Tiredness from Zytiga

[KatRobin71]

Hi group! My Dad who is 89 started Zytiga 3 weeks ago for advanced prostate cancer with mets to bone. He takes the Zytiga at 9:30 am with the prednisone on an empty stomach and has 1 Lupron injection. He is unable to wake up until late afternoon and is always tired and we were wondering if the Zytiga had anything to do with his extreme lethargy or if it was the advanced disease itself. From reading the posts from the group I am not seeing anyone complaining that it makes them extremely tired when taking in the am. We see his oncologist tomorrow and I was going to ask if we could switch to taking it at night before bed to see if this makes a difference.

[Tall_Allen]

He should have something to eat an hour later and take his prednisone. That might wake him up.

[KatRobin71 in reply to Tall_Allen]

Thank you! His cancer is so advanced he has little appetite. Mostly ensure or liquid protein shakes I can get him to drink. He said nothing tastes good.

[Tall_Allen in reply to KatRobin71]

Yes. Cachexia happens. Marijuana may help with his appetite.

[Kaliber in reply to KatRobin71]

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[JohnInTheMiddle]

I'm in my late 60s and I've been on Abiraterone/Zytiga for over 2 years.

1. I take methylphenidate AKA Ritalin for fatigue.

2. I take the Abiraterone in the morning on an empty stomach. One wants to hydrate in the morning so a good glass of water is part of that.

3. Take the prednisone with food an later, which is fine in terms of timing, and the bottle says to take it with food.

4. Drug absorption works the best if one is vertical and apparently it's also okay if one is lying on one's right side. But because of the asymmetry of the stomach apparently if one is lying on one's left side then absorption may be affected. If one takes one's drugs at night this could be an issue.

5. My own experience of lethargy is partly driven by metabolic issues. I'm taking metformin. I do not have philan diabetes. ADT will exacerbate this. And perhaps lethargy might be related to glucose management or something?

6. Okay now my personal opinion. Ensure his controversial apparently, based on what I've just read. And probably protein shakes too. Because they're they are liquid any carbs are absorbed very quickly. And they do have carbs in them. Maybe this is causing a glucose roller coaster?

7. Walking is so important and any kind of exercise. Sarcopenia is hard to fight against. I've already lost a little bit of muscle mass. And walking also helps maintain some bone density. If there's any way to get some activity in every day I'm sure you agree that this would certainly be helpful.

[WisdomSeeking]

Maybe try switching to different ARPI like Xtandi/Nubeqa/Erleada?

[vintage42]

KatRobin71 said: "... Dad who is 89 started Zytiga 3 weeks ago... at 9:30 am with the prednisone on an empty stomach and has 1 Lupron injection. He is unable to wake up until late afternoon and is always tired and we were wondering if the Zytiga had anything to do with his extreme lethargy or if it was the advanced disease itself."

It could be a combination of age, disease, the Zytiga, and progressive weakness all leading to fatigue.

So I am nearing 82 and started Abiratirone (generic Zytiga) 4 months ago, and also take Orgovix (a pill that works like Lupron). I take the Zytiga 90 minutes before breakfast, and the prednisone after breakfast.

I do feel a growing weakness, though no tiredness at all. I have started a machine exercise program for muscles and bones at a health facility, and find that exertion actually increases energy.

[leo2634]

I've been on the same regiment of medication going on 7 years now it does get better. I take my Zytiga at 4:00 am with a full glass of water and my Prendisone after breakfast around 8:30 . I put in a full day without fatigue. I also think his age may have a factor in it. My doctor tells me to stay active and when I'm tired rest. Never give up Never surrender Leo

[j-o-h-n]

He takes the Zytiga at 9:30 am with the prednisone on an empty stomach and has 1 Lupron injection. ?

Huh?

Greetings to you as a Newbie.

Would you be kind enough to update his bio. Helps him and helps us. Thank you!!!

Good Luck, Good Health and Good Humor.

j-o-h-n

[dk73]

is that how they said to take the prednisone? My husband takes it but must be with food. When he was on zytega, he would take it early, then eat 2 hours later with breakfast and prednisone. But I do think he could reverse that and take closer to bedtime

[Sagewiz]

Yes, he should be eating something one hour after taking the Zytiga an then taking the first prednisone. I take a second prednisone again with food at 4PM per doctor's orders.

Fatigue was my only symptom prior to diagnosis and it is still my biggest issue. I am on the same protocol and struggling to keep moving and build stamina after 9 months of treatments. Everyone here has told me to just start getting more active and that is the only way to get past the heavy fatigue. I am working on it. However, low testosterone, low iron, low minerals all contribute to fatigue. I am finding that it is very common based on other's shared experiences here added to my own.

[j-o-h-n]

I'm tired of being tired.

Good Luck, Good Health and Good Humor.

j-o-h-n