yayahahahaya

❤️❤️❤️

[CAMPSOUPS in reply to Kaliber]

Ya, ya. I know right. That's an ugly shot even without the rash lol.

[Kaliber in reply to CAMPSOUPS]

yayahahahaya. Good going, jumped right out in front of me yayahahahaya. You Lupron fog must not be as thick today 😂😂😂😂

[CAMPSOUPS in reply to Kaliber]

Yah mahn. It could be or could it be. I'm still thinking about Frank Zappa lol.

[Kaliber in reply to CAMPSOUPS]

thinking is the “ key “ there …. as long as we are still thinking ( however impaired , speaking of myself ) we’re still in the game brother . Yayahahahaya yayahahahaya. I think so, anyway.

😂😂😂

[Bassmaniac in reply to CAMPSOUPS]

The rash on legs looks just like that after starting Zolodex / Xtandi about two months ago. Not itchy just ugly. My escalated blood pressure worries me more. B4 I was ok on ADT and with Telmisartan 80 mg my readings were 120/80 fairly consistent. Now, despite adding another BP drug my readings are about 160/120 consistently. I told the professor but he hasn't changed a thing. I'm 1.5 years into this journey now and feel so crap I just want to stay in bed and sleep. I'll be seeing Dr again In a week so hopefully the PSA readings at least will be good. 🙏

[MateoBeach in reply to Bassmaniac]

For many, Xtandi is a terrible drug regarding side effects including extreme fatigue that is ruinous to QOL. Some respond by reducing dose in half and hoping it remains effective. Other options include switch to Nubeqa which has little to no such side effects since it doesn’t get into the brain. That would be an optimal choice for you since you are metastatic. Here in USA they require adding docetaxel chemo to get it at this time. May be best known combo (Triplet) if you were metastatic at diagnosis. Explore this option.

Another would be to switch the Xtandi for Zytiga (abiraterone) but requires low dose prednisone titrated to proper blood pressure. But works very well and better side effect profile than Xtandi.

As for the BP, yours is not acceptable as you indicated. The usual second line med to add would be a low dose thiazide such as 25mg hydrochlorothyazide. But one very effective BP choice that have good research showing strong activity against prostate cancer are the alpha-1 blockers prazosin and doxazosin. Between the two I chose doxazosin for it’s longer half-life. Though much evidence for prazosin for fighting PC as well. (Cell line, animal and retrospective studies, not prospective trials. However it is pretty compelling in aggregate.) see other posts on these drugs from me as well as Scoutforanswers.

[MateoBeach in reply to MateoBeach]

pubmed.ncbi.nlm.nih.gov/151...

[spolyu in reply to MateoBeach]

Thank you

[j-o-h-n in reply to CAMPSOUPS]

We're they mobile or inert?

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 03/04/2023 11:13 PM EST

[spolyu in reply to j-o-h-n]

Thank you for responding. Rash was inert

[CAMPSOUPS in reply to j-o-h-n]

Still there. Inert I would say. Haven't changed.

[j-o-h-n in reply to j-o-h-n]

Best that way........

As the saying goes, What's the difference between love and herpes?

Herpes is forever........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/05/2023 3:45 PM EST

[spolyu in reply to j-o-h-n]

Thank you

[Loudlibrarian]

My husband had a terrible rash on his back while on Xtandi. His dermatologist prescribed Triamcinolone twice daily. Took some time, but it worked.

[spolyu in reply to Loudlibrarian]

Thank you for your response

[spolyu in reply to Loudlibrarian]

Did your husband stop the medication when the rash happened? How long did he continue to take Xtandi?

Thank you

[Loudlibrarian]

He was on Xtandi for only 3 months as his PSA was still rising. The rash did clear up when he moved on to docetaxel. He has very sensitive skin. We still have a tub of the Triamcinolone cream for when anything flares up.

[spolyu in reply to Loudlibrarian]

Thank you. very much

[Brysonal]

I got a rash on my neck from Apa but steroid cream cleared it up straight away

[spolyu in reply to Brysonal]

Thank you for responding

[larry_dammit]

6 plus years on Xtandi, no rash but neuropathy once on a while, Benadryl to help that. Xtandi does have a hotline to talk to a pharmacist.

[spolyu in reply to larry_dammit]

Thank you

[Shamrock46]

One of the many SEs my husband has gotten is rosacea on his face and dermatologist said it's from hormone upheaval. He started Xtandi (plus Lupron) on the usual 4/day but had multiple SEs that resulted in reduction to 3/day, then 2/day which he tolerated better for a few months. He then had another SE that made it extremely difficult to lift his arms or legs and was put on 1/day. His PSA started to increase from undetectable and the MO convinced him to go back on 2/day to see if it would help lower it again. That was 7 wks. ago. The PSA is still going up. We'll see what it is in early April and decide whether to continue. He's been on it for about 20 mos. now.

[MateoBeach in reply to Shamrock46]

if it’s not working then it’s not working. Waiting until April unlikely to change that, riding the wrong horse. Consider / discuss switching to Zytiga + prednisone or darolutamide if he can get it.

[Shamrock46 in reply to MateoBeach]

I agree and that's what we discussed with the MO 2 wks. ago. She said that in the 6 wks. that she hadn't seen him it hadn't gone up as much...but I pointed out that it had only been 6 wks. instead of the 3 mos. between each past visit. She agreed that was true but said she wanted to see the PSA results at next visit to see if the rise was lessened by taking 2/day. She also rec. switching to Zytiga but I'm against that since he has only 2/3 of a working heart, CHF and other problems. I told her my concerns (that my husband and I have already discussed and he agrees) that since he's prone to SEs, if he gets a cardiac complication from Zytiga he'd end up in the hospital. She looked at my husband and said "Yes, that's true too." Not many good choices at this point.

[spolyu in reply to MateoBeach]

Thank you

[spolyu in reply to MateoBeach]

Thank you

[hfl20]

About 3 months after starting apalutamide (and 5 months on Orgovyx), I developed a rash over most of my body. This happened about 3 weeks into my 8 weeks of proton treatments so the techs were worried about anaphylactic shock and contacted the doctor. I had no other symptoms like itching, just the rash and extremely dry leathery skin mostly on my legs (though I was drinking 3 liters or more water per day). Dr suggested Benadryl then Zyrtec, neither of which worked. I just lived with it until the end of radiation. MO then had me stop taking apalutamide for 2 weeks, then go back at 1/2 dosage (2 tablets) which seems to have helped. I've been taking it at that dosage for about 2 weeks and the rash is not gone, but better. MO said he was aware of no studies that indicated why everyone needed 4 tablets. I had PSA checked 3 days ago and is still undetectable at 0.0. From my understanding the Orgovyx is probably responsible for that and the apalutamide works more as a testosterone receptor inhibitor, thus sort of double action on starving prostate cancer cells.

[hfl20 in reply to hfl20]

Another good article... onlinelibrary.wiley.com/doi...

[spolyu in reply to hfl20]

Thank you

[hfl20]

bmcurol.biomedcentral.com/a...

[spolyu in reply to hfl20]

Thank you

[Mikeski]

Yes, itched like hell,

I took Zyrtec and was prescribed Tramcinolone Acetonide cream 2x day.

I had the rash over 50% of body (back and trunk), so they held the Apaludamid for 2 weeks. It cleared and I started again without issue.

Hope you find relief!

Mike

[spolyu in reply to Mikeski]

Thank you very much

[icanwintwice]

Just started apalutamide in January and just had a rash show up on my inner elbows both sides. been using cortizone10 a topical steroid, and epsom baths, and it seems to be working....good luck to us both!!

[spolyu in reply to icanwintwice]

good luck and thank you for responding

[j-o-h-n]

Snitchy Bitch don't double my itch....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 03/04/2023 11:18 PM EST

[spolyu in reply to j-o-h-n]

Thank you

[Break60]

I had serious fatigue but no rash on two 80 mg Xtandi pills so dropped down to one pill and it greatly reduced fatigue. I’ve been on Xtandi since 3/22 along with estradiol ( three .1 mg patches changed weekly) which I’ve been using since 2/19.

[spolyu in reply to Break60]

Thank you very much