Hey all, my father has to stop taking Zytiga due to high liver enzymes. What is the next step after this? I am upset because he was responding very well and his PSA came down to 0.6 from 277. We wanted to use Chemo as a last resort. As always, thank you for any help and advice.
Zytiga discontinuation due to high AL... - Advanced Prostate...
Zytiga discontinuation due to high ALT/AST
It is a mistake to use chemo as a last resort. It works better and is less toxic if used earlier.
I have a feeling he will start it next. We see his doctor tomorrow. Have you heard of having to stop Zytiga for this reason? Thanks for the reply
Yes, many patients report that. Sometimes reducing the dose and then slowly increasing it helps.
Yes mine were high in full dose. Lowered to 3 pills a day and they improved the normalized.
Would you mind sharing the liver enzyme numbers (ALT, AST & ALK.P)? Mine are also very high, due to a combo of chemo for bone marrow cancer and 2 other meds, for hypertension and AFib.
My dad also is taking other meds for hypertension too, but his doctor thinks it’s because of Zytiga. His ALT is 137, ALK is normal at 113, and AST is 72.
not too bad - was diagnosed with probable cirrhosis and liver cancer:
AST 142
ALT 198
ALK.P 494
Got an MRI coming up but looks like I'm heading for the last roundup. The only upside is I'm asymptomatic, other than these tests and scans. Not in pain, not incontinent, can still live independently (good thing, cause I live alone, lol), got my agile mental faculties and rich imagination and count my blessings, not all the comorbidities... ok, I lie - I count those too, can't be helped. Ah well. Fight on, warrior!!
Can you ask for the liver fibroscan?
google.com.au/m?q=liver+fib...
Dunno if fibroscan yields more/better info than a 1.5T mpMRI but no harm in asking. Thnx for the suggestion ☺️
I really don't know, but it is like having 1000 biopsy of the liver and it is a very simple screening technic. Can you also test yourself for hep C? I assume you are immunized against hep B?
Mw I started zytiga @ 1000gm daily with 5gm prednisone 20months ago after 2 months I had blood test than showed liver enzymes told to come over zytiga a month blood test showed improvement in enzymes then went into 500gm daily + 5gm prednisone had no problems with liver and PSA has been 0.01 this last year hope this information helps your situation good luck !!
The same thing happened to me when I first started on Zytiga. I was taking 1000 mg/day and was also taking a number of supplements. My MO had me stop taking everything and retry Zytiga after a couple of months at 500 mg/day with regular tests to check my AST/ALT. After a couple of normal tests the dosage was upped to 750mg and then back up to 1000 mg. All was well. I slowly started retaking my supplements. My liver numbers have been normal since. We still don’t know why my liver numbers went wonky.
when I was dx a year ago with MPC my MO gave me Zytiga with prednisone and I also responded immediately ,my pains disappeared almost but my AST/ALT shoot up to 150/400 so I stopped.After 1 month My MO switched to Erleada 4 tablets a day and after a while I reacted to that with terrible rashes itching and dry skin so he stopped and restarted at 2 tablets a day which I generally tolerate and if the side effects increase I stop for 1-2 weeks then restart again.Since 1 year my PSA is undetectable. I wish you and your father good luck
You may have stopped the Zytiga too early. Per J & J, you should discontinue if ALT and/or AST are 5 times higher than norm. I stopped when my rising AST went to 126 and my ALT was 258. I quit Zytiga until my numbers were back down to normal. ( about 7 weeks)Then I restarted 500mg instead of the 1000mg I was taking. When my numbers were ok I went to 750mg. That was in Summer/Fall of 2018. Been taking 750mg since and always at <0.01. Good luck.
I was thinking the same. His doctor is at Sloan Kettering and told him to stop and come in to see him today, I trust his doctor but I also would hate to see him stop something that has worked so well for him. I’ve heard of liver enzymes at much higher levels than what he’s at right now. Thanks for sharing and best of luck to you also!
In my case, my bilirubin went way up after a week on abiraterone, but AST and ALT were normal. As I was about to start chemo, abiraterone was discontinued til chemo is done.