An thoughts

[katartizo61]

I am wondering. Saw 1000mg / day Zytiga standard and also men who do and have found effective 1 250mg with breakfast effective. Many men have terminal effectiveness of Albiterone and are switched, I am in this process. What if?? Take 750 around 1-2 am and 250 with breakfast. Made sense to me. I stumbled upon this thought as for the first time only took 3/4 tablets when I woke around 2. Did take the other at breakfast. Thoughts welcome

[RyderLake2]

Hello,

What I was told by my clinical care team and others was to take Zytiga (abiraterone) on an empty stomach and Prednisone (a 5 mg pill) twice a day, mornings and evenings, and after breakfast and dinner. The Zytiga prescription for me is two 500 mg pills. I normally take the two pills when I wake up to pee around 1:30 a.m. That way I know my stomach is empty. The cancer pharmacist was adamant that I take the two together and on an empty stomach. I was not aware that Zytiga came in 250 mg pills.

[Hidden in reply to RyderLake2]

Generic Abiraterone does!!

[jmarsh in reply to RyderLake2]

I'm being treated at Duke Cancer Center, for what it's worth. I'm on Lupron and daily Abiraterone 4x250mg and 5mg prednisone (with food). My doc said to take Abi one hour before eating or two hours after. I usually take mine about 2.5 hours after breakfast every day. I also take 5mg additional prednisone late in the day, around dinner. The second dose was required to help control blood pressure issue associated with the combined ADT. (never had high BP before). So far, so good with PSA undetectable. Hope to discontinue after a total of 24 months therapy

[tango65]

If you take 750 in an empty stomach and 250 mg with breakfast you will have a higher blood level of zytiga that it was intended when taking 1000 mg once a day in an empty stomach.

accessdata.fda.gov/drugsatf...

[katartizo61 in reply to tango65]

Thank you!!!! I was "thinking" maybe that would bring my slowly rising PSA back under control. Only did this my mistake yesterday, no ill effects.

[Tall_Allen]

To what purpose? If your cancer is Zytiga-resistant, what is the purpose of taking more? It only adds side effects.

[katartizo61 in reply to Tall_Allen]

actually it wasn't more, 4 total taken apart, maybe more effective??? IDK simply asking. Thank you for your reply

[Tall_Allen in reply to katartizo61]

It IS more, because the 250 mg dose taken with food is biologically equivalent (depending on individual) to 1000 mg taken without food, so you are nearly doubling the effective dose. If you are resistant to Zytiga, taking more isn't the right solution.

[Peealot in reply to Tall_Allen]

Not a clinical comment...Tall Allen, I commend you for all of your knowledgeable contributions to those of us trying our best to comprehend the nuances of PC. Thank you.

[Tall_Allen in reply to Peealot]

Thanks.

[PhilipSZacarias in reply to Tall_Allen]

Abiraterone, in addition to its ability to inhibit CYP17 (and therefore androgen synthesis), does have some AR antagonist function which is more apparent at higher dosages. Cheers, Phil

[Tall_Allen in reply to PhilipSZacarias]

So is toxicity.

[PhilipSZacarias in reply to Tall_Allen]

I read somewhere that up to 2000 mg is tolerable. This may require increasing the dosage of prednisone. Could use a potassium sparing diuretic too. Phil

[Tall_Allen in reply to PhilipSZacarias]

They tested doses up to 2000 mg - it provided no extra effectiveness, just side effects.

[PhilipSZacarias in reply to Tall_Allen]

True. Over time though, the glucocorticoids start to interact with AR variants and promote growth. The antagonist properties of abiraterone at higher dosages may help overcoming this problem (I don't think this has been investigated). I just found a paper (but have not read it fully yet) which appears to indicate that darolutamide is better a antagonist than enzalutamide at blocking AR variants. Previous studies combining abiraterone and enzalutamide did not find an improved efficacy of the combination presumably because enzalutamide increased the metabolism of abiraterone. I wonder if this would be the same for the combination of abiraterone and darolutamide? Thanks for the responses. Cheers, Phil

[Tall_Allen in reply to PhilipSZacarias]

Until it is investigated clinically, it is not a good idea.

[PhilipSZacarias in reply to Tall_Allen]

Yes. This was an academic discussion.

[Chrisbaird]

Hi Katartizo61. Been taking 500 mg zytiga for last 26months on empty stomach 6am before breakfast with 5mg prednisone with breakfast with no problem. PSA > 0.01 2 years. …Started 30 months a ago @ 1000mg but had liver enzymes with that dosage

[katartizo61 in reply to Chrisbaird]

Thank you. I don't have liver enzyme issues at this point. Simply PSA rising after 20 months,

[gsun]

250 with a low fat fat breakfast can have the same results as 1000 on an empty stomach but you must talk to your doctor about that. Don't take some at night and then more in the morning. You can get too much absorbed that way.