Abiraterone (Zytiga)

Abiraterone is a hormone therapy drug. You pronounce abiraterone as ah-bir-rat-te-rone.

It is a treatment for prostate cancer that has spread (advanced prostate cancer).

How does abiraterone work?

Prostate cancer needs testosterone (male sex hormone) to grow. Abiraterone blocks and stops your body from making testosterone. This can help slow down the growth of the cancer.

How do you have abiraterone?

You have abiraterone as tablets.

You should swallow your tablets whole with a glass of water on an empty stomach. Take them at least one hour before food, or at least 2 hours afterwards.

You take abiraterone with a steroid drug called prednisolone to help reduce some of the side effects. 

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.

How often do you have abiraterone?

You usually take abiraterone once a day.

You keep taking abiraterone for as long as it is working or until the side effects get too bad.

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

What are the side effects of abiraterone?

Side effects can vary from person to person. They also depend on what other treatments you're having. 

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 

• your side effects aren’t getting any better

• your side effects are getting worse

Early treatment can help manage side effects better. 

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Fluid build up (oedema) 

You may have swelling of your hands and legs due to a build up of fluid (oedema). 

Infection of the water works (urinary tract infection)

Urinary tract infections (UTIs) are an infection of your urinary tract. This includes your bladder , urethra or kidneys. A UTI can make it difficult to pass urine or you might go with some urgency or more often. There may be pain or burning when you go. You may see blood in your urine, or your urine might smell bad or look cloudy.

Tell your doctor or nurse if you think you might have a urinary tract infection.

Increased blood pressure

Tell your doctor or nurse if you have headaches, nosebleeds, blurred or double vision or shortness of breath. You have your blood pressure checked regularly.

Diarrhoea

Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a stoma , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.

Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain fibre. But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables. 

Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.

Low potassium levels in the blood

You will have regular blood tests to check for this. 

Liver changes 

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

• blood in the urine
• breaks in the bones (fractures)
• a serious reaction to an infection - signs can include feeling very unwell, not passing urine, being sick, a very high or very low temperature or shivering - contact your advice line straight away if you have any of these symptoms
• high fat levels in the blood
• heart problems such as heart failure, fast or irregular heartbeat, or chest pain that keeps coming back (angina). See a doctor straightaway if you start having chest pain or are feeling breathless.
• indigestion
• skin rash

Rare side effects

These side effects happen in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

• low levels of hormones from the glands above your kidneys (adrenal glands) – symptoms might include cravings of salt, low blood sugar, tummy pain, and feeling very tired
• muscle weakness and pain
• muscle damage (rhabdomyolysis) – symptoms include muscle pain, weakness, high temperature and red or brown urine. This can lead to kidney problems.

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do you need to know?

Other medicines, foods and drink 

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

Loss of fertility

You may not be able to father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you want to have a baby in the future. You may be able to store sperm before starting treatment.

Contraception

This drug may have a harmful effect on a developing baby. It is important not to father a child during treatment. Talk to your doctor or nurse about contraception before having treatment if there is any chance that your partner could become pregnant. You need to use a condom and another effective birth control method.  

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.