Most doctors follow an algorithym that insurance companies will pay. The Doctors follow protocal or they don't get paid by insurance or medicare.They give too high of dosage always. My wife insisted to the oncologist to give 250mg, not 1000mg. He fought ot but my wife won.
4673
why involve the doctor. Zytiga comes in 250 mg tablets. Just take 1 if you’re convinced that’s right for you. That bottle will go a long way.
I agree 6357axbz. I got prescription from mark cuban pharmacy online. My wife was just edgucating my young oncologist doctor. He was trying to throw lupron and 1000mg zytiga even though I already had a mild heart attack on orgovyx. Both Lupron and orgovyx are ADT's. zytiga 250mg seems to keep my PSA levels and testosterone levels down without having to add another ADT. Studies show 250mg works as well as 1000mg if on low fat diet. But I agree, the doctors just follow what the crooked pharmacies tell them now.
4673
I was taking half a Bicalutamide tablet (25 mg) every 5 days, since August 2023, with a PSA of 0.010 to 0.018 and as of this month I am reducing dosage to half a tablet every 6 days because my PSA declined to 0.009.
Well, that is really bad advice about the Zytiga dose. They arrived at the 1000mg dose (without food) by trying different doses. A lower dose will not suppress the cancer for as long and may encourage quicker resistance. It is a bad idea.
Look up the most current research. It shows of course without food but it also shows taking 250mg with a low fat diet has the same effect as 1000mg. Please do current research. I would be dead if I took 1000mg. I already had a heart attack from taking physician recommended orgovyx.4673
I am current, thanks. The study your wife is relying on is this:
ascopubs.org/doi/10.1200/JC...
As you can see for yourself, 36 patients took the 250mg dose with a low-fat breakfast and 36 took 1000 mg fasting. After 12 weeks there was no difference in PSA decline and no difference in side effects. However, more abiraterone was absorbed in the fasting group, so it is possible that abiraterone would last longer if the trial were longer than 12 weeks.
In the following trial, a high-fat breakfast doubled the absorption of a low-fat breakfast without increasing side effects.
accp1.onlinelibrary.wiley.c...
The 250mg dose with food provides exactly the same side effects as the 1000 mg dose without food. That is because fat increases the absorption of abiraterone through the gut. It is only "bioavailable" abiraterone that benefits you and causes side effects.
The problem with taking it with food is that the amount absorbed is unpredictable. It will vary from patient to patient, and even within the same patient because of the gut flora and what else is still in the gut.
In fact, the following trial found that reliable dosing was impossible with food:
ncbi.nlm.nih.gov/pmc/articl...
It made sense to take the smaller dose with food when brand name zytiga cost $9000 per month. But now that it is available as a low cost generic, it no longer makes sense.
Why would you take more than you need? Especially with cardiac issues already?
The amount you need is 1000 mg fasting. That dose was established in clinical trials that proved that lower doses were less effective.
I said with low fat diet. I take mine as prescribed on an empty stomach. My oncologist looked up several studies and he agrees with the 250mg on an empty stomach. It's working so why take more than I need? All patients are different. Medicine is fluid. Always changing. I was diagnosed already at stage 4 prostate cancer 4 years ago. I believe less is more. Remember everyone is different.
4673
If you are taking 250 mg on an empty stomach you are getting less than you need. "It's working so why take more than I need? " PSA is not the cancer. A lower dose may work for a shorter amount of time and lead to a more resistant cancer.
"All patients are different. Medicine is fluid. Always changing." All patients are different, but it is foolish to believe you are that different from the average. At any rate, one starts with the indicated dose, and may decrease it if there are side effects.
" I believe less is more. Remember everyone is different. Often overtreatment kills the patient. " Your beliefs are counter to medical science and will harm you. You either believe in medical science, or you believe the figments of your own imagination.
Actually I have a science degree and work in the medicsl field. It's called experience and inside knowlege.
I have a science degree too. There is no inside knowledge. It’s called transparency. It’s how science works, as any true scientist would know.
A man convinced against his will is of the same opinion still.
Aberaterone is prescribed at 1000 mg for what is to me a totally stupid reason and my suspicion is that this is because the drug companies make more money. Aberaterone is absurdly overpriced. studies in India and even in the US have shown that 250 mg taken with the proper meal is just as effective as 1000 without food. It is well documented that a certain amount fat in a meal increases the absorption of aberaterone. The company that makes the name brand Zytiga says the required dose of Aberateraterone is because it is difficult to insure that the proper amount of fat is taken with the drug. You have to follow specific instructions as to fasting before and after taking Aberaterone to insure the proper dose. What is so difficult about instead providing a specific meal recommendation to be taken with Aberaterone. I had difficulty following the fasting schedule and it would have been easier to take a package or specified meal with the drug instead of not eating anything for whatever time before and after was required. Saying that the diet can not be controlled is total bullshit. For me it would have been easier than following a strict fasting schedule. And it would have cost 1/4.
From the Annals of Oncology: "Standard dose of Abiraterone Acetate (AA) for metastatic CRPC is 1000mg/day in two divided doses to be taken on empty stomach. Food intake has shown alteration in pharmacokinetics of AA. Phase I studies have shown a 4.4 fold increase in drug absorption when taken with a high fat meal."
My question is who has the medical degree and treating the patient? It appears the the physician follows the insurance company protocol to insure payment. So is it the insurance company treating the patient or the physician? It is all about the money and not the patient!
This debate goes on and on. Here's my personal experience: I started on abiraterone 1000mg fasting per advice Dr. Sartor. No other medication except prednisone 5mg daily. This program gave me an upset stomach that lasted all morning even though I ate breakfast two hours after taking the med. I was very nauseated. Vomited once. Prednisone may have contributed to the nausea but 5mg is a pretty low dose. Anyway, Dr. Sartor then approved 250mg with low fat diet. I felt much better but my testosterone stayed around 40 though my PSA was undetectable. Therefore Dr. Sartor told me to increase dose to 500mg with meals. This brought testosterone down to 20 which he was satisfied with , PSA undetectable. I felt OK.
People have different sensitivities and side effects but I could not tolerate 1000mg of abiraterone fasting. Since 500mg with meals kept my labs in acceptable ranges and I felt pretty well, I am happy with that dose for when I inevitably have to go back on treatment. Maybe next time I'll try 250mg with a medium fat breakfast. I like fat, especially for breakfast but "all in moderation", etc..
I'm off meds now after 6 months on abiraterone. I like vacations.
With 4 tabs can we talk a half dose? Best of both worlds?
Did that with Xtandi. Numbers were good and less issues.
I’m not going to bad mouth anyone. Just thinking that 2 might be better than one or 4.
🤷
Cheers!
Transfusion dependent after Radium 223 and Xtandi - DRs want to stop his weekly transfusions. Help!
Looking for US for my next fight, need doc/institute references you bank on and notes on insurance coverage 
Advice: Insurance?... Thoughts....pre-existing conditions...
Denial of Axumin PET CT order
Experiences with securing ss and private disability
