A Guide to Zytiga

Prostate Cancer

Zytiga is a drug used to treat castration-resistant prostate cancer that has metastasized to other regions of the body in individuals who have had chemotherapy, including a taxane. It lowers testosterone levels, which are sex hormones.

How to take Zytiga?

Zytiga pills should only be taken once a day, empty-handed. You must avoid eating for at least an hour after taking Zytiga, and it should be taken at least two hours after eating. Taking Zytiga with meals, the body promotes the absorption of the drug more than necessary, which may have adverse side effects.

Tablets of Zytiga should be taken with water and consumed whole. Zytiga should not be eaten or crushed.

It’s recommended to take Zytiga one hour before breakfast and wait another hour before eating. You must take Zytiga every day at around the same time. Usually, you should take four pills every day. However, your doctor may change the dosage.

Prednisone or prednisolone is often administered with Zytiga. Prednisolone is typically given once daily at a dosage of 10 mg, as directed by the prescriber.

Indications and Usage

  • Zytiga is mainly used in patients with metastatic castration-resistant prostate. Moreover, it is a CYP17 inhibitor administered along with prednisone (CRPC).
  • It is also used in prostate cancer with metastatic high-risk castration sensitivity (CSPC).
  • When combined with androgen deprivation therapy (ADT), Zytiga is approved to treat recently diagnosed high-risk metastatic hormone-sensitive prostate cancer (mHSPC) in adult males and to manage metastatic castration-resistant prostate cancer (mCRPC).
  • It is used in adult men who are asymptomatic or mildly symptomatic after androgen deprivation therapy failure and for whom chemotherapy is not yet clinically indicated.

Dosage and Administration

Zytiga 1000mg once daily, along with Prednisone 5 mg twice daily. Also, Prednisone 5 mg is taken once daily, with Zytiga 1,000 mg oral.

Patients on Zytiga must also take GnRH analog simultaneously, or they should have undergone bilateral orchiectomy.

Zytiga tablets must be taken on an empty stomach once daily in a single dose.

Avoid eating for two hours before taking Zytiga and for one hour following. Do not crush or chew the tablets; the tablets must be taken whole, along with some water.

Dose Modification:

Modify or decrease the initial dose of Zytiga to 250 mg once daily for patients with baseline moderate hepatic impairment.

Hold Zytiga until recovery for individuals who have hepatotoxicity while receiving therapy. A lower dose may be used to start the retreatment process.

Interaction with other medicinal products and other forms of interaction

 Effect of food on abiraterone

The absorption of abiraterone is significantly increased when administered with food. This medication should not be used with food since it is not effective or safe when used that way.

Interactions with other medicinal products 

Possibility of other drugs having an impact on abiraterone action. The mean plasma AUC of abiraterone was reduced by 55% in a clinical pharmacokinetic interaction study in healthy participants primed with rifampicin, a potent CYP3A4 inducer, 600 mg daily for 6 days, then given a single dosage of 1000 mg of abiraterone acetate. Strong inducers of CYP3A4 should not be used throughout treatment unless there is no other practical option, such as phenytoin, carbamazepine, rifampicin, rifabutin, rifapentine, or St. John’s wort (Hypericum perforatum). Ketoconazole, a potent CYP3A4 inhibitor, was concurrently administered to healthy patients in a clinical pharmacokinetic interaction trial. However, it had no clinically significant impact on the pharmacokinetics of abiraterone.

Side effects of Zytiga

The following are the side effects of Zytiga:

While taking Zytiga, it is possible to experience high blood pressure (hypertension), low blood potassium levels (hypokalemia), fluid retention (edema), and irregular heartbeats. This may damage your life. You must take prednisone with Zytiga exactly as your doctor instructs to reduce the likelihood of this incident. Every month while you receive therapy with Zytiga, your healthcare practitioner will monitor your blood pressure, perform blood tests to assess your potassium levels, and look for any signs and symptoms of fluid retention.

You must contact your healthcare provider in case of the following symptoms:

  • Irregular or fast heartbeat
  • Leg pain
  • Swelling of feet or legs
  • Dizziness
  • Lightheadedness or fainting
  • Headache and confusion

Adrenal issues may arise due to Prednisone withdrawal, or a patient may get an illness, or stress because of adrenal issues.

Blood testing for liver function may fluctuate over time. Before starting therapy with ZYTIGA® and during treatment, your healthcare professional will do blood tests to assess your liver. Failure of the liver may develop, which may be fatal. The following changes may appear in case of the effect on liver:

  • Severe nausea and vomiting
  • Dark colour urine
  • Yellowing of eyes and skin

Severe hypoglycemia (hypoglycemia). When using Zytiga for severe low blood sugar, patients with diabetes who also use certain anti-diabetic medications may experience this effect. Throughout your Zytiga therapy and after you stop taking the medication, you and your healthcare practitioner should routinely monitor your blood sugar levels. The dosage of your anti-diabetic medications may also need to be adjusted by your healthcare professional. Low blood sugar symptoms and signs might include:

  • Hunger
  • Dizziness
  • Confusion
  • Headache
  • Weakness
  • Fast heartbeat
  • Sweating

Less common side effects of Zytiga

Discontinue the Zytiga after consultation with Zytiga if you notice any symptoms of low blood potassium, including:

  • Heart palpitations
  • Muscle weakness and twitches

High blood fat levels, elevated liver function tests, chest pain, irregular heartbeat, heart failure, a quick heartbeat, and issues with the adrenal glands are some additional Zytiga adverse effects. Speak with your doctor right away if these effects or any others appear.

If you observe any of these side effects and they bother you or notice any more adverse effects other than these that may still happen in some people, please let your doctor know.

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