abiraterone instructions

[Tommyj2]

just started abiraterone and note conflicting instructions for dosing…….MO instructions are 1 hour before food 2 hours after( makes sense for empty stomach)…..Monograph that came with meds states 2hours before food 1 hour after….how are most of you who are on it taking it? Prednisone WITH food complicates things as well. Thanks

[Hidden]

Eat, take prednisone with food, wait 2 hours without eating, take Abi pills, wait 1 hour then eat!!

[JohnInTheMiddle]

MO is sloppy. You are correct - you want to take Abiraterone an empty stomach: 2 hours before and 1 hour after.

In my case that turns out Abiraterone is the first thing I do in the morning. An hour later I have my breakfast with the prednisone - if you have not already done so you should check if prednisone needs to be with fat.

BTW but I have I read seems to suggest that coffee during that hour after taking Abi is okay.

There's another thing which I've wrestled with which is what to do if you forget to take Abi or are late some morning - say six or even 12 hours late.

One should try and take it at the same time every morning. The one time I was 12 hours late I then moved back my dosing every morning by 2 hours until I was back to my target time.

My theory, unreferenced, is that I would thereby miss overloading my liver if the following day I ended up taking it 12 hours early. If you can figure out what I mean.

Take it too early - liver overload. Take it too late - possible Testosterone spike. (Apparently the half-life of Abiraterone is fairly short.)

Another interesting aspect of taking this is that if you take food with Abiraterone, as you probably know, the effect is to multiply the effect - not diminish it.

Reading monographs is good!

[Hidden in reply to JohnInTheMiddle]

2 hours after eating, and 1 hour before next meal.

It takes 2 hours to clear stomach.

[Tommyj2 in reply to Hidden]

Thank you….this schedule seems to be the most popular.

Appreciate your answering.

[Rev214 in reply to Hidden]

This is what the label said on mine 1 hr b4 or 2hr after. If you take with food, it will overdose your liver and your liver enzymes will become elevated. I.e. damages liver. Apparently food increases absorption. In some countries, I have heard of cost saving dose that is 1/4 dose with food. One would have to research whether such a regime is equally effective...

I have recently switched to Xanti...Abby kept my PSA undetectible, yet I picked up new tumors growing at a slow rate of 1/2 cm/ year. I am still oligio Metastasis, so I am playing a game of "whack-a-mole" and hope to be successful in "Kicking the Can" done the road. Wacking the new ones with Proton Beam this coming week.

[Tommyj2 in reply to Rev214]

Thank you for the response Rev and best of luck going forward….. btw…there are several people here who are on the 250mg with food protocol.

[dhccpa in reply to Rev214]

One pill with food was studied at U. Chicago in 2018 and recommended. But there are still plenty who have never gone along with it.

[Tommyj2 in reply to dhccpa]

I wish more docs would get with this program…cheaper and easier on the liver and adrenals.

[Tommyj2 in reply to JohnInTheMiddle]

Thank you for your well considered thoughts on this topic…very helpful.

[GoBucks]

I always left my bottle on the bathroom counter in front of the toilet. I usually got up to pee in the middle of the night or early morning. Always took it then and went back to bed. Then took prednisone with bfast later.

[JohnInTheMiddle in reply to GoBucks]

I have written about this elsewhere. If you lie down after taking Abiraterone or any pills, there is some evidence that you should be lying on your right side. Not on your left side. Because of course the stomach is asymmetrical. And apparently absorption can be affected when you're not standing up or sitting up after ingesting anything.

[GoBucks in reply to JohnInTheMiddle]

Never heard of that. Didn't harm me at all luckily.

[JohnInTheMiddle in reply to GoBucks]

How would you know? 😀

[GoBucks]

Almost 6 years of <0.01 is pretty solid.

[RyderLake2]

Hello,

This is what I do to make sure I take Zytiga (abiraterone) on an empty stomach. Every night I wake up once (sometimes twice) to pee. I keep my Zytiga pills in our ensuite bathroom and take them in the middle of the night. Another tip I learned from a friend is to turn the bottle upside down after I have taken the pills. That way I don't take them twice. The Prednisone I take after breakfast. Hope that helps! Good luck!

[Tommyj2 in reply to RyderLake2]

Thank you for the response….and the tip….would be easy to take meds twice!

[Warrior13]

I take 250 mg wit 5mg prednisone as soon as I wake. Then eat something low-fat. Toast etc

Less than 3grams per 100 calories

[Buz78 in reply to Warrior13]

This is the same way I take my Abi and Pred in the morning, then I take a second Pred with my evening meal. Supposedly taking with a small amount of food in the morning you don't need that large a dosage. I'm taking 250mg Abi and 5mg of the Pred

[Tommyj2 in reply to Buz78]

I wish my MO was into that protocol….it would be a lot easier to manage…..thanks much for the reply.

[Professorgary in reply to Tommyj2]

My MO originally prescribed 1000 without food but when I questioned him about low dose with food he was ok with it but wanted to know what I eat for breakfast. Just started in Sept. and Psa dropped 75% in 25 days.

[Tommyj2 in reply to Warrior13]

Great protocol…makes it much easier to remember to take pred.

[Flaxseed]

Hi Tommyj2, the way I go about it is I take the Abiraterone first thing every morning - that way I know I have an empty stomach! Then an hour later I have breakfast and that’s when I take the Prednisone. It’s a routine that works for me. I can take a shower and stuff and prep the breakfast in that hour; (I have porridge with flaxseed I grind and blueberries and a banana along with a black coffee with beans I grind too; it’s like a ritual for me!)

[Tommyj2 in reply to Flaxseed]

Good to know…thanks for responding and good luck going forward.

[Realestate]

My instruction for the past year has been: Take in the morning when I wake up. Wait 1 hour before eating. Then I take my Prednisone.

[Tommyj2 in reply to Realestate]

Thank you for the response…I’ve gotten a lot of helpful ideas.

[DesertDaisy]

My husband takes abi when he first wakes up. He waits at least an hour to eat. He takes the prednisone with dinner.

[Tommyj2 in reply to DesertDaisy]

Thank you….does he take prednisone only once a day?

[DesertDaisy in reply to Tommyj2]

Once a day with dinner. We checked with the pharmacist at Mayo and she said it was fine to take the abi in the morning and the prednisone with dinner.

[hopefull99]

I take abi and prednisone at the same time first thing i the morning on empty stomach. It is recommended to take prednisone with food, but you can take it with without food if it does not bother you.

This regimen works for me. Breakfast after 1 hour.

Taking 2nd prednisone with dinner

[Tommyj2 in reply to hopefull99]

Good to hear….5mg strikes me as a low enough dose of pred to not bother the stomach.

[TMcgee]

Tommy: here is the label, which states no food 2 hours before and 1 hour after

accessdata.fda.gov/drugsatf...

Here are the studies discussing taking Abi with food:

clinicaltrials.gov/study/NC...

link.springer.com/article/1...

future-science.com/doi/10.4...

Also, Prednisone will contribute to sleeplessness, you should consume it as early in the day as possible.

I take 250mg of Abi with 10mg of Prednisone with yogurt/berries Based on the absorption studies, it is really unclear to me why anyone follows the labels for these two drugs that must be taken together.

[Tommyj2 in reply to TMcgee]

Great info TM….thank you!

[BigCDrugSurfin]

2hours after eating, then 1 hour after Abi until eating.

coffee and water don't count. the reason is the Abi uptake varies hugely depending on food in system, so it messes up the dosing. no food rule keeps the effect consistent.

[jmarsh]

I've been on it for 16 months. 1 hour before or 2 hours after. Like you said - empty stomach. I take my Pred at or before breakfast. Pretty regimented M-F. Sometimes on weekends, I get off schedule. If I'm late, I just take it when I remember, but still adhere to the empty stomach rules for the Abi. For the Pred, I'll take it with or without food. (I've had no issues with that)I figure late is better than none at all. I have never missed a dose of either in the proper day.

So far, PSA is undetectable, and T is <10.

[Tommyj2 in reply to jmarsh]

Good for you….best luck in the future….

[carbide]

There are many threads on this.I took mine on an empty stomach.

[swwags]

I have my alarm set every morning @ 5:30. I take the Abby. @ 6:30 or 7, depending on when I wake up, I take Synthroid which is also to be taken on an empty stomach. Then @ 7:30, I take the prednisone with oatmeal.

[ShipModeler]

I take my Abiraterone at 0400 (when I pee). My Endocrinologist wants me to wait 5 hours after taking Abiraterone before taking the Prednisone. I take it with my other meds at 0900.

[Tommyj2 in reply to ShipModeler]

Why the 5 hours? Did he provide a medical reason?

[ShipModeler in reply to Tommyj2]

Originally I took the Zytiga with the Prednisone. If I remember correctly she said Zytiga puts stress on our organs, as does Prednisone. She felt 5 hrs minimized organ stress.

[j-o-h-n]

Mind you.......... Never have anything to eat or drink while you're sleeping.....especially if your wife recently took out a life insurance policy on you and she hired a new pool boy named Enrique....(funny thing,- you don't have a pool)....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 10/20/2023 6:43 PM DST

[jedgar1]

I always took it when I got up in the middle of the night to take a Pee trying to keep track of the one hour two hour in the morning after I got up, just turned out to be too much trouble. I took the prednisone in the morning with food.

[Tommyj2]

it would be easy to mess up the dosing schedule…..I take so many meds it’s hard to keep track…..than goodness the Lupron is an injection.

[NewGame]

My oncologist said no to coffee either side of taking.