Managing side effects with Abiraterone – Seeking Advice

[Andy2025]

My dad's prostate cancer recurrence is primarily adenocarcinoma based on biopsy prostate. He was prescribed a Lupron injection along with 1000 mg of Abiraterone. However, he is experiencing significant vomiting with Abiraterone. Has anyone else had a similar experience? Any tips to manage this?

[Andy2025]

Forgot to mention: prednisone is prescribed alongside Abiraterone,

[Gimmishelter]

i've been on the same meds for almost 2 years now and never experienced nausea or vomiting. Plenty of other side effects though.

[wpeebles]

I have been on the same drugs for 6 months now and have never experienced vomiting. I do have very high liver enzymes and have stopped the zytiga for last 3 weeks. Will probably go to reduced dosage of Zytiga (500mg) or switch to xtandi.

[Grandpa4]

I am a bit concerned. Vomiting is not even listed as a side effect. Abiraterone can cause a serious liver toxicity and that might cause nausea and vomiting. Alternatively something else is going on. I would get labs to check on liver and fudcusss with his doctor.

[HikerWife]

Ask your doc about the reduced-dose-with-food protocol (instead of 1000mg on an empty stomach, 250 mg with a 300 calorie/9 grams fat breakfast - food causes higher uptake of the drug, ends up being the same level in the blood). Easier on the stomach, and perhaps on organs as well. My husband has been doing it for 2 years, PSA is undetectable. Two oncologists encouraged the protocol for him. There is info online.

[petabyte in reply to HikerWife]

Also low dose is often used in India where the OP is from.

ascopubs.org/doi/10.1200/JG...

But the effective serum levels are meant to be similar so liver impacts should also be similar.

I recently used low dose intermittently to extend my supply until my MO appointment. MO was not happy 😉. In that study above 9% of MOs in India would not use it. I suspect it is higher in Europe.

[Apisdorsata]

Abiraterone 1000mg on an empty stomach nauseated me too even caused vomiting once so I tried 250mg with food as described above. It was not enough to reduce my testosterone below 50 nor my PSA to undetectable so I changed to 500mg with food. It works well and no nausea.

[dhccpa in reply to Apisdorsata]

Still low fat meal or did it matter?

[Apisdorsata in reply to dhccpa]

I'm not super careful about fat. I try to get at least 8-10 grams but sometimes I'll have much more than that because I enjoy a good breakfast.

[God_Loves_Me]

Yes - I used to take 4mg zofran (Ondansetron) everyday

[Johnkelsey]

I was on abi for 5 years frequently felt nauseous in the morning and found that taking prednisone with it helped , then go do something for an hour or two before eating.

[leo2634]

I'll be on the same prescriptions 8 years this February while I've have many side effects nausea was never one of them. Consult with his Doctor could be something else. Never give up never surrender Leo

[cfsteak]

I started to vomit 2 years before I was diagnosed, about once every 6 months, it continued after abiraterone until last July when is started happening more often, I been trying to chock it up to rich food but that's not always the case. One day I puked several times and the next day. The last couple of months I feel like I have 5 gallons of water bouncing around in my stomach the 1st few hours of the day, but have just tossed twice, I take 250mg of abiraterone with oatmeal along with 5mg of prednisone. One doctor gave me 4mg Ondansetrone as needed but the 2 times I used it, it just back came up , same with OTC prilosec

Good Luck and holler if you find something that works

[Wgly in reply to cfsteak]

I took 500mg without food, middle of night, for two years and became undetectable soon after start. Started with 500 to determine reactions, it worked at that level, so stayed there. MO not happy, but went along. Got expert second opinion recently to go holiday because of SE's, in part I think, because Prednisone stayed at 10 mg