Starting xtandi - Can Xtandi and Orgo... - Advanced Prostate...

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Starting xtandi - Can Xtandi and Orgovyx be taken at same time ?

Tinkudi profile image
22 Replies

Dad , 83 has been on orgovyx since around 6 weeks. He takes it in the morning after breakfast.

He has to add xtandi. At 80 mg for a few days and then scale up to 160 mg.

Can both be taken at the same time or should there be a gap. The MO did not mention about any gap but on another group I read it is best if taken after a few hours of each other.

Also , would love to hear what side effects one can expect when starting xtandi. Orgovyx has had hardly any side effects.

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Tinkudi profile image
Tinkudi
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22 Replies
RyderLake2 profile image
RyderLake2

Hello,

I can't think of any reason why they can't be taken together. Orgovyx (relugolix) is a Luperon type drug. Its advantage is it can be taken orally whereas most of the other Luperon type drugs are injected by a health care professional. Xtandi (enzalutamide) is an ARPI drug (androgen receptor pathway inhibitor). If your doctor is recommending they be taken together and he or she says they can be taken at the same time then go ahead. In my opinion there is no need to stop the Orgovyx when you start the Xtandi. Especially when you are slowly ramping up the Xtandi from two pills (80 mg) to four (160 mg).

Tinkudi profile image
Tinkudi in reply to RyderLake2

on another group I read some saying it is best to take 6-7 hours apart as per earlier thinking but now they say taking together is ok too. Something about both using same pathway or something

RyderLake2 profile image
RyderLake2 in reply to Tinkudi

Hello,

Ask your doctor or oncologist.

Kaliber profile image
Kaliber in reply to RyderLake2

lol

Tinkudi profile image
Tinkudi in reply to Kaliber

😆

vintage42 profile image
vintage42

"... would love to hear what side effects one can expect when starting xtandi. Orgovyx has had hardly any side effects."

A friend has been on Orgoxyx for over a year with hardly any side effects. A few months ago his MO added Xtandi (enzalutamide), 4 pills at 60mg each. The Xtandi caused him to feel so bad that the dose was reduced from 4 pills to 2 pills and then 1 pill. But many people do not have a problem with Xtandi.

Tinkudi profile image
Tinkudi in reply to vintage42

thanks. Have started dad on one pill and then will make it two and scale up. Hope he is ok on it.

But just one pill would not be enough dose I guess for your friend.

vintage42 profile image
vintage42 in reply to Tinkudi

"... just one pill would not be enough dose I guess for your friend."

I think he said one pill, but will check next time I see him. I remember telling him I did not think that was a therapeutic dose, but he said his PSA was staying low so it must be OK. But that was after just a few weeks. I bet the MO will not let him stay on a dose too low to be effective.

Tinkudi profile image
Tinkudi in reply to vintage42

On one post I read here someone said there MO said some study shows 3 pills are as effective as 4 so he was sticking to 3.

Explorer08 profile image
Explorer08

I take Orgovyx in the morning with breakfast and Xtandi with the evening dinner and both my MO and the oncology pharmacist say this is OK. Never had side effects from Orgovyx but adding in Xtandi gave me 3 or 4 hot flashes per day along with some gynecomastia and afternoon fatigue. Exercise helps a lot!! I’m on the full dose of Xtandi.

Tinkudi profile image
Tinkudi in reply to Explorer08

Thanks. Did you start the whole dose of xtandi at once or slowly scaled it up ?

Did the doctor advise you to take both at separate times or you did that on own ?

Explorer08 profile image
Explorer08 in reply to Tinkudi

I've been taking Orgovyx for a long time and at breakfast so did not want to change that regimen. I started taking Xtandi at noon but felt I was quite fatigued in the afternoon. Then my electrophysiologist added Metoprolol 12.5mg to my overall regimen but that interacts with the Myrbetriq I am taking at bedtime. So, I take Metoprolol at noon and switched Xtandi to evening dinnertime upon advice from MO and oncology pharmacist.

I was going to scale down Xtandi at first but once I moved to taking it at evening dinnertime I returned to the full dose of 160mg and that seems OK for now. I get another round of blood tests in a couple of weeks and will find out how effective the Orgovyx and Xtandi regimen has been working. My PSA was at 0.07 at the last blood draw.

The Xtandi has caused some occasional bradycardia and irregularity in my heart which is why the Metolprolol was added. I still exercise at the gym, however, which helps a lot.

Tinkudi profile image
Tinkudi in reply to Explorer08

thank you. Best wishes for your upcoming tests 😊

Do you know if these heart issues are common side effects of xtandi. ?

Explorer08 profile image
Explorer08 in reply to Tinkudi

Yes, they certainly can be but men react differently to different meds.

jcarey79 profile image
jcarey79

I took both Xtandi and Orgovyx. I took them both in the morning.

I struggled with the side effects of Xtandi - very difficult on my heart. I also had muscle loss, weight gain, brain fog, loss of energy and general fatigue. However, I don't know which drug to attribute those to as both list all of them as possible side effects.

However, the combination did what they are supposed to do: my PSA (and testosterone went to undetectable and metastases did not show on subsequent PET Scans. I have been on holiday from all ADT drugs for one year now. My PSA is rising (still low but rising) and I am scheduled for another PSMA PET Scan.

Tinkudi profile image
Tinkudi in reply to jcarey79

Can you say more about what it did to the heart ? Did you start both together?

jcarey79 profile image
jcarey79 in reply to Tinkudi

The Xtandi caused very low heart rate, increased blood pressure, and caused 3 trips to the ER before I stopped. I started the Orgovyx first and tolerated that well. The Xtandi was added and obviously I did not do well with it.

Tinkudi profile image
Tinkudi in reply to jcarey79

Thanks. Is that a common side effect

jcarey79 profile image
jcarey79

I don't have experience to answer that question.

Clippedwingz profile image
Clippedwingz

Due to my initial diagnosis (Gleason 10, stage 4 at age 55), I was immediately started on combo of Xtandi and Orgovyx.

I’ve been them for a little over 3 months now and take them both in mid afternoon.

Side effects from the combo have been nominal and to be expected (hot flashes, brain fog, some occasional nightime anxiety, and joint soreness). I’ve had no real fatigue and my CV health is good (normal BP and no heart issue). A1C ok too. I’m a bit anemic which apparently is normal when your testosterone goes down so low.

Oh yeah, it’s working great for me so far too! Recent PSA is .002 and it’s shrunk or eliminated my Mets. Oncologist said Orgovyx is way easier on side effects than injections for what it’s worth. My experience seems to back that up.

Hope that helps!

Tinkudi profile image
Tinkudi in reply to Clippedwingz

thanks. Did you take 160 mg xtandi from the start ?

Clippedwingz profile image
Clippedwingz

yes and that’s my current dose

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