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Abiraterone (Zytiga)

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This page is about the hormone therapy abiraterone and its possible side effects. There is information about

 

What abiraterone is

Abiraterone is a type of hormone therapy. It is also called abiraterone acetate, CB7630 or Zytiga. It is used to treat prostate cancer that has spread to other parts of the body. Clinical trials are also using abiraterone for earlier stages of prostate cancer and advanced breast cancer.

 

How abiraterone works

Abiraterone blocks an enzyme called cytochrome P17 and this stops the testes and other tissues in the body making testosterone. This can slow the growth of prostate cancer or shrink it.

 

How you have abiraterone

You have abiraterone as tablets. The usual dose is 4 tablets taken together once a day. You should swallow them whole with a glass of water on an empty stomach. The tablets should be taken at least one hour before food, or at least 2 hours afterwards. You take abiraterone with a steroid called prednisolone to help reduce some of the side effects.

It is very important that you take the tablets according to the instructions your doctor or pharmacist gave you. For example, whether you have a full or empty stomach can affect how much of the drug gets into your bloodstream. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.

If you accidentally take more abiraterone than you should, talk to your doctor or go to a hospital straight away. If you forget to take a dose of abiraterone, prednisone or prednisolone, take your usual dose at the normal time the following day. If you forget to take abiraterone, prednisone or prednisolone for more than one day, talk to your doctor as soon as possible.

The side effects associated with abiraterone are listed below. We are still learning about the longer term side effects. If you have a new symptom or side effect always tell your doctor or specialist nurse so that they can work out if it is due to the drug or something else. They can then work out what you need.

You can use the links below to find out more about each side effect. For general information, see our cancer drug side effects section.

 

Common side effects

More than 10 in every 100 people have one or more of these.

  • An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre if you have any of these side effects or if your temperature goes above 38°C
  • Tiredness (fatigue) and breathlessness from a drop in red blood cells (anaemia)
  • Swelling of the legs due to fluid build up (known as peripheral oedema) affects about 3 in 10 men (30%)
  • Low levels of potassium in the blood (hypokalaemia) occur in 17 out of 100 men (17%) and you will have blood tests to check your potassium levels – if you have muscle twitching or a fast heart beat contact your doctor immediately
  • High blood pressure during treatment happens in about 1 in 10 men (10%) – your nurse or GP will check your blood pressure regularly
  • Bladder infections affect just over 1 in 10 men (10%) – let your doctor or nurse know if you are passing urine more often or have pain when passing it
  • Diarrhoea – drink plenty of fluids and tell your doctor or nurse if you are worried about how bad it is, or it continues for more than 3 days
  • A low sex drive
 

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these.

  • A mild effect on the liver that is unlikely to cause symptoms and will almost certainly go back to normal when you finish treatment – you will have regular blood tests to check how well your liver is working
  • Heart problems, including a faster heart beat, a change to the heart rhythm and chest pain
  • Bone thinning (osteoporosis) can occur with advanced prostate cancer and abiraterone can increase this – it can make bones more likely to break
  • High fat (cholesterol) levels in your blood – your doctor will check for this
  • Indigestion
  • Blood in the urine – let your doctor or nurse know straight away if you have this
  • A skin rash – you may develop a rash, which can be itchy. Let your doctor or nurse know
 

Rare side effects

Fewer than 1 in 100 men have aching joints and muscles.

 

Important points to remember

You won’t get all these side effects. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on

  • How many times you've had a drug before
  • Your general health
  • How much of the drug you have (the dose)
  • Other drugs you are having

Coping with side effects

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them.

Other medicines

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.

Drugs that may react with abiraterone include the following

  • Some heart medicines
  • Some medicines for anxiety
  • The herbal remedy St John’s wort
  • Other herbal remedies

Your doctor may want to change the dose of these medicines as they may change the way that abiraterone works. This can cause more side effects or may mean that abiraterone may not work as well as it should.

Lactose, sodium and abiraterone

Abiraterone contains a type of sugar called lactose. If you have an intolerance to some sugars, contact your doctor before taking this medicine.

Abiraterone also contains some salt (sodium). Talk to your doctor before starting treatment if you are on a controlled sodium diet.

Contraception and drug handling

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. 

If you have sex with a pregnant woman, use a condom to protect the unborn child.

Abiraterone is not for use in women and can cause harm to the unborn child if it is taken by women who are pregnant. Women who are pregnant or who may be pregnant should wear gloves if they need to touch or handle abiraterone tablets. It should not be taken by women who are breastfeeding. 

 

More information on abiraterone

This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.

If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.

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Updated: 25 September 2013