Abiraterone from 4 tabs daily to 3

[85236442968]

Finally cracked with MO concerning high blood pressure while using Abiraterone. History of high blood pressure that has went to the ceiling while using Abiraterone. Cardiologist has changed BP meds multiple times with very little relief. Some times during day BO is 180/100 or higher.

The Lupron/Abiraterone and radiation has worked well as PSA is now at 0.04. MO wants to continue for some time yet.

Presented charts of daily BP.

MO says we will try 3 tablets of Abiraterone instead of the 4 for a month to see it f it helps on the side effect of high blood pressure.

Anyone have any experience?

[Tall_Allen]

Discuss raising prednisone dose instead. Or try eplerenone.

prostatecancer.news/2019/06...

[85236442968 in reply to Tall_Allen]

Tall_Allen

Thanks for the feedback.

I looked up Eplerenone and will ask Cardiologist about it at next appointment.

I had asked the MO about raising the Prednisone some months back. For his reasons he was against it.

PSA is currently at 0.04 and testosterone is <7.00 (I think this is the bottom of the measuring scale). Anyway the blood pressure was at 170+ for over 4 months. I told the MO it was time to change to something other than Zytiga. He suggested the 3 instead of 4, due to the numbers.

Thanks again for the feedback.

[Tall_Allen in reply to 85236442968]

"For his reasons he was against it." What were his reasons? You have a right to an explanation. It is a shame to reduce a therapy that is working so well.

[Grandpa4]

I did reduce those because of elevated liver tests. Testosterone was always unmeasurable.

[85236442968 in reply to Grandpa4]

Grandpa 4

Thanks for the feedback. PSA is at 0.04 and the testosterone is at <7.00(I think that is close to unmeasurable). Liver tests are still ok, but blood pressure is intolerable. I had to ask the Dr to either get serios about the blood pressure or I needed something else for ADT. The result is 3 tabs, not 4. There has been a change in BP, but to early to tell.

Thanks again for the feedback.

[Grandpa4 in reply to 85236442968]

Yes not wild about increasing prednisone. Might works but there are long term side effects to even 5 mg of prednisone. For example my hemoglobin A1c was slightly elevated on prednisone. It accelerated bone loss.

[Sisto]

You might also consider swapping dexamethasone for pred. Good luck with whatever you do. Hypertension is not something to mess with.

[85236442968 in reply to Sisto]

Sisto

Thanks for the feedback.

I did a quick research on the dexamethasone, and will mention it to MO at next appointment. The 4 down to 3 of the Zytiga/Abit, seems to have had an impact. Wil be checking testosterone and PSA levels in a month. Currently, PSA is at 0.04 and the testosterone is at <7.00.

[GrantB47]

I have been taking two tablets a day for 4 months (along with prednisone and Eligard) because four tablets gave me an awful cough that I could not tolerate. PSA is .016 and T <4. I don't know what additional 2 tablets a day might help with. Maybe others can explain why 4 is the SOC. I take my tablets first thing in the morning and then wait an hour before eating.

[85236442968 in reply to GrantB47]

Grant

Thanks for the feedback. I am on day 2 of only 3 tablets. Blood Pressure has already dropped some.

I do not know if they overload us with the 4 tablets just to insure it works. If this is what they are doing, I am ok with that, as the results prove it does work. My PSA is at 0.04 and testosterone is <7.00.

Anyway the Cardiologist has tried a number of different things and has successfully got me under control for about 10 hours a day. I am hoping the reduced Abiraterone will help with the other 14.

I had asked about other ADT meds and the end result was I most likely would get High BP from all of them.

I do something similar in the morning, but get up at 5 to take the BP meds, then back to bed. Then Abiraterone/Prednisone at 7, then breakfast at 8.

[GrantB47 in reply to 85236442968]

If you check around you can find studies, specifically Rutgers University study that combines a dose of two pills per day with a specially designed 350 calorie breakfast. You might check with your MO to see if that might be something that could work for you if it is appropriate. Good luck.

[dhccpa in reply to GrantB47]

Actually one pill per day with food. Or is there a new study? That one was at U of Chicago in 2018.

[GrantB47 in reply to dhccpa]

Check Rutgers study.

[dhccpa in reply to GrantB47]

I did, but all I found was the 250 mg dose with low fat meal. That's one pill. You've seen one that recommended two pills?

[GrantB47 in reply to dhccpa]

Well, in India they often take one 500 mg pill with food, but of course you are right. The Rutgers study involved taking only one pill. (It apparently is true that some of these meds cause memory loss.) Sorry for the misinformation.

[dhccpa in reply to GrantB47]

No problem. I may have to use abiraterone next, so I like to follow what's going on with it.

[85236442968 in reply to GrantB47]

All

Thanks for your replies.

I have looked around and have found a number of studies with the single 250mg and food, and also found the study from India that did the 500 mg and food.

Probably the most interesting thing is I seen an article that NCCN advocates the 250mg with a low fat breakfast as an alternative treatment. The included it in their guidelines in 2019. Study address below the 250 Mg is on page 492-493. Yes it is a lengthy document but if you are bored read it.

If you have not been to NCCN website, you should, it is pretty intensive. Password setup required on your first visit.

jnccn.org/view/journals/jnc...

[85236442968 in reply to 85236442968]

All

To add to my previous post.

Have you been to zytigahcp.com/how-zytiga-wo...

Informative and it does explain the mechanism of the High Blood pressure (Not sure I understand it yet) but I have been unable to find a link to the Clinical Pharmacology studies they reference.

If you have the time check it out, It does have a link on it that takes you to Janseen.

[85236442968 in reply to 85236442968]

zytigahcp.com/how-zytiga-wo...

[Professorgary]

I take the low dose regimen, 250 mg with 350 calorie low fat breakfast but I doubt that will help bp because by doing this you don’t actually get a lower dose in system, it’s just that your body absorbs more. I will suggest you research magnesium and curcumin for blood pressure. I have friends who I have suggested this to for pain and when he asked his dr. about it he cautioned him to watch his bp as it may drop. It did, he no longer takes bp meds.

[85236442968 in reply to Professorgary]

Professorgary

Interesting comment on Magnesium and Curcumin. I have researched it somewhat but the guidance on dosage timing and amount is all over the place. Do the folks you know that use it have any input on dosage and guidance.

Not sure I will try it yet, but a good supplement is just that a good supplement. Of course bad supplement are also just that bad supplements.

Then there are the supplements that really do not do anything other than lighten your pocketbook.

[Professorgary in reply to 85236442968]

I take a magnesium, zinc and vitamin d complex which gives me 1500 in of d, 12 mg of zinc and 350 mg of magnesium. I think 450 mg of magnesium is rda. I take a curcumin complex with black pepper extract to aid in absorption. I also eat a few nuts when I take curcumin. I take 700 mg 4 x daily with some food. I have back issues so I take a larger amount than most. My family members and friends all take 350 x 3 daily and seem to have good results. On a cautionary note, curcumin can cause kidney stones so you need to drink a lot of water. It will also thin the blood. And as always, talk to your doctor before taking it.

[jfoesq]

fyi New article yesterday about the string effectiveness of bananas (2 per day) on reducing BP. I was just dx with high BP 2 months ago which is now under control with Valsartan 80mg but will be increasing my diet of bananas.

[j-o-h-n]

Greetings 85236442968,

Wondering. How do you know my license (tag) plate number? Are you the one who hit my parked 2024 Bright Red Mercedes AMG and, jotted down my number and then drove away?.....Witnesses said you then sped away from the scene in a titty pink 1980's rag top Yugo. BTW keep Fighting.....

Good Luck, Good Health and Good Humor.

j-o-h-n

[yardsailor]

it is interesting about this site I to am having high blood pressure problems after 2 years on abiraterone with 5mg of prednisone my bp is up and down

[yardsailor]

(any way i sent my reply out to soon) so back to bp mine is quite high as of late. 189over111 my gp has perscribed lisinopril 40 mg once daily ,I have a zio heart moniter on that i will remove tomorrow and send in I will get the results in two weeksor so. I really don 't want to change my abiraterone it is working so well psa .014. for over a year if things don"t get much better I ask my mo about upping the prednisone

[85236442968 in reply to yardsailor]

Yardsailor

That for the post.

I have been on the Abiraterone for about 6 months. Blood pressure went up right after I started. Yes I know what 189/111 feels like. I do monitor every day.

In the grand scheme of things the Abiraterone has worked well, PSA is at 0.04 and I certainly want to keep it down there. The only side effects I have are BP and some edema. As mentioned in others posts (Gym Rat), Working out does take care of the edema, but the BP is resisting anything the Cardiologist tries.

Check out my other post with the website address in it. May be informative to you and your MO/Cardiologist.

[tunin191319 in reply to 85236442968]

Anyone want to share what blood pressure medicines have worked while on Abiraterone ? My primary care Dr can't crack it!!! Thanks

[85236442968 in reply to tunin191319]

tunin 192319

2 items helped me.

1. Reduction of Abiraterone from 1000 mg daily to 750 daily alons wiht the same 5 mg prednisone.

2. Cardiologist has tried a number of medications. Currently on 1 daily EDARBYCLOR 40-25, 1 daily Amlodipine 10 mg, 2 daily Clonidine 0.2 md, and Carvedilol 2 daily 25 mg.

I will tell you it is not great, but better than it was at 180/110.

I have to get up early and take the Edarbyclor, a Carvedilol, and the Amlodipine. 2 hours before I take the Abiraterone and Prednisone. After a lot of trials this appeared to help. Taking the BP meds with or near the Abiraterone was futile. the BP meds did nothing.

[Gym-rat]

My MO reduced my Abiraterone from 4 tabs to 3 after my liver enzymes climbed up (AST/ALT). That brought them down to a manageable level, just above the normal range. The MO also recommended I get a home blood pressure testing device since high BP can also be a side effect of the drug. I’ve been on the meds for nearly 18 months Check BP daily.

I’ve managed to keep my BP well below the average range for a 70 y.o. I attribute this to daily workouts, that aside from weight lifting, include either 50 minutes of swimming or 50 minutes of spin bike. No sugar or added salt in my diet. I use a salt substitute.