Liver Enzymes

[wpeebles]

Been on Abbie/Pred for 3 months now. Posted earlier that liver enzymes (Alt & Ast) are getting close to 3x normal. MO just told me today to stop taking Abbie/Pred for a week and then get another blood test. and then he will determine what to do next. I suggested we just reduce the dosage from 1000 mg to 500 or 750 cause these drugs were working (PSA .024) but he said no. I'm sure he knows best. Has anyone else had this happen. thanks.

[fireandice123]

Something similar happened to me. My liver numbers went wonky within a month or so of starting Abi. My MO had me stop the Abi for a month and I had another blood test that showed my liver numbers back to normal. At that point I was started on a half dose of Abi (500 mg). After a month I had another blood test that showed my liver numbers were still good. The Abi dosage was increased to 750 mg for another month and after a subsequent blood test which showed good liver numbers the dosage was increased to the full 1000 mg. I’ve had no problems since then.

[wpeebles in reply to fireandice123]

thank you. much appreciated. felling better about this now.

[Jazzman2023]

I had a similar experience on Abiretarone. My ALT and AST numbers went bonkers within a couple weeks of starting Abi. Thankfully, in the beginning MO had me getting labs every 2 weeks, so we could closely watch what was going on. We tried reducing the dosage down to 750 mg, then 500, which didn't seem to help. Then we tried a 6 week vacation from Abi, which brought the ALT and AST numbers lower. Upon restarting Abi, the numbers climbed back up to very high levels....We finally threw in the towel on Abi, tapered off the prednisone, and switched to Apalutamide/Erleada.....So far so good on the Erleada, and it's been almost 5 months since I started on it.......In retrospect, I wish the 'dosage lowering/temporary holiday' strategy of Abi had worked for me, but it didn't...Best of luck to you ! And sorry to be so wordy...

[wpeebles in reply to Jazzman2023]

Thank you. at least I know of an alternative now.

[GoBucks]

Yes, common occurrence. In about month 7 my numbers went skyward. Took off about 7 weeks. Then started back at 500, then 750 for 4 years. Luckily always <0.01.

[wpeebles in reply to GoBucks]

Thank you. Congrats on the 4 years.

[GoBucks in reply to wpeebles]

Actually 4.5 years on abi. Now 2+ years off all cancer meds.

[petabyte in reply to GoBucks]

I just started Abi 2.5 weeks ago and had blood tests today. It was a bit weird because AST and ALT were lower than before (and cholesterol/ triglycerides as well). PSA dropped from 0.400 to 0.0894 in 4 weeks (which I was pretty happy about).

Interesting AST/ALT can still go up after 7 months, I was hoping to go to 3 monthly tests (is that not advised?)

[GoBucks in reply to petabyte]

I had monthly tests. Makes sense to find out ASAP if rising, especially when first starting. Actually the first couple months I had blood work every 2 weeks. After restarting I had weekly blood draws for awhile.

[petabyte in reply to GoBucks]

thanks, I'm having another test in 2 weeks so maybe that is the plan, but I'm not in on the secret yet 😉

[Tall_Allen]

Don't stop prednisone all at once.

[wpeebles in reply to Tall_Allen]

I did stop the prednisone when I stopped the abbie. I'm away now for a week and don't have access to the prednisone. Is this going to be a problem for me? Thanks.

[Tall_Allen in reply to wpeebles]

It may be- call your oncologist and get your BP checked.

[mababa]

wpeebles, I’ve taken a slightly different approach in that I’ve started on a half dose (500mg) +5mg Pred with the idea of increasing it to 1000mg if I’m tolerating it satisfactorily. I started Abi 3weeks ago. My MO doesn’t know this yet. I have blood tests Monday and my first follow up consult on Thursday when I’ll have to spill the beans. I’m doing this on the basis that I believe the drug concentration when prescribed for a 150lb person is twice that for someone of 300lbs. It’s easy to see where over medication can occur. I’d rather increase dosage slowly rather than have to back off after some negative test results. I’m also on Orgovyx which is working very well with tolerable SEs. Best wishes for your successful treatment.