I will be starting abiraterone and prednisone. My doctor has prescribed 250mg daily with a low fat breakfast and 5mg prednisone twice a day.
Has anyone else taken this dose? What constitutes a decent low fat meal/breakfast?
Can the first dose of prednisone be taken at the same time?
Has there been a decrease in side effects with this lower dose or does it not matter?
Also, will be switching from Eligard to Orgovyx, has anyone else taken this combination and can the Orgovyx be taken at the same time as the abiraterone?
Thanks guys.
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Vman1
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The only reason to guess about abi dosing was cost. But now that it is available as a low-cost generic, cost ($84), it is not a big issue for most men.
There are many posts in our H.U. history file that reference abiraterone (abiraterone acetate) which you can review. Refer to the top left of your screen to access the history file.
I just read your bio - In my opinion I think you need to start getting some more opinions in your care ASAP. The low dose / diet approach is very out of date due to the current costs. I also wonder how you are just now being put on Abi? I saw 9 different Drs before putting my care team together - you are your best advocate.
my husband diagnosed in 2008 with one bone met in his femur took full doses Abiraterone for 6 years 2012 - 2018 on NHS with Dexamethasone good QOL put him into remission but became toxic to his liver tried reducing initially to half, then increase to 750 but toxic to liver again so was stopped on consultants recommendation, I believe that endalutimide doesn’t affect the liver but in the Uk not eligible after having Abi
I was on 1000mg abi without food, 2 x 5mg pred, and orgovyx for about 2 and 1/2 years. Currently on first vacation. I always took abi separate from all other meds.
Congratulations on being able to start a vacation from these medications. Did you tolerate both of them well? Especially interested in the Orgovyx. I’ll be switching from Eligard (one 6 month injection) to Orgovyx.
Vman1 said: ... "starting abiraterone and prednisone... 250mg daily with a low fat breakfast and 5mg prednisone twice a day. Can the first dose of prednisone be taken at the same time?Has there been a decrease in side effects with this lower dose or does it not matter?... will be switching from Eligard to Orgovyx, has anyone else taken this combination and can the Orgovyx be taken at the same time as the abiraterone..."
The usual Abiraterone dose is 250mg x 4 daily without food. Maybe 250 mg daily with food is a cost thing, but my being responsible for the correct food factor would concern me.
Prednisone says take with food, but this article says when taking with Abiraterone for glucocorticoid replacement, taking with the Abiraterone (so without food) is best. endocrine-abstracts.org/ea/...
A year ago I was prescribed Abiraterone 250 mg x 4, and Prednisone 5 mg x 2. After 6 months the Prednisone skin effects were very unpleasant, and I found the article above, so I cut my dose to 5 mg and told the Urologist why.
I started taking Orgovyx a few months before the Abiraterone, and it is a really nice drug that can be taken at any time independent of the Abiraterone.
7 months on abi 1000mg plus prednisone 5 mg. I take the prednisone with breakfast so no chance of sleep problems. Abi later usually 5 pm. Eat after 6 pm. So far ok. Just hot flashes and oddly the occasi9nal skin pimple.
First month liver enzymes spiked, then returned to elevated, slightly above normal.
3 months later I started feeling a constant nausea and liver enzymes began to rise, nausea for me began around the 160 mark for AST.
Being a very active person, I was hiking the Adirondacks and got a tick bite.
Doxycycline pushed me over the edge, I felt like I was at deaths door… MO immediately pulled the Abiraterone and I was given a break from May until Sept, during Radiation Therapy… still no rise in PSA during this time.
I was put on half dose and immediately the nausea returned and AST soared to 265.
Blood pressure elevated to 150/87
Normally, 120/78
Blood sugar elevated as well 115 fasting
Normally, 110 non fasting and in the 80’s fasting.
I was taken off of Abiraterone and moved to Nubeqa, No liver involvement with Nubeqa at all.
More importantly, no identifiable liver damage.
My dosage was 1000 daily of Abiraterone 500 in morning 500 at night on empty stomach, take prednisone with your meals… mine was 5mg morning and night.
I have heard low dose Abiraterone ingestion can be maximized by taking with oatmeal.
When I started Abiraterone, cost was 10k a month to insurance.
I take 250mg with my morning oatmeal with added tablespoon of peanut butter and a little milk in it for the last 2 1/2 years blood numbers are good. Was prescribed 1000mg but I started out with 250 dose and take 5mg prednisone at the same time. Jokingly 1000mg of abiraterone is a meal
I am there now, year 10. Started on Arbiterone after Casodex failed in year 9. Same prescription from oncologist PW Van Zijl, probably the best that you will get in SA.
250 mg Arbiterone plus 5 mg Prednisone. I eat a small pineapple and a sardine from a can, in soy oil. So, I break the 250 in half. 125 in the morning, 125 in the evening with 5mg Prednisone. I feel good, has got a lot of energy. Headaches are with me now and then. No mets anywhere. Has got 1 lymph node in the upper stomach area that floats between 10 - 15 mm. PSA floats between 0.03 and 0.3.
Hi Vman . I take mine every morning with eggs, toast with butter, coffee and 3/4 cup of delicious cottage cheese. I target 5mg of total fat along with the med. I take the prednisone later with lunch an all other daily meds.
I’m unfamiliar with this “low fat meal”’approach. I’ve been on ABI 1000mg before breakfast and Prednisone 5mg after for 2.5 years. To my understanding the reason Prednisone is after is because it can irritate your stomach. 5mg is a small dose though.
A comment about the "low fat" diet. If the doc is "prescribing" it he should tell you what he means, because the term does not mean much. The term fat covers both oils and hard fats. It is the choice of fat which is important.
BAD: The fats that are really bad for you are trans-fats/saturated fatty acids which were widely used in food processing, but are now banned and should not be in the foods you buy.
GOOD: Plant based oils are generally healthy - olive oil, avocado oil, sesame oil, sunflower oil, and flaxseed oil. So having a salad for example with one of these is fine and good for you. It is impossible to consume too much as you quickly become satiated (unlike sugar which does not satiate)
GOOD: Fish oils are good for you (contain omega 3 fatty acids) - a couple of meals/week of an oily fish (eg salmon, trout, mackerel, sardines, anchovies, trout, kippers)
GOOD: Fermented milk products eg natural yogurt are good for you even though made from full fat milk.
BAD: Cooking/frying in healthy oil can be a problem because over heating causes oxidation and lead to formation of unhealthy fats. You can look up the safe temp to cook at.
BAD: So called "low fat" products in the supermarket (eg low fat yogurt) are generally unhealthy because they often substitute fats with sugar or sweeteners to make it palatable, which are even worse for your health than fat!
CHOLESTEROL: The world obsesses about cholesterol but there is a poor correlation between dietary intake and circulating blood cholesterol (eg review PMCID: PMC9143438 PMID: 35631308)( pubmed.ncbi.nlm.nih.gov/299... . Statins lower chol but probably actually work by reducing vascular inflammation . Lots of really healthy foods contain cholesterol - eggs, meat etc. and are good for you. It is trans fats and saturated fatty acids that are the culprit. Personally I eat butter and hate anything like maragerine which has been processed. Your cholesterol levels are mostly genetically determined.
SUGAR & FATS: Table sugar (a disaccharide) contains glucose and fructose. Glucose is the brains only nutrient and without it you die; excess is stored as glycogen in muscle and liver mainly. But, fructose (bad news) is metabolised tounhealthy fats and deposited in the abdomen (obesity) and contributes to fatty liver disease. Fructose (10X more sweet than glucose) is also found free in many soft fruits but also used as a sweetener in many soft drinks (coke and the rest). Avoid the latter completely. Moderate amount of soft fruits (in season and dont binge); hard fruits eg apples are great. Smoothies are bad news because they give you a lot of fructose and disrupt the fruit cells which releases the sugar quickly.
Hope that gives you some guidance to a healthy way to consume healthy essential fats/oils.
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