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Has anyone heard of this? My brother goes to the UofC, and he’s starting this on Monday. One 250mg pill with a small meal.
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Zytiga
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Jzner
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The only reason to do this was to save money. Now that abiraterone is available as a lower cost generic, there is no need to guess what the bioavailable dose is when taken with meals.
Interesting. NUBEQA also has much higher absorption when taken with food. Up to 2.5x as much per my specialty pharmacist.
If AA works, though, it's much more affordable.
NUBEQA cost me $0, but I’m not on Medicare.
I wasn’t recommending NUBEQA over anything else, just pointing out it absorbs better with food like Zytiga. Makes me wonder if all the AR drugs do the same.
I'm on Medicare. I've read good things about Nubeqa, but have wondered if it's being hyped over the generic drug. Kind of like Orgovyx and generic Lupron.
Not sure about NUBEQA over generics of drugs like Xtandi or Zytiga other than that it was part of the triplet therapy I’m in right now. I believe (from slides at a PCa conference) that NUBEQA can’t cross the brain blood barrier so has fewer side effects than other drugs.
I think Orgovyx has a clear/distinct advantage over lupron in that it’s daily and can be stopped at any time if there’s a reason to. I’ve seen reports here from patients that the side effects are much less bothersome than lupron.
Totally agree with GI448 about Orgovyx.
My husband was on Zytiga at this dosage per recommendation from Univ of Colorado nothing to do with fianaces. All oncologists felt a higher dose wouldn't change outcomes.
He did well with it for nearly two years in spite of gene test showed resistive to hormonal treatment. Minimal side effects and great quality of life- he's 70.
PSA started to increase and PSMA and MRI done last week shows mets to liver. Will begin Jevtana on Tuesday and re-evaluate after a few doses. Best wishes to you.
Thank you for the response. Hoping my brother does just as well as your husband. He’s had Jevanta/Carboplatin already.
”He did well with it for nearly two years in spite of gene test showed resistive to hormonal treatment.”
But that’s the point of Zytiga, to test castration-resistant cancer. His being resistant to hormonal treatment is (likely) he was out on that drug in the first place.
I know it’s confusing calling PCa treatments “hormone treatments”, but unless you’re in the estradiol crowd, aPCa treatments are about blocking hormones (testosterone), either by turning off the gonads with first generation ADT drugs, or blocking the receptors for testosterone with 2nd generation drugs like Zytiga.
Hi Jzner I’m Uk been on Zytiga for 2.5 years started on 1000 gms daily 1 hour before food with 5 gm steroid with food after 2 months I had to reduce to 500 gms as liver enzymes been on this dosage since…. last 22 months PSA has been 0.01> also on H T long side 3x monthly injections Good luck hope it’s successful
hi Chris. I noticed your remark about enzymes. I’ve been on Zytiga for 16 months and take 5mg of Prednisolone. As I understand it, this avoids the need to convert the Prednisone by liver enzymes to prednisolone before it can work. Just saying in case it may be useful.
yeah been on 5 mg of prednisone daily with food @ breakfast only side effect are hot flushes night times Energy levels could be better.. walk usual weather permitting mile a day thanx reply Ian 99
Hi Jzner,
I've been taking Zytiga 500 mg a day with a breakfast of fried egg on toast followed by a yoghurt and of course tea, for nearly 4+ years now. Originally I took 1000 mg with water for about 6 months.
I have the prednisone before breakfast.
My PSA has remained undetectable for 3+ years. I don't have the records in front of me, I'll look properly when I get a minute.
Absorption is my line of thought and my urologist is of the same opinion. It will be 10 years since diagnosis in December this year, PSA 150.
I hope this helps with your query and I wish your brother well with his battle.
Lettuce: just to clarify, you take 5mg Pred before breakfast on empty stomach and 500mg Abi with breakfast? Why 500mg, instead of 250mg? Aren’t you overdosing?
Because of liver enzyme issues, I was taken off Abi for month and am now taking 500mg on empty stomach (half dose) with 5mg Pred. My next step is 250mg with my standard yogurt/berry breakfast that I have eaten for more than 20 years.
I am assuming that 250mg w/food is less than 1000mg w/empty stomach???
Hi, the reason I take 500 mg is that 250 mg is no longer issued here in France 🤔. I've tried and so has my Oncologist.
Yes the prednisone is always taken before, on an empty stomach, for me anyway, I was told at the beginning to follow that procedure.
Not being a doctor 1000 mg vs 250 mg on an empty stomach it wouldn't be correct for me to give an opinion. But food is the key for absorption. Its like drinking beer on an empty stomach or soaking it up with a curry.
The jury is out, but do we all need 1000 mg, or could we survive on less without any worse side effects. We do have this beast but each of us is a different human being a different metabolism.
I hope that helps.
Sorry I should had said 1000 on an empty stomach and 250 mg with food 🤫
Great information! Thank you
Using your beer analogy, if I drink on an empty stomach more alcohol is absorbed into my system. Doesn’t that analogy suggest that I would need more than 1000mg of Abi on a full stomach to equal 1000mg on empty stomach? The more I learn the more confused I get…
Imagine eating a huge plate of rice and then having a few 🍻. The rice helps to soak it up, well it did when I was younger.
Now if you swallow a 1000 mg of Zytiga on an empty stomach washed down with a pint of water, where do think the majority might end up ?
250 mg with food gets absorbed not wasted, is that a better analogy 😂
Drinking on an empty stomach is why you get ........ so fast, or did. Then you end up shaking with the unemployed.
I hope that helps 😉
excellent! You’re good with analogies
Thanks 😊.,
met with MO yesterday and he agreed with my decision to switch from 500mg/empty stomach to 250mg/with low fat breakfast. I am assuming that the absorption will get me closer to the full dose of 1000mg.
How long do you wait each day before consuming fats? It pained me to drop granola from my yogurt/berry breakfast. I am subbing rice crispiest to get my crunch lol.
Thanks for your help
Hello TMcgee, first question from me is why did you stop eating granola ?
Phil
I would eat the granola, and fruit. My brother eats oatmeal and fruit some days other days yogurt and fruit.
On a like for like basis your granola has pretty much the same amount of fat as my egg on toast. I wouldn't change that.
I do eat meat, cheese, vegetables, butter, but I am healthy and not heavy 😅
I like red wine and whiskey, don't kill yourself trying to stay alive 🎶 ✨
Phil
I have adopted the Mediterranean diet. My theory is I may not live longer, but it will seem longer
Is that because its boring 😴, nice plastic saturated fish, yummy 😋 😜
I sincerely wish you all the best 👍
the cardboard fish are the biggest disappointment.
Grow your own, much healthier.
Seriously though, try not to change everything you did before this. I've changed only on thing, I no longer smoke.
Only because its too expensive 🤫
”Hi, the reason I take 500 mg is that 250 mg is no longer issued here in France 🤔. I've tried and so has my Oncologist.”
Can’t you just cut the 500mg pill in half?
My urologist explained that to cut it wouldn't be a clean cut, powder etc, its not the same as the manufactured pill. He is correct.
Have a go and see what you get, but if it works, why fix it. 🤔
I split pills all the time with a pill cutter. Rarely is it not a clean cut. I’d think a little over or under 250 ( if that’s the dose you’re looking for) would be better than overdosing daily taking 500.
Many pills come scored for easy breaking or cutting in half.
Anyways do what works for you and your doctor.
Cheers.
Thanks, you too, as I said we all have a different metabolism. Nice to chat with you 👍
Should have said 5mg of prednisone, but that wouldn't work for everyone. 🙂
I think this has been added to the NCCN guidelines. Here is one link to a suggested breakfast with it. cinj.org/sites/cinj/files/d...
thank you for the link. I have switched to 250mg/w low fat meal. The file that you posted help me tweak my breakfast. Now, I’ll wait to see how my liver enzymes respond,
as someone reported below, the effect on your body should be the same as the full dose on empty stomach …e.g. impact on your liver.
I have recently gotten a prescription with the 250mg dosage Zytiga. I am looking for meal recommendations. The cinj.org/sites/cinj/files/d... file is incomplete and does not complete
Google “ Rutgers Abiraterone breakfast “ if this doesn’t work. cinj.org/sites/cinj/files/d...
this was done when the price of zytiga was very high. Plenty of generic affordable ones now My Liver enzymes are checked every 3 months as well as creatinine been on 1000 mg Zytiga and 5 mg prednisone for 2 years now . 10 years since diagnosis , 5 years since mets PSA 259 . PSA now is .016 . QOL is very good hope you find the right combination of meds . Best Regards
My husband has been doing this for 2 months, and is responding beautifully. We aim for as close to 300 cal/9 g fat as we can get, for his breakfast.
yes that’s what I take. With a low-fat breakfast. It absorbs. No need for 1000 mg on an empty stomach
I asked my MO just this past week about taking abi-with-food.
1, there is no difference in terms of the amount of drug in your system.
2, there is no reduction in prednisone dose.
3, there is no difference in outcomes.
4, you have to take it with a meal with some fat.
5, it was based on a very small study in England where the NHS are always looking for cheaper ways.
I get abi from scriptco.com, about $80/month for 120 tables 250mg each, and in fact get a three month supply per shipment, so going to 1 instead of 4 saves maybe $2.00 a day.
If I didn't use scriptco.com it would cost over $11K per year out of pocket (I'm on Medicare Advantage.)
...The city's cold and dirty. Nobody's around to judge me... ooh, I'm blinded by the light...
A published study was done by the U of Chicago
OK Conerned, I scanned through the study. Outcomes are not different and with abi bought from a cash-generic pharmacy like Scriptco, cost is moot. The study said that much more abi got into one's system on a meal with fat, but no one has studied long-term excess abi blood-concentration and I for one am not willing to make my adrenal gland work harder than it is already doing on regular abi absorption. At some point abi must become toxic. My PSA and T are both undetectable: it doesn't get better than that.
. The Chicago study with food required low-fat diet.
My husband took 4 on empty stomach. Adrenal glands seemed quite messed up after 2 years. He is now on vacation from it and Lupron. Fingers crossed, PSA monitored.
What stage was your husband at? You said in your profile he hasn't had PSMA (presumably PSMA PET/CT) scan yet. That would have been massively important up front and (assuming you can foot a ~$1200 copay) can be done now should his PSA reach 4+ during his L+A vacation. During 2 years on L+A, has he had a DEX bone density scan? Why do you think his adrenal gland is messed up? Good luck and God bless.
were told in 2020 he didn’t need it. We now know it might have been helpful. On the other hand, because traditional scans detected only one de novo bone met, he was treated aggressively with MRI guided radiation to it and his prostate. Now he is on a vacation from meds and will get a PSMA scan if his PSA rises to 2.0. ( we now consult with a center of excellence). Thanks for taking the time to reach out! ( his normally wonderful blood pressure went crazy after 2 years of abi)
Last posting for you for now. 1, You didn't answer the stage question. 2, You didn't answer the DEX scan question. There are alternatives to Abi and Lupron. Stopping is risky since once one's PCa is stage 4, it is incurable. Again I wish you luck and God's blessing. But I also subscribe to the notion that God can and does work through SOC treatment. Its like the guy who stood up to his neck in rising waters and turned away one passing boat after another, believing that God was going to save him. At St. Peter's gate, God asked him why he turned away the boats he sent.
I thought I had answered by saying de novo met…I.e., stage 4. Yes, he had dexa scan
Two centers of excellence have advised on his vacation but each man needs to make his own decision I have always liked that joke about the boats
Yes, it'll probably be the next thing I do. Either that or docetaxel.
My husband is starting this Monday and the directions clearly state on the bottle " take 4 pills every morning on an empty stomach". he takes nothing else except he gets Lupron every three months.
My brothers clearly states take one 250mg tablet every morning with a low-fat breakfast. Also, takes prednisone twice daily. He takes Lupron every 3 months and Xgeva once a month. Thanks for the response.
Its amazing to me how everyone journey is so completely different. They did add prednisone to my husbands meds twice a day as well.
I take Abi at bedtime. Given the 1 hour before and 2 hours after, I would be starving if I had to delay breakfast for two hours. I’m hoping to switch to 250mg with breakfast, because I need a full glass of water to swallow the pills and it automatically wakes me up during the night.
Odd. My husband is on that and he has to take four HUGE pills on a completely empty stomach and not eat for at least 2 hrs. after taking it. He's been getting up at 4am every morning just to take the pills and go back to bed.
yes that is what my husband does. since he wakes up to use the bathroom at about 3 am every night that's when he takes his pills
If the C is Chicago its where this was determined a few years back. They may have a ongoing clinical trial still if I read the website correctly. Thats said their website doesn't appear to very up to date.
Yes, I've been taking it for 3 years (with food), with Gosrelen (ADT), and I pay for it myself. I had an initial PSA of 679, and the cancer had metastasized into my lower spine (late grade 3). I had radiotherapy for the cancer in my spine, and my Oncologist put me on Zytiga (Abiraterone), with the hormone treatment. His theory is that Zytiga is better at the castration sensitive stage, which is where I am. I am 3 years on, with the lowest PSA the machine can measure. His theory is that the Zytiga (with food), combined with the ADT treatment, stands a good chance of keeping me alive until there is a more comprehensive treatment for prostate cancer. I certainly hope that is true. I take it every morning with oatmeal, or muesli, and non-dairy yoghurt. I am healthy and active, and maintain a 10 acre property (amongst other things), and with only ocassional bouts of tiredness (the Zytiga can do that it seems). Along with the Zytiga, I take a low dose prednisone, and Candesartan (the Zytiga has definiely increased my blood pressure, and that's a balance you have to keep an eye on). As well I take Magnesium and Theracurmin (along with a few other supplements). I don't know how, or if the supplements help, but I'm prepared to give them the benefit of the doubt, certainly if there is any likelihood them improve my chances! I hope this makes some sense, and is of some help? My very best regards, and best wishes to your brother, and yourself.
I take 4 250 mg (1000 mg total) on an empty stomach each night when awakening for my first pee. In the morning I take 5mg of prednisone on a full stomach. Have been doing this for six months. I feel no I’ll effects from this.
I started taking 250 mg with a low fat breakfast 2.5 years ago because my first months copay was $2000. The first month's prescription lasted four months and by the time I needed to refill the price had come down. It was working well and so I kept with it. I saw a documentary about how large volumes of drugs made it into the water system because sewer treatment could not remove them well. I'm sure they would not want us to flush the pills down the tolet, but by taking 4 pills we are flushing at least 3 of those every day.
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