Abiraterone acetate (Zytiga®)
Abiraterone acetate (often shortened to abiraterone) is a hormonal therapy drug used to treat advanced prostate cancer. It is also known as Zytiga®.
It’s best to read this information with our general information on prostate cancer and advanced prostate cancer.
You will see a doctor or nurse regularly while you have this treatment, so they can monitor its effects.
Hormones are substances produced naturally in the body. They act as chemical messengers and help control the activity of cells and organs. Hormonal therapies interfere with the way hormones are made or how they work in the body.
Most prostate cancers need the hormone testosterone to grow. Almost all testosterone in men is made by the testicles. A very small amount is made by the adrenal glands, which sit above the kidneys.
Abiraterone reduces the amount of testosterone made by your body. This reduces testosterone levels and may shrink the prostate cancer or stop it growing.
When abiraterone is given
Back to top
Abiraterone is used to treat prostate cancer in men whose cancer has spread to other parts of the body (advanced cancer). It can be used alone or alongside other types of treatment. If you’re already taking a hormonal therapy drug such as goserelin (Zoladex®) or leuprorelin (Prostap®), your doctor may ask you to continue taking it while taking abiraterone.
Your doctor or nurse will explain how long you should take abiraterone for.
Taking your abiraterone tablet
Back to top
You take abiraterone as tablets once a day. You take it at the same time each day. Always take your tablets exactly as your nurse or pharmacist explained. This is important to make sure they work as well as possible for you.
You take abiraterone on an empty stomach. Take it at least two hours after eating, and don’t eat for at least one hour after taking the tablets. Many people find it’s best to take abiraterone an hour before breakfast. Swallow the tablets whole with a glass of water and don’t crush or chew them.
You will also be given steroid tablets called prednisolone to take every day. These help reduce some of the side effects of abiraterone.
It’s important that you do not stop taking any of your tablets unless advised by your doctor. Here are some important things to remember:
Don’t take a double dose if you forget to take your tablet. Just take your usual dose the next day.
Keep tablets in the original package and at room temperature, away from heat and direct sunlight.
Keep them safe and out of the reach of children.
Get a new prescription before you run out of tablets and make sure you have plenty for holidays.
Return any remaining tablets to the pharmacist if your treatment is stopped.
Possible side effects of abiraterone
Back to top
We explain the most common side effects of abiraterone here. But we don’t include all the rare ones that are unlikely to affect you. You may get some of the side effects we mention, but you are very unlikely to get all of them. If you are taking other drugs as well, you may have some side effects that we don’t list here.
Always tell your doctor or nurse about the side effects you have. They can prescribe drugs to help control them and give you advice about managing them. Don’t stop taking abiraterone without talking to your doctor first.
You may feel tired and lack energy while taking abiraterone. Try to pace yourself if you feel tired. Aim for a balance between resting and being physically active. There is evidence that regular exercise can reduce tiredness in men taking hormonal therapy. Ask your doctor or nurse what is safe for you to do.
If tiredness makes you feel sleepy, don’t drive or operate machinery.
Anaemia (low number of red blood cells)
Abiraterone can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this.
High blood pressure
Abiraterone may cause an increase in blood pressure. You will have regular blood pressure checks when taking this drug.
Build-up of fluid
You may put on weight or your ankles and legs may swell because of fluid building up. Tell your doctor or nurse if you notice this. If your ankles and legs swell, it can help to put your legs up on a foot stool or cushion. The steroid tablets your doctor prescribes will help to prevent this.
Most men lose their sex drive and have erection difficulties (impotence) during hormonal therapy. Things often return to normal after you stop taking the drug, but some men continue to have difficulties after treatment is over. Your doctor can prescribe treatments to help with erection difficulties but these don’t affect sex drive.
If you need support coping with sexual difficulties, your nurse or doctor can give you information and refer you for specialist support services.
Muscle or bone pain
If you have soreness or stiffness in your muscles or bones, your doctor can prescribe painkillers to ease this.
Urinary tract infections (UTI)
Speak to your doctor if you develop symptoms of a urinary tract infection. Symptoms include cloudy or smelly urine, pain or discomfort when passing urine.
Occasionally, abiraterone can cause diarrhoea. Drink plenty of fluids if you have diarrhoea – at least 2 litres (about 3 pints) a day. Your doctor can prescribe anti-diarrhoea tablets if needed.
Occasionally people develop a mild skin rash. This often gets better without treatment. Tell your doctor if you have a rash.
Changes to your heartbeat
Abiraterone may cause changes to your heartbeat. If this happens, it’s usually temporary and can be treated with medication. You will have checks on your heart before and during treatment. You’ll also have regular blood tests to check a chemical in the blood called potassium.
Changes in your potassium levels can affect the normal rhythm of the heart. Muscle weakness or twitching can also be signs that the level of potassium in your blood is low. You should contact your doctor or nurse if you have any of these symptoms.
Possible side effects of abiraterone with long term use
Back to top
Effect on liver
Abiraterone can sometimes affect the liver. Your doctor will do regular blood tests to check your liver. Usually any effect is mild and you can continue to take abiraterone.
Raised blood sugar levels
Steroids can raise your blood sugar levels. Your nurse will check your blood regularly for this. They may also test your urine for sugar. Symptoms of raised blood sugar include feeling thirsty, needing to pass urine more often and feeling tired. Tell your doctor or nurse if you have these symptoms.
If you have diabetes, your blood sugar levels may be higher than usual. Your doctor will talk to you about how to manage this. You may need to adjust your insulin or tablet dose.
Bone thinning (osteoporosis)
Taking abiraterone will, over time, increase your risk of bone thinning (osteoporosis). In some men this can increase the risk of a broken bone (fracture). Your doctor can give you advice on how this can be monitored and treated if needed. Regular walking and resistance exercises, such as lifting weights, can help to keep your bones strong. Eating a healthy diet, not smoking and sticking to sensible drinking guidelines will also help to protect your bones. Let your doctor know if you have any discomfort in your bones or joints.
We have more information on our website about bone health.
Always let your doctor or nurse know about any side effects you have. There are usually ways in which they can be controlled or improved.
Other information about abiraterone
Back to top
Abiraterone can interact with other drugs. This includes medicines you can buy in a shop or chemist. Tell your doctor about any medicines you are taking, including ones you can buy for yourself, complementary therapies, vitamins and herbal drugs.
Your doctor will advise you not to father a child during treatment. This is because the drugs may harm a developing baby. It’s important to use effective contraception during and for a few months after treatment. You can talk to your doctor or nurse about this.
If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are taking abiraterone. Explain you are taking hormonal therapy and that no one should stop or restart without advice from your cancer doctor. Give them contact details for your cancer doctor so they can ask for advice.
The information in this section has been produced in accordance with the following sources and guidelines:
If you’d like further information on the sources we use, please feel free to contact us.
With thanks to Kavita Kantilal, Advanced Pharmacist - Electronic Prescribing , who reviewed this edition.
Thanks to people like you
Thank you to all of the people affected by cancer who reviewed what you're reading and have helped our information to grow.
You could help us too when you join our Cancer Voices Network - find out more.